Autism spectrum disorders: let's talk about glucose?
Autism spectrum disorders: let's talk about glucose?
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DOI：
10.1038/s41398-019-0370-4
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发表时间：
2019-01-31
影响因子：
6.8
通讯作者：
Nardi, Antonio E.
中科院分区：
文献类型：
--
作者：
Hoirisch-Clapauch, Silvia;Nardi, Antonio E.
自闭症谱系障碍（ASD）的特征在于由于神经元迁移障碍而导致的断开连接以及神经元线粒体功能障碍。宫内高血糖和高胰岛素血症影响神经元迁移的不同途径，而新生儿长期低血糖可能导致线粒体功能障碍。我们的假设是，导致宫内高血糖或新生儿低血糖的条件会影响ASD的发病机制。在这项研究中，我们通过使用MeSH术语“自闭症谱系障碍”和“风险因素”搜索PubMed来确定ASD的风险因素。然后，我们分析了母亲和后代的危险因素和血糖异常之间的关系。血糖异常与肥胖、母亲体重过度增加或糖尿病等危险因素之间的关系是显而易见的。对于畸形或暴露于选择性5-羟色胺再摄取抑制剂等风险因素，这种关系是推测性的。例如，在啮齿类动物中，子宫内高血糖与畸形相关，与母体糖尿病无关。反过来，选择性5-羟色胺再摄取抑制剂减少新生儿低血糖的迹象。未被发现的长期低血糖可能会损害新生儿的大脑。重要的是，我们的研究小组证明，分娩前一天的高碳水化合物饮食或身体活动可能会影响新生儿的体重。在这项研究中，根据母亲的生活方式风险因素选择了158名新生儿进行筛查，其中48名患有低血糖症。值得注意的是，其中5人尚未通过目前的筛查计划确定。需要对照研究来澄清是否产妇干预措施，旨在维持血糖控制，以及筛查计划的基础上产妇的生活方式危险因素和暴露于特定的产前药物的新生儿低血糖可以降低ASD的患病率。
Autism spectrum disorders (ASD) are characterized by disconnectivity due to disordered neuronal migration, and by neuronal mitochondrial dysfunction. Different pathways involved in neuronal migration are affected by intrauterine hyperglycemia and hyperinsulinemia, while prolonged neonatal hypoglycemia may cause mitochondrial dysfunction. Our hypothesis was that conditions leading to intrauterine hyperglycemia or neonatal hypoglycemia would influence ASD pathogenesis. In this study, we identified risk factors for ASD by searching PubMed with the MeSH terms "autism spectrum disorder" and "risk factors". We then analyzed the relationship between the risk factors and glucose abnormalities in the mother and the offspring. The relationship between glucose abnormalities and risk factors such as obesity, excessive maternal weight gain, or diabetes mellitus is evident. For risk factors such as malformations or exposure to selective serotonin reuptake inhibitors, the relationship is speculative. In rodents, for example, intrauterine hyperglycemia is associated with malformations, independent of maternal diabetes. In their turn, selective serotonin reuptake inhibitors reduce the signs of neonatal hypoglycemia. Going undetected, prolonged hypoglycemia may harm the neonatal brain. Importantly, our group demonstrated that either high-carbohydrate diets or physical inactivity the day before delivery may influence neonatal glycemia. In that study, of 158 neonates selected to be screened according to maternal lifestyle risk factors, 48 had hypoglycemia. Of note, five of them had not been identified with current screening programs. Controlled studies are needed to clarify whether maternal interventions aiming at maintaining glycemic control, together with screening programs for neonatal hypoglycemia based on maternal lifestyle risk factors and on exposure to specific prenatal medications can reduce the prevalence of ASD.