Research On Relationship And Mechanism Of Vitamin A And Symptoms In Preschool Children With Autism Spectrum Disorders(ASD)

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MICRONUTRIENT INVESTIGATION IN PRESCHOOL CHILDREN WITH AUTISM SPECTRUM DISORDERS(ASD)Objective: This research was designed to compare micronutrient levels of children with Autism Spectrum Disorders(ASD)and typically developing(TD)children,and to investigate micronutrients condition of children with autism.Methods: This study include 332 ASD children(2-7 years old)and 197 age-and gender-matched TD children.Serum vitamin A(VA)was detect with high-performance liquid chromatography(HPLC);serum levels of vitamin D(VD),vitamin B12(VB12),folate,and ferritin were measured with immunoassay method in two groups.Results: The ZHA,ZWA,and ZBMIA of the children with ASD were significantly lower than those of the control children,and the stunting/short stature rate of ASD group was higher than that of control group(7.53% vs.2.54%).Furthermore,higher proportions of children with picky eating,resistance to new foods,and eating problems were observed in the ASD group compared with the control group(73% vs.58%,72% vs.53%,71% vs.34%).Serum VA,VD,VB12 and folate levels in ASD children were significantly lower than those in the control children,and no difference was found regarding serum ferritin.The rates of vitamin A normal(VAN)and vitamin D normal(VDN)in autistic children were significantly lower than that in control group(12% vs.30%,40% vs.67%),and the rates of vitamin A deficiency(VAD)in ASD group were significantly higher than that in control group(35% vs.24%),and the rates of vitamin D inadequate(VDI)and vitamin D deficiency(VDD)in ASD group were also significantly higher than that in control group(53% vs.33%,7% vs.0%).The deficiency rates of VB12,folate,and ferritin have no significant difference in two groups(0% vs.0%,0.6% vs.0%,16% vs.19%).And patients with severe ASD had lower serum VA,VD,VB12,folate and ferrtin levels than those with mild-moderate ASD.Conclusion: We found that children with autism had more nutrients insufficiency than TD children,and VA and VD existed the highest deficiency rate.Therefore,it is essential to formulate a detailed nutritional evaluation for ASD so that timely and intensive interventions can be provided.PART ? VITAMIN A AND VITAMIN D DEFICIENCIES EXACERBATE SYMPTOMS IN CHILDREN WITH AUTISM SPECTRUM DISORDER(ASD)Objective: This study was designed to investigate the vitamin A(VA)and vitamin D(VD)levels in children with autism spectrum disorder(ASD)and to determine whether co-deficiency of VA and VD exacerbates clinical symptoms in autistic children.Methods: The Autism Behavior Checklist(ABC),Childhood Autism Rating Scales(CARS)and Social Responsiveness Scale(SRS)were used to assess the symptoms of 332 children diagnosed as ASD.And the Gesell Developmental Scale(GDS)was used to evaluate neurodevelopment of children as ASD.Questionnaire results were compared for all ASD children and 197 age-and gender-matched control children.Serum VA was detected with high-performance liquid chromatography(HPLC),and serum levels of VD were measured with an immunoassay method in the two groups.Results: Serum VA and VD levels in ASD children were significantly lower than those in the control children.Both serum VA and VD levels were lower in children with picky eating habits and resistance to new foods when compared with those with non-picky eating habits and non-resistance to new foods.Patients with severe ASD had lower serum VA and VD levels than those with mild-moderate ASD,and VD levels in female ASD children were lower than those in male ASD children.Two-way ANOVA revealed a significant interaction between VA level and VD level in the CARS score,ABC score and scores of ABC subscales,including sensory,social withdrawal,and stereotypic behavior scores.VA level has an effect on total ABC score,sensation,social withdrawal and laggard daily living ability scores.VD level has an effect on stereotypic behavior.Additionally,children with autism in the VAD+VDD group had higher SRS and ABC scale scores than VAN+VDN group,which suggests that VA and VD co-deficiency has a impact on symptoms in autistic children.There was no significant interaction between the effects of VA and VD levels on GDS score.VA level was the main factor associated with adaptive behavior and language scores,VD level was the main factor associated with gross motor function,fine motor function and personal-social behavior scores.In addition,scores of adaptive behavior,gross motor function,fine motor function,language,and personal-social behavior were significantly lower in the VAD+VDD group compared with the VAN+VDN group,suggesting that VA and VD co-deficiency impairs the cognition and behavioral development of autistic children.Conclusion: We found that children with autism had more VA and VD deficiency than control children,and VA and VD co-deficiency may exacerbate ASD symptoms and impair neurodevelopment.PART ? VITAMIN A IMPROVES THE SYMPTOMS OF AUTISM SPECTRUM DISORDERS BY DOWNREGULATING 5-HYDROXYTRYPTAMINE(5-HT) LEVELSObjective: In the present study,we sought to test whether vitamin A(VA)supplementation could improve symptoms of autistic children by decrease serum 5-Hydroxytryptamine(5-HT)levels.Methods: The DSM-V criteria and Childhood Autism Rating Scale(CARS)were used for symptom description and symptom assessment of the patients,respectively,before and after vitamin A supplementation(VAS).Serum VA and 5-HT levels were detected using HPLC,and m RNA expression levels of retinoic acid receptor(RAR)?,?,? and tryptophan hydroxylase 1(Tp H1)were detected with real-time PCR in autistic children before and after VAS and in normal children.Results: Serum VA levels in children with ASD were significantly lower than in control children.Serum 5-HT levels in children with ASD were higher than in control children,which was correlated with symptom severity of children with autism.After VA supplementation,the children with ASD exhibited significant improvements in autism symptoms.Serum VA concentrations of children with ASD were significantly increased,and serum 5-HT levels were decreased.Moreover,statistically significant change were observed in m RNA expression levels of RAR ?,RAR ?,and Tp H1 after VAS compared to baseline.Conclusion: This study suggested that VA supplementation may improve symptoms and reduce 5-HT levels in children with ASD,indicating that VA supplementation is a reasonable therapy at least for a subset of children with autism.