تقييم بعض المؤشرات الكيموحيوية لدى اطفال اضطراب طيف التوحد

Evaluation of Some Biochemical Markers in Child Autistic Spectrum Disorder

abstract

Autism is a complex condition defined by many causes one of them being excessive concentrations of necessary and harmful chemicals in children. Thus, this study examined some potential biochemical markers in serum specimens from children with autism spectrum disorder (ASD), such as sphingomyelin, plasminogen, docosahexaenoic acid, homocysteine, folate, vitamin B12, and trace elements specifically zinc (Zn), aluminum (Al), and selenium (Se). The study also looked for the links between biochemical markers levels and autistic severity. This study included 100 participants, 10 of them were excluded and the number became 42 kids with autism spectrum disorder (Gilliam’s Scale was used for severity) and 48 healthy kids with age and gender-matched with those of autistic children. According to the severity of autism, children were classified into two sub-groups, medium and under medium case. Graphite furnace atomic absorption spectrophotometry was used for serum trace element analysis while the enzyme-linked immunosorbent assay (ELISA) technique was used for other biomarkers. The results of the study found significant increase in levels of sphingomyelin (OR:4.691, CI:1.289~17.068, p=0.014), plasminogen (OR:7.5, CI:1.844~30.509, p=0.001), and docosahexaenoic acid (OR:5.156, CI:1.412~18.831, p=0.001) when compared medium cases for severity ASD with a control group. In contrast, under medium cases for severity, ASD showed a significant decrease in levels of sphingomyelin (OR:10.33, CI: 2.59-41.256, p=0.001), plasminogen (OR: 0.5, CI: 0.169~0.560, p=0.05), and docosahexaenoic acid(OR: 4.55, CI: 1.30-15.96, p=0.003). The results also revealed notable elevations in homocysteine levels (OR: 2.00, CI: 0.792-5.05, p=0.02) and significant reductions in folate and vitamin B12 concentrations [(OR:4.66, CI: 2.615~8.327, p<0.001), (OR: 9.25, CI: 3.66-23.339, p <0.001)] respectively when comparing children with ASD with control subjects, for trace elements found decreases in selenium and zinc concentration (OR: 5.25, CI: 1.96~14.08, p<0.001), (OR: 5.25, CI: 1.96~14.08, p<0.001), (OR: 3.75, CI: 1.44~9.76, p =0.02) and increases in aluminum level (OR: 7.68, CI: 2.64~ 22.34, p <0.001) in children with ASD compared to the control group. The area under the curve (AUC) values for most parameters are considered excellent, AUC for sphingomyelin, plasminogen, and docosahexaenoic acid is more than 0.7 in medium and under medium severity ASD cases, while AUC for folate, vitamin B12, Se, and Al ranged from 0.85 to 0.95. These values correspond to high levels of sensitivity and specificity for these parameters. Results indicate a strong positive correlation between ASD and their levels of homocysteine, selenium (Se), and zinc (Zn) (β: 0.43 CI: 0.004~0.083 p=0.03), (β: 0.48 CI: 0.280~0.679, p <0.001) and (β: 0.31 CI: 0.10~0.52, p =0.005) respectively. Besides, the results they were revealed that there is a negative relation between ASD and levels of vitamin B12, folate, and Aluminum (Al) (β: -0.993 CI: -1.418~ -0.568 p<0.001), (β: -0.903 CI: -1.335~ -0.471 p<0.001), and (β: 0.83 CI: 0.71~0.95 p <0.001) when comparing children with autism spectrum disorder (ASD) to a control group. The biochemical markers in this study considered risk factors in autistic children and also suggest using them to diagnose autism spectrum disorder in children specifically markers that have a high sensitivity degree after further study.