Gastrointestinal Factors in Autistic Disorder: A Critical Review
ABSTRACT Interest in the gastrointestinal (GI) factors of autistic disorder (autism) has developed from descriptions of symptoms such as constipation and diarrhea in autistic children and advanced towards more detailed studies of GI histopathology and treatment modalities. This review attempts to critically and comprehensively analyze the literature as it applies to all aspects of GI factors in autism, including discussion of symptoms, pathology, nutrition, and treatment. While much literature is available on this topic, a dearth of rigorous study was found to validate GI factors specific to children with autism.
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ABSTRACT: We aimed to compare body mass index( BMI) and healthy eating index( HEI) in children with autism spectrum disorder( ASD, n = 105) and typically developing (TD, n = 495) children.They were aged 6–9years,lived in Valencia (Spain) and came from similar cultural and socio-economic backgrounds.In this case–control study,the weight,height and BMI were measured for both groups.Three-day food records were used to assess dietary intake.Although the differences between children with ASD and TD children in raw BMI (p = 0.44),BMI z-score (p = 0.37),HEI(p = 0.43)and total energy intake (p = 0.86) were not significant,children with ASD and the boys subgroup were shorter (p = 0.01),but not the girls subgroup,compared to TD children of the same gender.Using the controls values as a reference,the BMI distribution in children with ASD be came distorted,with values below the 5th percentile (11%vs.4%, p = 0.03) and above the 95th percentile (8%vs.5%, p = 0.04).The gender-and age-adjusted odds ratios for being underweight in the groups of all children and boys with ASD were 3.03 and 2.39,respectively,vs.TD children.Our data suggest that routine monitoring of children with ASD should include anthropometric measurements and assessment of their dietary habitsResearch in Autism Spectrum Disorders 10/2014; 9(2015)26–33. DOI:10.1016/j.rasd.2014.09.013 · 2.96 Impact Factor
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ABSTRACT: To test whether gut permeability is increased in autism spectrum disorders (ASD) by evaluating gut permeability in a population-derived cohort of children with ASD compared with age- and intelligence quotient-matched controls without ASD but with special educational needs (SEN). One hundred thirty-three children aged 10-14 years, 103 with ASD and 30 with SEN, were given an oral test dose of mannitol and lactulose and urine collected for 6 hr. Gut permeability was assessed by measuring the urine lactulose/mannitol (L/M) recovery ratio by electrospray mass spectrometry-mass spectrometry. The ASD group was subcategorized for comparison into those without (n = 83) and with (n = 20) regression. There was no significant difference in L/M recovery ratio (mean (95% confidence interval)) between the groups with ASD: 0.015 (0.013-0.018), and SEN: 0.014 (0.009-0.019), nor in lactulose, mannitol, or creatinine recovery. No significant differences were observed in any parameter for the regressed versus non-regressed ASD groups. Results were consistent with previously published normal ranges. Eleven children (9/103 = 8.7% ASD and 2/30 = 6.7% SEN) had L/M recovery ratio > 0.03 (the accepted normal range cut-off), of whom two (one ASD and one SEN) had more definitely pathological L/M recovery ratios > 0.04. There is no statistically significant group difference in small intestine permeability in a population cohort-derived group of children with ASD compared with a control group with SEN. Of the two children (one ASD and one SEN) with an L/M recovery ratio of > 0.04, one had undiagnosed asymptomatic celiac disease (ASD) and the other (SEN) past extensive surgery for gastroschisis. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.Autism Research 06/2014; 7(3). DOI:10.1002/aur.1350 · 4.53 Impact Factor
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ABSTRACT: Risperidone has been shown to improve serious behavioral problems in children with autism. Here we asked whether risperidone-associated improvement was related to changes in concentrations of inflammatory molecules in the serum of these subjects. Seven molecules were identified as worthy of further assessment by performing a pilot analysis of 31 inflammatory markers in 21 medication-free subjects with autism versus 15 healthy controls: epidermal growth factor (EGF), interferon-γ (IFN-γ), interleukin (IL)-13, IL-17, monocyte chemoattractant protein-1 (MCP-1), IL-1 and IL-1-receptor antagonist. Serum concentrations of these markers were then established in a different set of subjects that participated in a double-blind, clinical trial and an expanded group of healthy subjects. In the first analysis, samples obtained from subjects with autism at baseline visits were compared to visits after 8-week treatment with placebo (n=37) or risperidone (n=40). The cytokine concentrations remained stable over the 8-week period for both risperidone and placebo groups. In the second analysis, we explored further the differences between medication-free subjects with autism (n=77) and healthy controls (recruited independently; n=19). Serum levels of EGF were elevated in subjects with autism (median=103 pg/mL, n=75) in comparison to healthy controls (75 pg/mL, n=19; p<0.05), and levels of IL-13 were decreased in autism (median=0.8 pg/mL, n=77) in comparison to controls (9.8 pg/mL, n=19; p=0.0003). These changes did not correlate with standardized measures used for a diagnosis of autism. In summary, risperidone-induced clinical improvement in subjects with autism was not associated with changes in the serum inflammatory markers measured. Whether altered levels of EGF and IL-13 play a role in the pathogenesis or phenotype of autism requires further investigation.Journal of child and adolescent psychopharmacology 11/2011; 21(6):555-64. DOI:10.1089/cap.2010.0134 · 3.07 Impact Factor