Growth And Maturation In Children With Autism

患有自闭症和自闭症谱系障碍（ASD）的儿童在社会化、语言和非语言交流以及对感官刺激的反应方面存在缺陷。虽然自闭症的原因尚不清楚，但在几项研究中，自闭症和ASD儿童的大头畸形患病率很高，平均身高似乎高于一般人群，并且可能患有胃肠道并发症，因此规定了无麸质和/或酪蛋白饮食。自闭症儿童的生长模式和成熟标志物尚未得到详细研究，其他评估自闭症儿童成熟的方法，如激素分析和骨龄，尚未探索。 横截面数据被用于评估自闭症/ASD儿童的生长和成熟的三种方式：1）与发育正常的年龄、性别和种族匹配的对照组相比，81名4至8岁自闭症/ASD儿童（75名男孩）的身高、体重、体重指数（BMI）和头围，2）DHEA-S水平和其他显著的生长激素（IGF-1，IGF-2，IGFBP 3）在自闭症/ASD儿童与相同的发育正常对照组相比，和3）骨龄和第二掌骨形态测量自闭症/ASD儿童与参考人群相比。 初步分析表明了几个重要的临床结果。 首先，自闭症/ASD病例的头围、体重和体重指数显著高于对照组，尽管两组之间的身高没有显著差异。 病例组IGF-1、IGF-2、IGFBP 3和GHBP的平均水平均显著较高，且显著更多的病例DHEA-S水平在可检测范围内。 未来的研究应探讨生长相关激素在自闭症病理生理学和自闭症/ASD儿童的儿童发育中的潜在作用。 第二，自闭症或ASD男孩在4至8岁之间也表现出渐进性的骨骼生长下降或减缓，到6岁时差异显著。 对无酪蛋白饮食的儿童影响最大。 这些年龄段的自闭症/ASD儿童的骨骼发育应作为常规护理的一部分进行仔细监测，特别是如果他们采用无酪蛋白饮食。

Children with autism and autism spectrum disorder (ASD) suffer from defects in socialization, verbal and nonverbal communication, and response to sensory stimuli. While the cause of autism is unknown, children with autism and ASD have been noted in several studies to have a high prevalence of macrocephaly, appear to be taller on average than the general population, and may have gastrointestinal co-morbidities for which gluten- and/or casein-free diets are prescribed. Growth patterns and markers of maturation in autistic children have not been studied in detail, and other methods of assessing maturation in autistic children, such as hormone analyses and bone age, have not been explored. Cross-sectional data are being used to assess growth and maturation of children with autism/ASD in three ways: 1) the height, weight, body mass index (BMI) and head circumference of 81 children (75 boys) with autism/ASD between 4 and 8 years of age in comparison with developmentally normal age-, gender-, and race-matched controls, 2) DHEA-S levels and other significant growth hormones (IGF-1, IGF-2, IGFBP3) in children with autism/ASD in comparison with the same developmentally normal controls, and 3) bone age and second metacarpal morphometry in children with autism/ASD in comparison with reference populations. Preliminary analyses have indicated several significant clinical findings. First, the autism/ASD cases had significantly greater head circumference, weight, and body mass index than controls, although height did not differ significantly between groups. The case groups mean levels of IGF-1, IGF-2, IGFBP3 and GHBP were all significantly higher, and significantly more of the cases had DHEA-S levels in the detectable range. Future studies should examine the potential role of growth-related hormones in the pathophysiology of autism and childhood development of children with autism/ASD. Second, boys with autism or ASD also showed a progressive fall-off or slowing of appositional bone growth between 4 and 8 years, with the discrepancy being significant by age 6 years. The effect was strongest for children on casein-free diets. The bone development of children with autism/ASD at these ages should be monitored carefully as part of routine care, especially if they are on casein-free diets.