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Serum Folate Status Is Primarily Associated With Neurodevelopment in Children With Autism Spectrum Disorders Aged
1Chongqing Key Laboratory of Childhood Nutrition and Health, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, China.
Insights
Serum folate levels are lower in children with autism spectrum disorder (ASD). Higher folate levels in young children with ASD are linked to better neurodevelopment, particularly in communication and motor skills.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Nutritional Psychiatry
Background:
- Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with debated links to folate.
- Previous research on folate and ASD symptoms is inconsistent, often using small samples and lacking age-specific analysis.
Purpose of the Study:
- To investigate the association between serum folate levels and symptoms in children with ASD across different age groups.
- To provide a multi-center perspective on folate's role in ASD.
Main Methods:
- A multi-center study involving 1,300 children with ASD and 1,246 typically developing children (under 7 years).
- Assessment of ASD symptoms using Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Childhood Autism Rating Scale (CARS).
- Neurodevelopmental evaluation using China neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016); serum folate measured via chemiluminescence assay.
Main Results:
- Children with ASD exhibited lower serum folate levels compared to typically developing peers.
- Serum folate was not associated with core ASD symptoms (ABC, SRS, CARS) but negatively correlated with communication warning behaviors in ASD children aged three and under.
- In ASD children aged three and under, serum folate positively correlated with gross motor, fine motor, language, and general quotients.
Conclusions:
- Serum folate status is significantly associated with the neurodevelopment of young children (aged three and under) with ASD.
- Higher serum folate levels appear beneficial for improving neurodevelopmental outcomes in this group.
- Increased attention to folate levels in early childhood is recommended for ASD intervention strategies.
Abstract:
Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Folate has been demonstrated to be associated with ASD. However, current studies on the correlation between folate and symptoms of children with ASD have inconsistent conclusions, use mainly small samples, and lack age-stratified analysis. This study aimed to explore the association between serum folate and symptoms of autistic children at different age groups from a multi-center perspective. Methods: We enrolled 1,300 children with ASD and 1,246 typically developing (TD) children under 7 years old from 13 cities in China. The Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Childhood autism rating scale (CARS) were used to evaluate the symptoms of children with ASD. China neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) scale was used to evaluate the neurodevelopment of children with ASD. Serum folate was measured by chemiluminescence assay in the two groups. Results: The serum folate levels of children with ASD were lower than that of TD children. In terms of core symptoms of ASD, we found that the serum folate levels were not associated with ABC, SRS, and CARS scores in ASD children of all ages but negatively associated with communication warning behavior scores of CNBS-R2016 in ASD children aged three and under. Concerning development quotients, it was at the age of three and under that serum folate levels were positively associated with gross motor, fine motor, language, and general quotient of ASD children. These ASD children aged three and under were further divided into two groups according to the median of serum folate (14.33 ng/mL); we found that compared to ASD children with folate ≤ 14.33 ng/mL, those with folate >14.33 ng/mL had lower communication warning behavior score and higher gross motor, fine motor, adaptive behavior, language, person-social, and general development quotients. Conclusion: We found that serum folate status was primarily associated with the neurodevelopment of children with ASD aged three and under. Furthermore, relatively higher serum folate levels may be more beneficial for children with ASD. Our results suggest that folate level should be paid more attention in ASD children, especially in early life, to better promote the intervention of ASD children.
