Bone Accrual in Males with Autism Spectrum Disorder.
Bone Accrual in Males with Autism Spectrum Disorder.
复制标题
自闭症谱系障碍男性的骨骼应计。
DOI：
10.1016/j.jpeds.2016.10.080
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发表时间：
2017-02
期刊：
影响因子：
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通讯作者：
Misra M
中科院分区：
文献类型：
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作者：
Neumeyer AM;Cano Sokoloff N;McDonnell E;Macklin EA;McDougle CJ;Misra M
为了验证这一假设，即与正常发育的对照组相比，自闭症谱系障碍（ASD）男孩在4年期间的骨增量减少。对25名ASD男孩和24名对照者的骨结局进行了评估。14名ASD男孩和11名对照者在基线和4年后进行了评估。研究开始时受试者的平均年龄为11.0 ± 1.6岁，随访时为14.9 ± 1.6岁。采用双能X线骨密度仪测量脊柱、髋关节和全身的骨密度（BMD），并根据年龄、种族和性别进行标准化（BMD z评分）。还进行了高度调整。我们评估了病史，使用问卷调查的体力活动，使用食物记录的维生素D和钙摄入量，以及血清钙，磷，25（OH）-维生素D和青春期激素水平。与对照组相比，ASD男孩的脊柱、髋关节和全身BMD z评分较低。在基线和4年后评估的受试者中，两组之间的骨增长率没有差异;然而，在随访时，ASD男孩的脊柱和髋部BMD z评分仍然低于对照组。值得注意的是，ASD组在两个时间点的体力活动较少。虽然青春期骨增量与对照组相似，但ASD儿童的BMD在4年的随访期内仍然较低，这表明低BMD是青春期前因素的结果，如低体力活动。需要进行研究以调查BMD降低的原因和后果，评估ASD女性和成人的BMD，并评估治疗干预措施。
To test the hypothesis that bone accrual over a 4-year period is reduced in boys with autism spectrum disorder (ASD) compared with typically developing controls. Twenty-five boys with ASD and 24 controls were assessed for bone outcomes. Fourteen boys with ASD and 11 controls were assessed both at baseline and after 4 years. The mean subject age was 11.0 ± 1.6 years at study initiation and 14.9 ± 1.6 years at follow-up. Bone mineral density (BMD) was measured at the spine, hip, and whole body using dual-energy X-ray absorptiometry and normalized for age, race, and sex (BMD z-scores). Height adjustments were performed as well. We assessed medical history, physical activity using questionnaires, vitamin D and calcium intake using food records, and serum calcium, phosphorus, 25(OH)-vitamin D, and pubertal hormone levels. Boys with ASD had lower spine, hip, and whole body BMD z-scores compared with controls. In those subjects assessed both at baseline and after 4 years, bone accrual rates did not differ between the 2 groups; however, spine and hip BMD z-scores remained lower in the boys with ASD than in controls at follow-up. Notably, the ASD group was less physically active at both time points. Although pubertal bone accrual was similar to that in controls, BMD in children with ASD remained low over a 4-year follow-up period, suggesting that low BMD is a consequence of prepubertal factors, such as low physical activity. Studies are needed to investigate the causes and consequences of decreased BMD, to assess BMD in females and adults with ASD, and to evaluate therapeutic interventions.