Otizm spektrum bozukluğu olan çocuklarda vitamin D düzeyleri

AMAC: Calismamizda OSB olan kucuk cocuklarda Vitamin D, Ca, P, ALP ve folat serum duzeylerinin normal kontrollerle karsilastirilarak bunlarin duzeyleri ile sorun davranis siddeti, OSB belirti siddeti, bilissel gelisim duzeyi gibi degiskenler arasindaki iliskinin arastirilmasi amaclanmistir.YONTEM: Tum katilimcilar DSM-IV-TR olcutlerine gore bir cocuk psikiyatrisi uzmani tarafindan degerlendirilmis ve OBve BTA-YGB tanisi konan olgular arastirma grubu olarak calismaya dahil edilmistir. Olgular arasinda AS tanisi konan bir cocuk olmamistir. OSB tanisi konulan ve kontrol grubu olarak calismaya katilmayi kabul eden olgulara kendi hazirladigimiz sosyodemografik veri formu uygulanmistir ve Sorun Davranis Kontrol Listesi (SDKL) doldurulmak uzere verilmistir. Hasta grubuna ayrica Otizm Davranis Kontrol Listesi (ODKL), Cocukluk Otizm Derecelendirme Olcegi (CODO) ve yas gruplarina uygun gelisimsel tarama olcegi ve/veya zekâ testleri uygulanmistir. Ayrica tum cocuklardan Mart 2013-Eylul 2013 tarihleri arasinda vitamin D, Ca, P, ALP ve folat kan tetkikleri istenmis ve universitemiz bunyesindeki merkez ve endokrinoloji laboratuarinda calisilmistir. Elde edilen verilerin degerlendirilmesinde Ki-Kare testleri, t testleri ve baginti analizleri kullanilmistir.SONUC: OSB olan cocuklarda %29.6, normal cocuklarda ise %38.9 oraninda Vitamin D eksikligi saptamistir, ancak iki grup arasindaki fark istatistiksel olarak anlamli bulunmamistir. OSB olan cocuklarin Vitamin D, Ca, P, ALP ve folat duzeyleri kontrol grubu ile karsilastirildiginda gruplar arasinda istatistiksel olarak anlamli bir fark saptanmamistir. Ayrica OSB’li cocuklarin SDKL, ODKL, CODO alt olcek ve toplam puan ortalamalari ile biyokimyasal ve endokrinolojik tetkik sonuclari arasinda istatistiksel olarak anlamli bir iliski saptanmamistir. TARTIŞMA: Arastirmamizda 3-8 yas arasinda vitamin D, Ca, P, ALP ve folat duzeylerinin OSB’li cocuklarda saglikli cocuklardan daha dusuk seviyelerde bulunmadigi sonucuna ulasilmistir. Vitamin D’nin 3-8 yas arasinda OSB’li cocuklarda rutin olarak calisilmasi anlamli gorunmemektedir. Gelecek calismalarda dogumda ya da kordon kaninda Vitamin D duzeylerine bakilarak cocuklarin prospektif olarak izlenmesi farkli sonuclar dogurabilir.  AbstractOBJECTIVE: In this study, it is aimed to define serum levels of Vitamin D, calcium (Ca), phosphorus (P), alkaline phosphatase (ALP) and folate in young children with Autism Spectrum Disorders (ASD) and to compare them with those of normal controls and to explore the association between these serum values and the severity of the problem behavior, ASD symptom severity, and level of cognitive development. METHOD: All participants were assessed by a child and and adolescent psychiatry specialist according to DSM-IV-TR criteria and patients with the diagnosis of Autistic Disorder (AD) and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) were included in the study. None of the patients fulfilled the criteria for Asperger Syndrome (AS). All of the participants were interviewed and sociodemographic form and Aberrant Behavior Checklist (AbBC) were administered. Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and developmentally appropriate screening or IQ tests were administered to ASD patients. Besides, Vitamin D, Ca, P, ALP and folate levels of all participants were calculated at central and endocrinology laboratories of our university hospital from March 2013 to September 2013. Chi square tests, t tests and correlation analyses were used to evaluate the data. RESULTS:  In 29.6% of the children with ASD and 38.9% of the normal children, Vitamin D deficiency was detected, however, the difference was not statistically significant between the groups. No statistically significant differences were detected between levels of Vitamin D, Ca, P, ALP and folate in children with ASD compared to those of controls. The correlational analysis in children with ASD revealed that AbBC, ABC, CARS scores were not correlated with biochemical and endocrine laboratory results.DISCUSSION: The results of the study showed that Vitamin D, Ca, P, ALP and folate levels in 3-8 years old children with ASD were not different from normal controls. The routine screening of Vitamin D levels in 3-8 years old children with ASD does not seem to feasible. In future studies, defining Vitamin D levels in cord blood or perinatal period and prospectively following up children may generate different results.