维生素D在孤独症谱系障碍中作用机制的研究进展

孤独症谱系障碍(ASD)是一种神经发育障碍性疾病,目前发病机制尚不明确,也没有确切有效的治疗措施。近年来许多研究表明维生素D对脑发育及ASD的发生发展有重要意义,本文将对近年来维生素D在ASD中作用机制的研究进展作一综述。     

维生素D在孤独症谱系障碍中作用的研究进展

孤独症谱系障碍(ASD)是影响儿童健康的严重公共问题之一,以社交沟通障碍、兴趣或活动范围狭窄以及重复刻板行为为特征。近年来越来越多的研究显示,ASD患儿维生素D(VitD)水平明显低于同龄健康儿童,VitD缺乏可能与ASD的发病机制相关。本文就VitD与ASD的相关研究进行综述。     

维生素D在孤独症谱系障碍中作用的研究进展

孤独症谱系障碍(ASD)是影响儿童健康的严重公共问题之一,以社交沟通障碍、兴趣或活动范围狭窄以及重复刻板行为为特征。近年来越来越多的研究显示,ASD患儿维生素D(VitD)水平明显低于同龄健康儿童,VitD缺乏可能与ASD的发病机制相关。本文就VitD与ASD的相关研究进行综述。     

维生素D3类似物治疗白癜风分子生物学机制及临床应用现状

维生素 D3 活性代谢产物 1,25（OH）2D3 及其类似物通过维生素 D 受体 （VDR） 发挥对表皮黑素单位的保护作用.近年来研究表明,维生素 D3 类似物单独或联合应用紫外线或皮质类固醇激素可以提高白癜风皮损的复色.因此,进一步了解维生素 D3 类似物在白癜风复色中的作用机制,研制新的、高效的维生素 D3 类似物,对白癜风的治疗具有重要意义.     

妊娠期母体维生素代谢异常与孤独症谱系障碍的关系

孤独症谱系障碍(autism spectrum disorder,ASD)是一类神经发育障碍,发病率逐渐增高而病因至今未明,可能与遗传和环境因素的相互作用有关。妊娠期母体营养状况是重要的环境因素之一。近年来母体维生素代谢异常与ASD发病之间的关系受到重视。本文将从遗传、蛋白修饰和免疫调节等方面综述母体维生素代谢水平与子代ASD发病之间的关系。     

维生素D与儿童支气管哮喘

越来越多的研究表明维生素D与支气管哮喘发病有关, 机制包括维生素D和遗传、环境危险因素等共同作用导致免疫系统的失衡, 以及维生素D对胚胎肺发育的影响等。如果维生素D参与儿童哮喘发病机制, 将对哮喘治疗产生重大影响。本文对维生素D水平与儿童哮喘的发病与防治关系的相关研究做一综述。     

25-羟维生素D 维生素B_(12)及叶酸对2～6岁孤独症谱系障碍儿童智力及核心症状的影响

目的分析25-羟维生素D[25(OH)D]、维生素B_(12)及叶酸对2～6岁孤独症谱系障碍(ASD)患儿智力及核心症状的影响。方法选取2019年1-12月湖北省妇幼保健院收治的2～6岁ASD患儿116例为观察组,另选取同期体检健康儿童116例为对照组,检测并比较两组儿童血清25(OH)D、维生素B_(12)及叶酸水平。观察组儿童采用中国韦氏幼儿智力量表第四版(WPPSI-Ⅳ)测定智力,采用孤独症评定量表(CARS)和孤独症行为量表(ABC)评估孤独症病情程度和症状;根据CARS评分将观察组分为轻中度组和重度组,比较不同组别儿童血清25(OH)D、维生素B_(12)及叶酸水平的差异;运用Pearson偏相关分析各指标与韦氏总智商和ABC评分的相关性。结果观察组患儿血清25(OH)D、维生素B_(12)及叶酸水平均明显低于对照组,且轻中度组高于重度组,差异均有统计学意义(均P0.01)。患儿血清25(OH)D、维生素B_(12)及叶酸水平与智力水平呈正相关关系(P0.01),与ABC量表评分均呈负相关关系(P0.05)。结论 ASD患儿的血清25(OH)D、维生素B_(12)及叶酸水平均下降,且与患儿的病情严重程度、智力及核心症状相关。     

维生素D与代谢综合征

正代谢综合征(MS)是一种由遗传因素和环境因素共同介导的一组复杂的代谢紊乱,以中心性肥胖、糖代谢异常、高血压及血脂紊乱等多种代谢异常合并出现的一组临床症候群,其机制尚不明确。近年来,研究表明维生素D缺乏与胰岛素抵抗、糖调节异常、高血压、脂代谢异常及肥胖症等心血管疾病危险因素密切相关,低维生素D状态可能是MS的危险因素之一[1]。但目前有关维生素D与MS之间的关系尚存争议,以下就维生素D与MS各组分的临床研究及可能机制作     

维生素D与代谢综合征

<正>代谢综合征(MS)是一种由遗传因素和环境因素共同介导的一组复杂的代谢紊乱,以中心性肥胖、糖代谢异常、高血压及血脂紊乱等多种代谢异常合并出现的一组临床症候群,其机制尚不明确。近年来,研究表明维生素D缺乏与胰岛素抵抗、糖调节异常、高血压、脂代谢异常及肥胖症等心血管疾病危险因素密切相关,低维生素D状态可能是MS的危险因素之一[1]。但目前有关维生素D与MS之间的关系尚存争议,以下就维生素D与MS各组分的临床研究及可能机制作     

环境因素与孤独症谱系障碍关系的研究进展

孤独症谱系障碍(ASD)是一组起病于儿童早期的神经发育障碍性疾病,是遗传学、免疫学、表观遗传学和环境等多因素共同作用的结果。近年来,环境因素成为国内外ASD发病机制研究的热点,故本文对与ASD发病相关的环境因素进行综述。     

The Role of Vitamin D Supplementation in Children with Autism Spectrum Disorder: A Narrative Review

Children with autism spectrum disorder (ASD) present with persistent deficits in both social communication and interactions, along with the presence of restricted and repetitive behaviors, resulting in significant impairment in significant areas of functioning. Children with ASD consistently reported significantly lower vitamin D levels than typically developing children. Moreover, vitamin D deficiency was found to be strongly correlated with ASD severity. Theoretically, vitamin D can affect neurodevelopment in children with ASD through its anti-inflammatory properties, stimulating the production of neurotrophins, decreasing the risk of seizures, and regulating glutathione and serotonin levels. A Title/Abstract specific search for publications on Vitamin D supplementation trials up to June 2021 was performed using two databases: PubMed and Cochrane Library. Twelve experimental studies were included in the synthesis of this review. Children with ASD reported a high prevalence of vitamin D deficiency or insufficiency. In general, it was observed that improved vitamin D status significantly reduced the ASD severity, however, this effect was not consistently different between the treatment and control groups. The variations in vitamin D dose protocols and the presence of concurrent interventions might provide an explanation for the variability of results. The age of the child for introducing vitamin D intervention was identified as a possible factor determining the effectiveness of the treatment. Common limitations included a small number of participants and a short duration of follow-ups in the selected studies. Long-term, well-designed randomized controlled trials are warranted to confirm the effect of vitamin D on severity in children with ASD.     

Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children

Objectives: Autism spectrum disorder (ASD) is a developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and non-verbal communication, and stereotyped patterns of interests and activities. Vitamin-D deficiency was previously reported in autistic children. However, the data on the relationship between vitamin D deficiency and the severity of autism are limited.

Methods: We performed a case–controlled cross-sectional analysis conducted on 122 ASD children, to assess their vitamin D status compared to controls and the relationship between vitamin D deficiency and the severity of autism. We also conducted an open trial of vitamin D supplementation in ASD children.

Results: Fifty-seven percent of the patients in the present study had vitamin D deficiency, and 30% had vitamin D insufficiency. The mean 25-OHD levels in patients with severe autism were significantly lower than those in patients with mild/moderate autism. Serum 25-OHD levels had significant negative correlations with Childhood Autism Rating Scale (CARS) scores. Of the ASD group, 106 patients with low-serum 25-OHD levels (<30?ng/ml) participated in the open label trial. They received vitamin D3 (300?IU/kg/day not to exceed 5000 IU/day) for 3 months. Eighty-three subjects completed 3 months of daily vitamin D treatment. Collectively, 80.72% (67/83) of subjects who received vitamin D3 treatment had significantly improved outcome, which was mainly in the sections of the CARS and aberrant behavior checklist subscales that measure behavior, stereotypy, eye contact, and attention span.

Conclusion: Vitamin D is inexpensive, readily available and safe. It may have beneficial effects in ASD subjects, especially when the final serum level is more than 40?ng/ml.

Trial registration number: UMIN-CTR Study Design: trial Number: R000016846.     

营养素信号通路作为孤独症谱系障碍生物标志的进展和思考

孤独症谱系障碍(ASD)是常见的复杂神经发育障碍,营养是儿童生长发育的重要因素,其与ASD亚型的发生、发展及预后存在一定关联,随着研究的深入,发现单用血清营养素水平关联ASD的症状受到极大挑战.本文以叶酸、维生素A(VA)为例综述了将营养素信号通路作为ASD潜在生物标志物的新思路,望对进一步探寻ASD的发生、诊治起到抛...     

The Association between Vitamin D Status and Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis

The association between vitamin D status and autism spectrum disorder (ASD) is well-investigated but remains to be elucidated. We quantitatively combined relevant studies to estimate whether vitamin D status was related to ASD in this work. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to include eligible studies. A random-effects model was applied to pool overall estimates of vitamin D concentration or odds ratio (OR) for ASD. In total, 34 publications involving 20,580 participants were identified in this present study. Meta-analysis of 24 case–control studies demonstrated that children and adolescents with ASD had significantly lower vitamin D concentration than that of the control group (mean difference (MD): −7.46 ng/mL, 95% confidence interval (CI): −10.26; −4.66 ng/mL, p < 0.0001, I² = 98%). Quantitative integration of 10 case–control studies reporting OR revealed that lower vitamin D was associated with higher risk of ASD (OR: 5.23, 95% CI: 3.13; 8.73, p < 0.0001, I² = 78.2%). Analysis of 15 case–control studies barring data from previous meta-analysis reached a similar result with that of the meta-analysis of 24 case–control studies (MD: −6.2, 95% CI: −9.62; −2.78, p = 0.0004, I² = 96.8%), which confirmed the association. Furthermore, meta-analysis of maternal and neonatal vitamin D showed a trend of decreased early-life vitamin D concentration in the ASD group (MD: −3.15, 95% CI: −6.57; 0.26, p = 0.07, I² = 99%). Meta-analysis of prospective studies suggested that children with reduced maternal or neonatal vitamin D had 54% higher likelihood of developing ASD (OR: 1.54, 95% CI: 1.12; 2.10, p = 0.0071, I² = 81.2%). These analyses indicated that vitamin D status was related to the risk of ASD. The detection and appropriate intervention of vitamin D deficiency in ASD patients and pregnant and lactating women have clinical and public significance.     

天津市孤独症谱系障碍儿童膳食营养状况

  目的  调查分析天津市孤独症谱系障碍(ASD)儿童的膳食营养素摄入量和营养状况,为ASD儿童制定科学有效的营养干预措施提供依据。  方法  采用3 d 24h膳食回顾法调查天津市某特殊教育学校90名3~9岁ASD儿童24种膳食营养素的摄入情况,并对儿童进行体格测量。  结果  ASD儿童中超重肥胖儿童共31名,占34.4%;3名消瘦者占3.3%;1名生长迟缓者占1.1%。各年龄组ASD儿童维生素A、维生素B₁、维生素D、维生素B₆、叶酸、钙和碘的平均摄入量均低于推荐摄入量标准,铜、磷和锌的摄入量均高于推荐摄入量标准,其中有超过10%的ASD儿童铜和镁的摄入量超过可耐受最高摄入量。能量、脂肪、维生素A摄入情况构成在正常、超重、肥胖组差异有统计学意义(χ2值分别为9.24,10.03,P值均 <0.05)。  结论  孤独症谱系障碍儿童超重、肥胖率较高,营养素缺乏与过量的现象同时存在,建议采取个性化的饮食营养干预方案。     

Amino Acids,B Vitamins,and Choline May Independently and Collaboratively Influence the Incidence and Core Symptoms of Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a developmental disorder of variable severity, characterized by difficulties in social interaction, communication, and restricted or repetitive patterns of thought and behavior. In 2018, the incidence of ASD was 2.4 times higher than estimated in 2000. Behavior and brain development abnormalities are present in the complex disorder of ASD. Nutritional status plays a key role in the incidence and severity of the core symptoms of ASD. The aim of this study was to review the available peer-reviewed studies that evaluated the relationship between amino acids, choline, B vitamins, and ASD incidence and/or severity of symptoms. Through examining plasma profiles, urine samples, and dietary intake, researchers found that low choline, abnormal amino acid, and low B vitamin levels were present in children with ASD compared to those without ASD. The evidence supports the need for future research that implements simultaneous supplementation of all essential nutrients in individuals with ASD and among prenatal mothers. Future evidence could lead to scientific breakthroughs, ultimately reducing the rates of ASD incidence and severity of symptoms by applying nutritional interventions in at-risk populations.     

Clinical improvement following vitamin D3 supplementation in Autism Spectrum Disorder

Objective: High prevalence of vitamin D deficiency was previously reported in children with Autism Spectrum Disorder (ASD), but little is known about the efficacy of vitamin D3 treatment in ASD, although data from pilot studies seem promising. We hypothesized that serum vitamin D levels are reduced in ASD and correlate with the severity of disease. Also, we hypothesized that vitamin D3 treatment may be beneficial for a considerable portion of children with ASD.

Methods: In total, 215 children with ASD and 285 healthy control children were recruited in our study. Thirty seven of 215 ASD children received vitamin D3 treatment. The Autism Behaviour Checklist (ABC) and the Childhood Autism Rating Scale (CARS) were used to assess autism symptoms. High-performance liquid chromatography was used to assess the serum 25-hydroxyvitamin D [25(OH) D] level. Evaluations of ABC, CARS, and serum 25(OH) D levels were performed before and after 3 months of treatment.

Results: Serum levels of 25(OH) D were significantly lower in ASD children than typically developing children. Levels of serum 25(OH) D were negatively correlated with ABC total scores and language subscale scores. After vitamin D3 supplementation, symptom scores were significantly reduced on the CARS and ABC. In addition, the data also suggest that treatment effects were more pronounced in younger children with ASD.

Conclusion: Vitamin D deficiency might contribute to the aetiology of ASD. Supplementation of vitamin D3, which is a safe and cost-effective form of treatment, may significantly improve the outcome of some children with ASD, especially younger children (identifier ChiCTR-CCC-13004498).

Clinical Trial Registration: The trial ‘Association of Polymorphisms of Vitamin D Metabolism-Related Genes With Autism and the Treatment of Autism with Vitamin D’ has been registered at www.chictr.org/cn/proj/show.aspx? proj=6135 (identifier ChiCTR-CCC-13004498).