Growth And Maturation In Children With Autism

患有自闭症和自闭症谱系障碍(ASD)的儿童在社交、言语和非言语交流以及对感觉刺激的反应方面存在缺陷。虽然自闭症的原因尚不清楚，但在几项研究中已经注意到，患有自闭症和自闭症的儿童有很高的巨头症患病率，似乎比普通人群平均身高更高，并且可能患有胃肠道并发症，因此建议使用无麸质和/或无酪蛋白饮食。自闭症儿童的生长模式和成熟标志还没有被详细研究，也没有探索其他评估自闭症儿童成熟的方法，如激素分析和骨龄。利用横断面数据以三种方法评估自闭症/自闭症儿童的生长和成熟情况：1)81例(75名男童)4-8岁自闭症/自闭症儿童与发育正常对照组的身高、体重指数和头围的比较；2)自闭症/自闭症儿童的脱氢表雄酮-S水平及其他显著生长激素(胰岛素样生长因子-1、胰岛素样生长因子-2、胰岛素样生长因子P3)水平与相同发育正常对照组的比较；以及3)自闭症/自闭症儿童与参考人群的骨龄和第二掌骨形态测量。初步分析表明有几个重要的临床表现。首先，自闭症/自闭症患者的头围、体重和身体质量指数显著高于对照组，尽管身高在不同组之间没有显著差异。病例组血清IGF1、IGF2、IGFBP3和GHBP水平均显著高于对照组，且脱氢表雄酮-S水平在可检测范围内的病例明显多于对照组。未来的研究应该检查生长相关激素在自闭症的病理生理学和自闭症/自闭症儿童的童年发展中的潜在作用。其次，患有自闭症或自闭症的男孩在4到8岁之间也表现出对位骨生长的渐进性下降或减慢，这种差异在6岁时显著。无酪蛋白饮食对儿童的影响最大。作为常规护理的一部分，应该仔细监测自闭症/自闭症儿童在这些年龄段的骨骼发育情况，特别是如果他们正在吃无酪蛋白饮食的话。

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.