学龄前孤独症谱系障碍儿童血清叶酸、维生素B_(12)水平及其与神经发育特征的关联  

Serum folate and vitamin B_(12)levels and their association with neurodevelopmental features in preschool children with autism spectrum disorder

作　　者：吴媛 杨亭[1] 陈红羽 龙丹 向雪利 冯钰茹 韦秋宏 陈洁[1] 李廷玉[1] WU Yuan;YANG Ting;CHEN Hong-Yu;LONG Dan;XIANG Xue-Li;FENG Yu-Ru;WEI Qiu-Hong;CHEN Jie;LI Ting-Yu(Children's Nutrition Research Center,Children's Hospital of Chongqing Medical University/Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院儿童营养研究中心/儿童神经发育与认知障碍重庆市重点实验室/儿童发育疾病研究教育部重点实验室/国家儿童健康与疾病临床医学研究中心,重庆400014

出　　处：《中国当代儿科杂志》2024年第4期371-377,共7页Chinese Journal of Contemporary Pediatrics

基　　金：国家自然科学基金面上项目(81771223)。

摘　　要：目的调查学龄前孤独症谱系障碍(autism spectrum disorder,ASD)儿童血清叶酸和维生素B_(12)(vitamin B_(12),VB_(12))水平及其与神经发育水平的关联。方法招募324例2~6岁ASD儿童和318例2~6岁健康儿童,采用化学发光免疫分析法测定血清叶酸和VB_(12)水平,采用社交反应量表和儿童孤独症评定量表评估ASD儿童的核心症状,采用格塞尔发育量表评估神经发育水平。结果ASD儿童的血清叶酸及VB_(12)水平均显著低于健康儿童(P<0.05)。ASD儿童血清叶酸水平与大运动和精细运动发育商呈正相关(P<0.05),血清VB_(12)水平与适应性行为、精细运动、语言发育商呈正相关(P<0.05)。2~<4岁ASD儿童血清叶酸水平与各能区发育商均呈正相关(P<0.05),血清VB_(12)水平与语言发育商呈正相关(P<0.05);ASD男童血清VB_(12)水平与语言、个人-社会发育商呈正相关(P<0.05)。结论学龄前ASD儿童血清叶酸和VB_(12)水平较健康儿童低,且与神经发育水平相关,尤其<4岁ASD儿童。因此,保持正常的血清叶酸和VB_(12)水平可能有益于ASD儿童,特别是<4岁ASD儿童的神经发育。Objective To investigate the levels of serum folate and vitamin B_(12)(VB_(12))and their association with the level of neurodevelopment in preschool children with autism spectrum disorder(ASD).Methods A total of 324 ASD children aged 2-6 years and 318 healthy children aged 2-6 years were recruited.Serum levels of folate and VB_(12)were measured using chemiluminescent immunoassay.The Social Responsiveness Scale and the Childhood Autism Rating Scale were used to assess the core symptoms of ASD children,and the Gesell Developmental Schedule was employed to evaluate the level of neurodevelopment.Results The levels of serum folate and VB_(12)in ASD children were significantly lower than those in healthy children(P<0.05).Serum folate levels in ASD children were positively correlated with gross and fine motor developmental quotients(P<0.05),and serum VB_(12)levels were positively correlated with adaptive behavior,fine motor,and language developmental quotients(P<0.05).In ASD children aged 2 to<4 years,serum folate levels were positively correlated with developmental quotients in all domains(P<0.05),and serum VB_(12)levels were positively correlated with language developmental quotient(P<0.05).In male ASD children,serum VB_(12)levels were positively correlated with language and personal-social developmental quotients(P<0.05).Conclusions Serum folate and VB_(12)levels in preschool ASD children are lower than those in healthy children and are associated with neurodevelopmental levels,especially in ASD children under 4 years of age.Therefore,maintaining normal serum folate and VB_(12)levels may be beneficial for the neurodevelopment of ASD children,especially in ASD children under 4 years of age.

关 键 词：孤独症谱系障碍 神经发育水平 叶酸 维生素B_(12) 儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学]