Analysis of Whole Blood and Urine Trace Elements in Children with Autism Spectrum Disorders and Autistic Behaviors

Biol Trace Elem Res. 2023 Feb;201(2):627-635. doi: 10.1007/s12011-022-03197-4. Epub 2022 Mar 19.


The relationship between trace elements and neurological development is an emerging research focus. We performed a case-control study to explore (1) the differences of 13 trace elements chromium (Cr), manganese (Mn), cobalt (Co), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), stannum (Sn), stibium (Sb), mercury (Hg), titanium (TI), and plumbum (Pb) concentration in whole blood and urine between autism spectrum disorder (ASD) children and their typical development peers, and (2) the association between the 13 trace elements and core behaviors of ASD. Thirty ASD subjects (cases) and 30 age-sex-matched healthy subjects from Baise City, Guangxi Zhuang Autonomous Region, China, were recruited. Element analysis was carried out by inductively coupled plasma-optical emission spectrometry. Autistic behaviors were assessed using Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Children Neuropsychological and Behavior Scale (CNBS). The whole blood concentrations of Mo (p = 0.004), Cd (0.007), Sn (p = 0.003), and Pb (p = 0.037) were significantly higher in the ASD cases than in the controls. Moreover, Se (0.393), Hg (0.408), and Mn (- 0.373) concentrations were significantly correlated between whole blood and urine levels in ASD case subjects. There were significant correlations between whole blood Sb (0.406), Tl (0.365), Mo (- 0.4237), Mn (- 0.389), Zn (0.476), and Se (0.375) levels and core behaviors of ASD. Although the mechanism of trace element imbalance in ASD is unclear, these data demonstrate that core behaviors of ASD may be affected by certain trace elements. Further studies are recommended for exploring the mechanism of element imbalance and providing corresponding clinical treatment measures.

Keywords: Autism spectrum disorders; Metals; Trace element; Urine analysis; Whole blood.

MeSH terms

  • Autism Spectrum Disorder*
  • Autistic Disorder*
  • Cadmium / analysis
  • Case-Control Studies
  • Child
  • China
  • Humans
  • Lead / analysis
  • Manganese / analysis
  • Mercury* / analysis
  • Molybdenum / analysis
  • Selenium* / analysis
  • Tin / analysis
  • Trace Elements* / analysis


  • Trace Elements
  • Cadmium
  • Lead
  • Selenium
  • Manganese
  • Molybdenum
  • Tin
  • Mercury