孤独症谱系障碍儿童血清25-羟维生素D水平与情绪社会功能的关系

许占斌; 王飞英; 秦宏超; 陶小冬; 瞿秋婵; 倪勇

doi:10.16835/j.cnki.1000-9817.2024284

孤独症谱系障碍儿童血清25-羟维生素D水平与情绪社会功能的关系

doi: 10.16835/j.cnki.1000-9817.2024284

1.
南通大学附属妇幼保健院儿童保健科, 江苏 226018
2.
如东县妇幼保健计划生育服务中心儿童保健科

基金项目:

南通市卫生健康委面上项目 MS2022075

南通市卫生健康委面上项目 MSZ2023058

南通市科技局社会民生科技计划项目 MSZ2023011

详细信息

作者简介:
许占斌(1990-)，男，黑龙江省人，硕士，主治医师，主要从事儿童发育行为相关研究

通讯作者:
倪勇, E-mail: 2440198476@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R748 B844.1 Q565
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出版历程
- 收稿日期: 2024-07-12
- 修回日期: 2024-08-27
- 网络出版日期: 2024-10-08
- 刊出日期: 2024-09-25

Relationship of serum 25(OH)D levels and social-emotional functioning in children with autism spectrum disorder

1.
Child Health Section, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong (226018), Jiangsu Province, China

摘要

摘要: 目的了解孤独症谱系障碍(ASD)儿童血清25-羟维生素D[25(OH)D]水平和情绪社会功能的关系，为ASD儿童综合干预提供参考依据。方法 2024年1—6月，选取南通市定点康复机构康复训练的124名1~3岁ASD儿童纳入病例组，同时选取同期健康体检的124名性别、年龄相匹配的健康儿童纳入对照组。采用液质联用法测定两组儿童血清25(OH)D水平，采用中国幼儿情绪及社会性发展量表(CITSEA)评估ASD儿童情绪社会化功能，并探讨血清25(OH)D水平与情绪社会功能的关系。结果病例组儿童的血清25(OH)D水平[(59.22±19.96)nmol/L]低于对照组[(85.50±21.59)nmol/L]，25(OH)D不足或缺乏率(21.77%)高于对照组(7.26%)，差异均有统计学意义(t/χ²值分别为-7.75，8.91，P值均 < 0.01)。CITSEA评估结果显示，ASD儿童外显行为域、内隐行为域、失调域和能力域得分分别为(63.37±10.44，56.29±9.36，57.04±10.65，38.92±17.91)分，各维度异常检出率分别为50.81%，35.48%，41.13%，45.16%。其中男童外显行为域、能力域异常检出率(57.14%，51.02%)均高于女童(34.62%，23.08%)，差异均有统计学意义(χ²值分别为4.18，6.48，P值均 < 0.05)。血清25(OH)D不足或缺乏组ASD儿童外显行为域、失调域异常检出率(77.78%，59.26%)均高于血清25(OH)D正常组(37.11%，18.56%)，差异均有统计学意义(χ²值分别为14.06，17.58，P值均 < 0.01)。结论 ASD儿童血清25(OH)D水平明显低于健康儿童，且普遍存在情绪社会功能发育异常。
- 孤独性障碍 /
- 维生素D /
- 情绪 /
- 精神卫生 /
- 儿童
Abstract: Objective To understand the relationship between serum 25 hydroxyvitamin D [25(OH)D] levels and social-emotional functions in children with autism spectrum disorder (ASD), in order to provide the reference for comprehensive interventions in ASD children. Methods From January to June 2024, 124 ASD children aged 1-3 who received rehabilitation training at designated rehabilitation institutions in Nantong City, China were selected as the case group, while 124 healthy gender- and age-matched children who underwent health examinations at the same time were selected as the control group. The study used liquid chromatography-mass spectrometry to measure serum 25(OH)D levels in both groups of children. The Chinese Infant-Toddler Social and Emotional Assessment (CITSEA) was used to evaluate the emotional and socialization functioning of children with ASD, and to explore the relationship between serum 25(OH)D levels and their emotional and social functioning. Results The serum 25(OH)D levels were lower in the case group [(59.22±19.96)nmol/L] compared to the control group [(85.50±21.59)nmol/L], and the rate of 25(OH)D deficiency or insufficiency (21.77%) was higher than that of the control group (7.26%), with statistically significant differences (t/χ²=-7.75, 8.91, P < 0.01). The CITSEA evaluation results showed that the scores of the explicit behavior domain, implicit behavior domain, dysregulation domain, and ability domain in children with ASD were (63.37±10.44, 56.29±9.36, 57.04±10.65, 38.92±17.91) points, and the abnormal detection rates were 50.81%, 35.48%, 41.13%, and 45.16%, respectively. Among them, the abnormal detection rates of the explicit behavior domain and ability domain were higher in boys (57.14%, 51.02%) compared to girls (34.62%, 23.08%), and the differences were statistically significant (χ²=4.18, 6.48, P < 0.05). The abnormal detection rates of explicit behavioral domains and dysregulated domains in ASD children with insufficient or deficient serum 25(OH)D (77.78%, 59.26%) were higher than those in the normal serum 25(OH)D group (37.11%, 18.56%), and the differences were statistically significant (χ²=14.06, 17.58, P < 0.01). Conclusion The serum 25(OH)D levels in children with ASD are significantly lower compared to levels in healthy children, and developmental abnormalities in social-emotional functioning are common concurrent problems.
- Autistic disorder /
- Vitamin D /
- Emotions /
- Mental health /
- Child
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表 1 不同组别ASD儿童情绪社会功能各维度异常检出率比较

Table 1. Comparison of abnormal detection rates of emotional social function for each dimension among children with ASD in different groups

组别	选项	人数	统计值	外显行为域	内隐行为域	失调域	能力域
性别	男	98		56(57.14)	34(34.69)	40(40.82)	50(51.02)
	女	26		9(34.62)	10(38.46)	11(42.31)	6(23.08)
			χ²值	4.18	0.13	0.02	6.48
			P值	0.04	0.72	0.89	0.01
25(OH)D	正常	97		36(37.11)	4(4.12)	18(18.56)	44(45.36)
水平	不足或缺乏	27		21(77.78)	3(11.11)	16(59.26)	15(55.56)
			χ²值	14.06	1.94	17.58	0.88
			P值	＜0.01	0.16	＜0.01	0.35
注：()内数字为检出率/%。

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参考文献(28)

[1]	GENOVESE A, BUTLER M G. The autism spectrum: behavioral, psy-chiatric and genetic associations[J]. Genes, 2023, 14(3): 677-670. doi: 10.3390/genes14030677
[2]	SALARI N, RASOULPOOR S, RASOULPOOR S, et al. The global prevalence of autism spectrum disorder: a comprehensive systematic review and Meta-analysis[J]. Ital J Pediatr, 2022, 48(1): 112. doi: 10.1186/s13052-022-01310-w
[3]	MUSKENS J, KLIP H, ZINKSTOK J R, et al. Vitamin D status in children with a psychiatric diagnosis, autism spectrum disorders, or internalizing disorders[J]. Front Psychiatry, 2022, 13(8): 556-560.
[4]	KADHIM R A, BABAN R S, AL-OMRANI A, et al. Serum levels of 25-OH vitamin D₃ and vitamin D receptor among Iraqi children with autism spectrum disorder[J]. Adv Life Sci, 2024, 11(1): 233-236.
[5]	GALLARDO-CARRASCO M C, JIMÉNEZ-BARBERO J A, BRAVO-PASTOR M M, et al. Serum vitamin D, folate and fatty acid levels in children with autism spectrum disorders: a systematic review and Meta-analysis[J]. J Autism Dev Disord, 2022, 12(5): 1-14.
[6]	JIANG Y, DANG W, NIE H, et al. Omega-3 polyunsaturated fatty acids and/or vitamin D in autism spectrum disorders: a systematic review[J]. Front Psychiatry, 2023, 14(12): 973-980.
[7]	韩晨思宇. 3~6岁幼儿网络媒介使用与情绪社会化的关系研究[D]. 福州: 福建师范大学, 2021. HAN C S Y. A study on the relationship between Internet media use and emotional socialization in 3-6-year-old children[D]. Fuzhou: Fujian Normal University, 2021. (in Chinese)
[8]	HASTINGS S E, HASTINGS R P, SWALES M A, et al. Emotional and behavioural problems of children with autism spectrum disorder attending mainstream schools[J]. Int J Dev Disabil, 2022, 68(5): 633-640. doi: 10.1080/20473869.2020.1869414
[9]	American Psychiatric Association, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5[M]. Washington DC: American Psychiatric Association, 2013.
[10]	中华预防医学会儿童保健分会. 中国儿童维生素A、维生素D临床应用专家共识(2024)[J]. 中国儿童保健杂志, 2024, 32(4): 349-358, 361. Child Health Branch, Chinese Preventive Medicine Association. Expert consensus on clinical application of vitamin A and vitamin D in Chinese children (2024)[J]. Chin J Child Health Care, 2024, 32(4): 349-358, 361. (in Chinese)
[11]	王惠珊, 张建端, 黄小娜, 等. 中国城市幼儿情绪及社会性发展量表标准化的信度和效度分析[J]. 中国儿童保健杂志, 2009, 17(3): 271-274. WANG H S, ZHANG J D, HUANG X N, et al. Reliability and validity of standardized Chinese Urban in Infant-toddler Social and Emotional Assessment[J]. Chin J Child Health Care, 2009, 17(3): 271-274. (in Chinese)
[12]	张强, 钟晓珂, 黄辰, 等. 身体活动改善孤独症谱系障碍儿童神经认知功能的系统评价[J]. 中国学校卫生, 2024, 45(7): 983-987. doi: 10.16835/j.cnki.1000-9817.2024218 ZHANG Q, ZHONG X K, HUANG C, et al. A systematic review on the improvement of neurocognitive function in children with autism spectrum disorder through physical activity[J]. Chin J Sch Health, 2024, 45(7): 983-987. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024218
[13]	QIN Y, DU Y, CHEN L, et al. A recurrent SHANK1 mutation implicated in autism spectrum disorder causes autistic-like core behaviors in mice via downregulation of mGluR1-IP3R1-calcium signaling[J]. Mol Psychiatry, 2022, 27(7): 2985-2998. doi: 10.1038/s41380-022-01539-1
[14]	WANG J, HUANG H, LIU C, et al. Research progress on the role of vitamin D in autism spectrum disorder[J]. Front Behav Neurosci, 2022, 16(8): 859-862.
[15]	GUIDUCCI L, VASSALLE C, PROSPERI M, et al. Vitamin D status in children with autism spectrum disorders: determinants and effects of the response to probiotic supplementation[J]. Metabolites, 2022, 12(7): 611-614.
[16]	GANTA A, PILLAI S S, FREDETTE M E, et al. Severe vitamin D deficiency in youth with autism spectrum disorder during the COVID-19 pandemic[J]. J Dev Behav Pediatr, 2022, 43(8): 461-464.
[17]	MANSOUR A, AMER A, SOBH A, et al. Vitamin D profile in autism spectrum disorder children and its relation to the disease severity[J]. Egypt J Otolaryngol, 2024, 40(1): 1173-1178.
[18]	QI X, YANG T, CHEN J, et al. Vitamin D status is primarily associated with core symptoms in children with autism spectrum disorder: a multicenter study in China[J]. Psychiatry Res, 2022, 317(12): 1148-1153.
[19]	BOLOGNESI E, GUERINI F R, SOTGIU S, et al. GC1f vitamin D binding protein isoform as a marker of severity in autism spectrum disorders[J]. Nutrients, 2022, 14(23): 5153-5159.
[20]	ZHANG Z, LIU J, JIANG G, et al. Vitamin D receptor gene variants and serum vitamin D in childhood autism spectrum disorder[J]. Mol Biol Rep, 2022, 49(10): 9481-9488.
[21]	ZHANG M, WU Y R, LU Z X, et al. Effects of vitamin D supplementation on children with autism spectrum disorder: a systematic review and Meta-analysis[J]. Clin Psychopharmacol Neurosci, 2023, 21(2): 240-245.
[22]	LI B, XU Y, ZHANG X, et al. The effect of vitamin D supplementation in treatment of children with autism spectrum disorder: a systematic review and Meta-analysis of randomized controlled trials[J]. Nutr Neurosci, 2022, 25(4): 835-845.
[23]	许占斌, 倪钰飞, 徐小晶, 等. 母亲孕期焦虑状态对幼儿情绪社会化发展的影响[J]. 中国学校卫生, 2023, 44(9): 1370-1372. doi: 10.16835/j.cnki.1000-9817.2023.09.020 XU Z B, NI Y F, XU X J, et al. The impact of maternal anxiety during pregnancy on the social-emotional development among toddlers[J]. Chin J Sch Health, 2023, 44(9): 1370-1372. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.09.020
[24]	REAUME C, SEDDON J A, COLWELL S, et al. Racial-ethnic diff-erences in positive emotion socialization: links to child emotional lability[J]. J Appl Dev Psychol, 2022, 81(11): 459-461.
[25]	BOYD N K, NGUYEN J, KHOSHNOOD M M, et al. Hypovitaminosis D in persons with Down syndrome and autism spectrum disorder[J]. J Neurodev Disord, 2023, 15(1): 35-38.
[26]	ESNAFOGLU E, SUBAŞ B. Association of low 25-OH-vitamin D levels and peripheral inflammatory markers in patients with autism spectrum disorder: vitamin D and inflammation in autism[J]. Psychia-try Res, 2022, 31(6): 1147-1150.
[27]	WANG B, DONG H Y, LI H H, et al. A probable way vitamin D affects autism spectrum disorder: the nitric oxide signaling pathway[J]. Front Psychiatry, 2022, 13(10): 908-911.
[28]	GUSSO D, PRAUCHNER G R K, RIEDER A S, et al. Biological pathways associated with vitamins in autism spectrum disorder[J]. Neurotox Res, 2023, 41(6): 730-740.