Vitamin A deficiency increases the risk of gastrointestinal comorbidity and exacerbates core symptoms in children with autism spectrum disorder

Pediatr Res. 2021 Jan;89(1):211-216. doi: 10.1038/s41390-020-0865-y. Epub 2020 Mar 30.

Abstract

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder, and many individuals with ASD have gastrointestinal (GI) comorbidities. Vitamin A (VA) is an essential micronutrient that plays an important role in brain development and GI function.

Methods: A total of 323 children with ASD and 180 control children were enrolled in this study. Symptoms of ASD were assessed with the Child Autism Rating Scale (CARS), the Social Responsiveness Scale (SRS), and the Autism Behavior Checklist (ABC). Caregivers of the children completed questionnaires about GI symptoms. Serum retinol levels were detected with high-performance liquid chromatography (HPLC).

Results: Children with ASD and with GI comorbidity and constipation had considerably lower serum VA levels than autistic children without these symptoms. VA level was associated with CARS, SRS, and ABC scores, whereas GI symptoms were associated some SRS and ABC scores. The interaction of VAD and GI symptoms appeared to aggravate some of the core symptoms of children with ASD.

Conclusions: VAD exacerbates core symptoms in children with ASD, and ASD children with GI comorbidities also have more serious core symptoms than ASD children without GI comorbidities. VAD comorbid with GI symptoms aggravates autistic children's core symptoms.

Impact: VAD exacerbates core symptoms in children with ASD. ASD children with GI comorbidities have more serious core symptoms than ASD children without GI comorbidities. VAD comorbid with GI symptoms aggravates autistic children's core symptoms. We speculate that VAD might be related to a subtype of ASD that involves GI comorbidities. We believe that our findings will be of fundamental importance to the scientific community.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autism Spectrum Disorder / diagnosis
  • Autism Spectrum Disorder / epidemiology*
  • Biomarkers / blood
  • Case-Control Studies
  • Child
  • Child, Preschool
  • China / epidemiology
  • Comorbidity
  • Constipation / epidemiology
  • Constipation / physiopathology
  • Defecation
  • Disease Progression
  • Female
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / epidemiology*
  • Gastrointestinal Diseases / physiopathology
  • Humans
  • Male
  • Risk Assessment
  • Risk Factors
  • Vitamin A / blood
  • Vitamin A Deficiency / blood
  • Vitamin A Deficiency / diagnosis
  • Vitamin A Deficiency / epidemiology*

Substances

  • Biomarkers
  • Vitamin A