Abstract:

Objective　To explore the relation of serum minerals, gamma-aminobutyric acid (GABA), and glutamic acid (Glu) with the core symptoms of autistic children. Methods　A total of 102 children with autism admitted to Xi'an Ninth Hospital from January 2021 to July 2023 were selected as an observation group, including 68 boys and 34 girls who were (7.23±2.15) years old. One hundred and two healthy children who underwent physical examination in Xi'an Ninth Hospital during the same period were selected as a control group, including 68 boys and 34 girls who were (7.40±2.08) years old. The serum levels of calcium (Ca), magnesium (Mg), iron (Fe), copper (Cu), and zinc (Zn) in the two groups were measured by the inductively coupled plasma mass spectrometry. The levels of GABA and Glu were determined by the high performance liquid chromatography. The Child Autism Rating Scale (CARS) and Autism Behavior Scale (ABC) were used to evaluate the illness and symptoms of the observation group; the children were divided into a mild to moderate group and a severe group according to the CARS score; the levels of Ca, Mg, Fe, Cu, Zn, GABA, and Glu were compared between the two groups. t and χ² tests were used for the statistical analysis. The relationship between the above indicators and scores of ABC and CARS was analyzed by the Pearson partial correlation analysis. Results　The levels of Mg, Cu, and Zn in the observation group were lower than those in the control group [(18.00±1.00) mg/L vs. (19.96±1.33) mg/L, (1 095.85±10.82) μg/L vs. (1 152.47±13.62) μg/L, and (752.38±12.63) μg/L vs. (770.15±14.63) μg/L; t=11.896, 32.874, and 9.286; all P<0.05], and the levels of GABA and Glu were higher [(108.69±26.27) pmol/L vs. (70.15±18.63) pmol/L and (985.63±158.20) pmol/L vs. (653.77±102.36) pmol/L; t=12.055 and 17.787; both P<0.05]. The levels of Mg, Cu, and Zn in the severe group were lower than those in the mild to moderate group [(15.77±1.02) mg/L vs. (19.56±1.18) mg/L, (1 056.55±8.26) μg/L vs. (1 123.36±11.65) μg/L, and (738.42±8.82) μg/L vs. (762.15±9.45) μg/L; t=16.862, 31.947, and 12.825; all P<0.05], and the levels of GABA and Glu were higher [(120.75±25.69) pmol/L vs. (100.25±23.14) pmol/L and (1 021.92±185.36) pmol/L vs. (960.23±118.36) pmol/L; t=4.207 and 2.051; both P<0.05]. Mg, Cu, and Zn were negatively correlated with autism conditions (r=-0.896, -0.958, and -0.807; all P<0.05). GABA and Glu were positively correlated with autism conditions (r=0.381 and 0.426; both P<0.05). The Mg level was negatively correlated with the score of interaction and total score (r=-0.280 and -0.323; both P<0.05). The Zn level was negatively correlated with the scores of interaction and physical activity and total score (r=-0.275, -0.213, and -0.223; all P<0.05). The GABA level was positively correlated with the scores of sensation and interaction and total score (r=0.495, 0.416, and 0.402; all P<0.05). The Glu level was positively correlated with the scores of communication and language and total score (r=0.382, 0.420, and 0.463; all P<0.05). Conclusions　The levels of Mg, Cu, Zn, and other minerals in children with autism are low, while the levels of GABA and Glu are high. The mineral contents and levels of GABA and Glu are associated with the core symptoms of the disease. Clinical monitoring of the mineral nutrition and levels of GABA and Glu in children with autism should be focused.

Key words:

Autism, Gamma-aminobutyric acid, Glutamic acid, Minerals, Core symptoms

摘要：

目的　探究血清矿物质、γ-氨基丁酸（gamma-aminobutyric acid，GABA）、谷氨酸（glutamic acid，Glu）与孤独症儿童核心症状的关系。方法　选取2021年1月至2023年7月西安市第九医院收治的孤独症患儿102例为观察组，其中男68例，女34例，年龄（7.23±2.15）岁。另选取同期在西安市第九医院进行体检的健康儿童102例作为对照组，其中男68例，女34例，年龄（7.40±2.08）岁。采用电感耦合等离子体质谱法测定两组血清矿物质钙（Ca）、镁（Mg）、铁（Fe）、铜（Cu）、锌（Zn）水平，采用高效液相色谱法测定GABA、Glu水平。采用孤独症评定量表（Child Autism Rating Scale，CARS）和孤独症行为量表（Autism Behavior Checklist，ABC）评估观察组患儿病情与症状；依据CARS评分将其分为轻中度组与重度组，比较两组Ca、Mg、Fe、Cu、Zn、GABA以及Glu水平。分析上述各指标水平与CARS、ABC评分的关系。采用t检验、χ²检验进行统计分析；采用Pearson偏相关分析各指标间的关系。结果　观察组Mg、Cu、Zn水平均低于对照组［（18.00±1.00）mg/L比（19.96±1.33）mg/L、（1 095.85±10.82）μg/L比（1 152.47±13.62）μg/L、（752.38±12.63）μg/L比（770.15±14.63）μg/L；t=11.896、32.874、9.286，均P<0.05］，GABA、Glu水平均高于对照组［（108.69±26.27）pmol/L比（70.15±18.63）pmol/L、（985.63±158.20）pmol/L比（653.77±102.36）pmol/L；t=12.055、17.787，均P<0.05］。重度组Mg、Cu、Zn水平均低于轻中度组［（15.77±1.02）mg/L比（19.56±1.18）mg/L、（1 056.55±8.26）μg/L比（1 123.36±11.65）μg/L、（738.42±8.82）μg/L比（762.15±9.45）μg/L；t=16.862、31.947、12.825，均P<0.05］，GABA、Glu水平均高于轻中度组［（120.75±25.69）pmol/L比（100.25±23.14）pmol/L、（1 021.92±185.36）pmol/L比（960.23±118.36）pmol/L；t=4.207、2.051，均P<0.05］。Mg、Cu、Zn均分别与孤独症患儿病情呈负相关（r=-0.896、-0.958、-0.807，均P<0.05），GABA、Glu均分别与孤独症病情呈正相关（r=0.381、0.426，均P<0.05）。Mg水平与交往得分、总分均呈负相关（r=-0.280、-0.323，均P<0.05）；Zn水平与交往得分、躯体运动得分、总分均呈负相关（r=-0.275、-0.213、-0.223，均P<0.05）；GABA水平与感觉得分、交往得分、总分均呈正相关（r=0.495、0.416、0.402，均P<0.05）；Glu水平与交往得分、语言得分、总分均呈正相关（r=0.382、0.420、0.463，均P<0.05）。结论　孤独症患儿Mg、Cu、Zn等矿物质水平偏低，GABA、Glu水平偏高，且矿物质含量和GABA、Glu水平均与疾病的核心症状具有一定的关联。临床需要重点监测孤独症患儿矿物质营养状况以及GABA、Glu水平。

关键词:

孤独症, γ-氨基丁酸, 谷氨酸, 矿物质, 核心症状