Incidence of gastrointestinal symptoms in children with autism: a population-based study.
Incidence of gastrointestinal symptoms in children with autism: a population-based study.
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DOI：
10.1542/peds.2008-2933
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发表时间：
2009-08
期刊：
影响因子：
8
通讯作者：
Barbaresi WJ
中科院分区：
文献类型：
--
作者：
Ibrahim SH;Voigt RG;Katusic SK;Weaver AL;Barbaresi WJ
确定在基于人群的样本中，与匹配的对照组相比，自闭症儿童的胃肠道（GI）症状发生率是否增加。在之前的一项研究中，包括1976年至1997年期间明尼苏达州奥姆斯特德县年龄< 21岁的所有居民，我们确定了124名符合DSM-IV标准的自闭症研究诊断儿童。每个自闭症病例确定两个对照组，在性别、年龄、首次登记年份和随访时间上匹配。通过罗切斯特流行病学项目，所有住院和门诊诊断，包括GI诊断，都被编入计算机检索索引。21岁之前的GI诊断分为5类：1）便秘，2）腹泻，3）腹胀、不适或易怒，4）胃食管反流或呕吐，以及5）进食问题或食物选择性。使用Kaplan-Meier方法计算每个类别的累积发生率。拟合考克斯比例风险模型以估计风险比（RR：病例与对照）和相应的95%置信区间（95% CI）。受试者的中位年龄为18.2岁（病例组）和18.7岁（对照组）。到20岁时，孤独症患者和对照组的便秘累积发病率有显著差异（33.9% vs 17.6%; RR=1.97; 95% CI：1.25-3.10; p = 0.003）和喂养问题/食物选择性（24.5% vs 16.1%; RR=1.95; 95% CI：1.18-3.24; p = 0.009）。自闭症病例状态与GI症状（RR=1.21）、腹泻（RR=1.34）、胃食管反流/呕吐（RR=1.55）或腹胀/不适/易怒（RR=1.03）的总体发生率之间无显著相关性。我们发现自闭症儿童便秘和进食问题/食物选择性的发生率增加。由于这些症状通常有行为病因，我们基于人群的数据表明，神经行为而不是主要的有机胃肠道病因，可能是自闭症儿童这些GI症状发生率较高的原因。
To determine whether children with autism have an increased incidence of gastrointestinal (GI) symptoms compared to matched controls in a population-based sample. In a previous study including all residents of Olmsted County, MN age < 21 years between 1976 and 1997, we identified 124 children who fulfilled DSM-IV based criteria for a research diagnosis of autism. Two controls were identified for each autism case, matched on gender, age, year of first registration, and duration of follow-up. Through the Rochester Epidemiology Project, all inpatient and outpatient diagnoses, including GI diagnoses, are indexed for computerized retrieval. GI diagnoses prior to 21 years of age were grouped into 5 categories: 1) constipation, 2) diarrhea, 3) abdominal bloating, discomfort, or irritability, 4) gastroesophageal reflux or vomiting, and 5) feeding issues or food selectivity. The cumulative incidence of each category was calculated using the Kaplan-Meier method. Cox proportional hazards models were fit to estimate the risk ratios (RR: cases versus controls) and corresponding ninety-five percent confidence intervals (95% CI). Subjects were followed to median ages of 18.2 (cases) and 18.7 (control) years. There were significant differences between autism cases and controls in the cumulative incidence by age 20 of constipation (33.9% versus 17.6%; RR=1.97; 95% CI: 1.25–3.10; p = 0.003) and feeding issues/food selectivity (24.5 % versus 16.1%; RR=1.95; 95% CI: 1.18–3.24; p = 0.009). There was no significant association between autism case status and overall incidence of GI symptoms (RR=1.21), diarrhea (RR=1.34), gastroesophageal reflux/vomiting (RR=1.55), or abdominal bloating/discomfort/irritability (RR=1.03). We found that children with autism had an increased incidence of constipation and feeding issues/food selectivity. Since these symptoms often have a behavioral etiology, our population-based data suggest a neurobehavioral rather than a primary organic gastrointestinal etiology, may account for the higher incidence of these GI symptoms in children with autism.
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影响因子：
5.2
作者：
Molloy, CA;Manning-Courtney, P
通讯作者：
Manning-Courtney, P
DOI：
10.1097/dbp.0b013e31815f24f7
发表时间：
2008-04-01
影响因子：
2.4
作者：
Nickels, Katherine C.;Katusic, Slavica K.;Barbaresi, William J.
通讯作者：
Barbaresi, William J.
影响因子：
2.9
作者：
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Rey, Jose A.
影响因子：
3.9
作者：
Herndon, Alison C.;DiGuiseppi, Carolyn;Reynolds, Ann
通讯作者：
Reynolds, Ann
影响因子：
158.5
作者：
McCracken, JT;McGough, J;McMahon, D
通讯作者：
McMahon, D