Correlation of Co-Morbidities with Symptom Severity of Children with Autism Spectrum Disorder: A Cross-Sectional Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measurements
- (a)
- The ABC is used for behavioral examination, auxiliary diagnosis, and screening of ASD. A cut-off total score greater than 67 points indicates a high probability of ASD, while scores of 53–67 indicate potential ASD [18].
- (b)
- The CARS is used to evaluate the symptoms and duration of ASD. Scores of 30–36 points indicate moderate ASD and scores > 36 points indicate severe ASD [19].
- (c)
- The SRS is used to screen the social behavior of children and adolescents with ASD to determine the severity of social disorders [20].
2.3. Lab Measurements
2.4. Physical Examination
2.5. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Serum Nutrient Levels and Body Composition
3.3. Sleep Disturbances and Diet Partiality
3.4. Correlation Analyses in Children with ASD
4. Discussion
Limitations and Future Research Directions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Sleep Habits Questionnaire and Dietary Behavior Questionnaire
Classification | Main Problems | Items | Option |
Sleep disturbances | Night awakening | Whether your child wakes up at night? | 1. YES; 2. NO |
Daytime sleepiness | Whether your child has one of the following conditions? ① Inability to wake up spontaneously in the morning requires someone else to wake up. ② Waking up in the morning in a bad state. ③ Fatigue or sleepiness during the day while watching TV. ④ Fatigue or sleepiness during the day when travelling in a car. | 1. YES; 2. NO | |
Parasomnias | Whether your child has one of the following conditions? ① Grind teeth (during sleep). ② Talk in sleep. ③ Sleepwalking. ④ Have nightmares. ⑤ Restlessness (often with large body movements). ⑥ Snoring loudly. ⑦ Sleep apnea. | 1. YES; 2. NO | |
Sleep anxiety | Whether your child has one of the following conditions? ① Afraid of the dark. ② Crying before bedtime. ③ Afraid to sleep alone. ④ Difficulty sleeping in unfamiliar surroundings. ⑤ Moving into someone else’s bed in the middle of the night. ⑥ Waking up in the middle of the night crying and being difficult to calm. ⑦ Dyspnoea | 1. YES; 2. NO | |
Prolonged time to fall asleep | Is your child unable to fall asleep within 20 minutes of going to bed? | 1. YES; 2. NO | |
Poor sleep habits | Whether your child has one of the following conditions? ① Unable to sleep alone. ② Needs to be put to sleep. | 1. YES; 2. NO | |
Dietary behavior | Diet partiality | Does your child have a significant diet partiality? | 1. YES; 2. NO |
Please list the types of food your child resists eating. | Unrestricted options |
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General Characteristics | ASD | TD | |
---|---|---|---|
Age | 4.06 ± 0.98 | 4.34 ± 0.88 | 0.024 |
Sex (male) [n (%)] | 95 (79.2) | 81 (73.6) | 0.323 |
Ethnicity (Han) [n (%)] | 111 (92.5) | 101 (91.8) | 0.847 |
Resident (Urban) [n (%)] | 92 (66.7) | 110 (100) | <0.001 |
Maternal abnormalities during pregnancy [n (%)] | 55 (45.8) | 38 (34.6) | 0.081 |
Mother’s education [n (%)] | |||
Illiterate/elementary/middle school | 37 (30.8) | 3 (2.7) | <0.001 |
High school | 14 (11.7) | 6 (5.5) | |
College or above | 69 (57.5) | 101 (91.8) | |
Father’s education [n (%)] | |||
Illiterate/elementary/middle school | 34 (28.3) | 2 (1.8) | <0.001 |
High school | 13 (10.8) | 7 (6.4) | |
College or above | 73 (60.8) | 101 (91.8) | |
Family structure (Nuclear family) [n (%)] | 58 (48.33) | 53 (48.18) | 0.982 |
Types | ASD | TD | ||
---|---|---|---|---|
Serotonin | 127.5 (81.75–172.75) | 133 (92.5–167) | −0.18 | 0.858 |
Folic acid | 11.33 ± 3.29 | 12.48 ± 3.10 | −2.711 | 0.007 |
Calcium | 92.9 (88.25–95.98) | 92.8 (87.2–98.4) | −0.816 | 0.414 |
Magnesium | 19.86 ± 1.81 | 18.92 ± 1.54 | 4.266 | <0.001 |
Iron | 1133 (873–1445.25) | 1087 (844.5–1346.5) | −0.442 | 0.658 |
Copper | 1054.5 (929.75–1170.5) | 1123 (998.5–1301) | −3.303 | 0.001 |
Zinc | 815.5 (728.5–887.75) | 810 (759–876) | −0.465 | 0.642 |
Vitamin A | 0.36 ± 0.08 | 0.35 ± 0.07 | 0.565 | 0.572 |
Vitamin E | 8.9 (7.6–10) | 8.4 (7.3–9.95) | −1.162 | 0.245 |
Vitamin D3 | 18.55 (12.9–27.75) | 20.5 (15.25–28.05) | −0.785 | 0.433 |
Vitamin D | 19.75 (13.4–28.05) | 21.2 (15.9–28.2) | −0.769 | 0.442 |
Homocysteine | 5.66 (4.953–6.523) | 5.39 (4.63–6.125) | −1.984 | 0.047 |
Vitamin B12 | 736.52 (550.4–1039.4) | 919 (710.4–1131.4) | −3.49 | <0.001 |
Body Dimension | ASD | TD | ||
---|---|---|---|---|
Head circumference | 50.5 (49.5–51.5) | 50.5 (49.35–51.55) | −0.259 | 0.796 |
Chest circumference | 53.5 (51.8–56.8) | 52.6 (50.55–54.65) | −3.377 | 0.001 |
Waistline | 49 (47.5–52.43) | 49.5 (47.25–51.7) | −0.016 | 0.987 |
Hip circumference | 55 (52.05–59) | 55.7 (52.2–58.3) | −0.176 | 0.861 |
Height | 104.2 ± 8.66 | 104.78 ± 7.8 | −0.535 | 0.593 |
Weight | 18.50 ± 4.11 | 17.69 ± 3.25 | 1.646 | 0.101 |
Triceps skinfold thickness | 9 (8–11) | 10 (8.5–11.5) | −0.756 | 0.45 |
Subscapular skinfold thickness | 6 (5–7) | 6 (5.5–7) | −0.174 | 0.862 |
Abdominal skinfold thickness | 6 (5–8.5) | 5.5 (4.5–7) | −3.028 | 0.002 |
Total Body Water | 10.35 (8.75–11.79) | 9.8 (8.75–11.2) | −1.557 | 0.12 |
Protein | 2.7 (2.3–3.1) | 2.6 (2.3–2.9) | −1.145 | 0.135 |
Minerals | 0.87 (0.74–1.06) | 0.86 (0.74–0.98) | −0.75 | 0.454 |
Body Fat Mass | 3.95 (3.1–5.3) | 4.1 (3.2–5.1) | −0.21 | 0.833 |
Soft Lean Mass | 13.2 (11.25–15.18) | 12.6 (11.2–14.3) | −1.576 | 0.115 |
Fat Free Mass | 14.05 (11.83–16.04) | 13.3 (11.8–15.15) | −1.486 | 0.137 |
Skeletal Muscle Mass | 6.25 (5.017–7.388) | 5.9 (5–6.95) | −1.48 | 0.139 |
Body Mass Index | 17.03 ± 1.94 | 16.02 ± 1.54 | 4.338 | <0.001 |
Percent Body Fat | 22.75 (19.6–27.78) | 23.5 (19.4–26.8) | −0.003 | 0.998 |
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Zou, M.; Zhang, Y.; Li, D.; Li, S.; Hu, J.; Gao, Y.; Cheng, Z.; Liu, S.; Wu, L.; Sun, C. Correlation of Co-Morbidities with Symptom Severity of Children with Autism Spectrum Disorder: A Cross-Sectional Survey. Nutrients 2024, 16, 2960. https://doi.org/10.3390/nu16172960
Zou M, Zhang Y, Li D, Li S, Hu J, Gao Y, Cheng Z, Liu S, Wu L, Sun C. Correlation of Co-Morbidities with Symptom Severity of Children with Autism Spectrum Disorder: A Cross-Sectional Survey. Nutrients. 2024; 16(17):2960. https://doi.org/10.3390/nu16172960
Chicago/Turabian StyleZou, Mingyang, Yilin Zhang, Dexin Li, Shengqi Li, Jingyi Hu, Ya Gao, Zeyu Cheng, Shidan Liu, Lijie Wu, and Caihong Sun. 2024. "Correlation of Co-Morbidities with Symptom Severity of Children with Autism Spectrum Disorder: A Cross-Sectional Survey" Nutrients 16, no. 17: 2960. https://doi.org/10.3390/nu16172960