学龄前孤独症谱系障碍儿童血清叶酸、维生素B12水平及其与神经发育特征的关联

Serum folate and vitamin B12 levels and their association with neurodevelopmental features in preschool children with autism spectrum disorder

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B₁₂（vitamin B₁₂, VB₁₂）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VB₁₂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VB₁₂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VB₁₂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VB₁₂水平与语言发育商呈正相关（P<0.05）；ASD男童血清VB₁₂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VB₁₂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VB₁₂水平可能有益于ASD儿童，特别是<4岁ASD儿童的神经发育。

Abstract:

Objective To investigate the levels of serum folate and vitamin B₁₂ (VB₁₂) 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 VB₁₂ 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 VB₁₂ 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 VB₁₂ 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 VB₁₂ levels were positively correlated with language developmental quotient (P<0.05). In male ASD children, serum VB₁₂ levels were positively correlated with language and personal-social developmental quotients (P<0.05).Conclusions Serum folate and VB₁₂ 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 VB₁₂ levels may be beneficial for the neurodevelopment of ASD children, especially in ASD children under 4 years of age.