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Nutrition in acute and chronic diseases

A weekly vitamin A supplementary program alleviates social impairment in Chinese children with autism spectrum disorders and vitamin A deficiency

European Journal of Clinical Nutrition volume 75, pages 1118–1125 (2021)Cite this article

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Abstract

Background

Children in China with Autism Spectrum Disorders (ASD) are prone to vitamin A deficiency (VAD). The present study compared two vitamin A supplements (VAS) in two groups of children with ASD and VAD to explore a better VAS program for children with ASD.

Method

A total of 138 3–8-year-old children with ASD (118 males and 20 females) were enrolled in this 6-month study. Of these 138 children, 82 who had VAD (ASD-VAD) were divided into two VAS groups that received the recommended VAS program (RNI-VAS) or a weekly dose of VAS (WD-VAS). The 56 children who had normal vitamin A levels (ASD-VAN) served as a control group. The Social Responsiveness Scale (SRS) was used to assess the severity of social impairment before and after the interventions. Their serum retinol (VA) and oxytocin (OXT) concentrations, the mRNA expression of retinoic acid receptors (RARs), and CD38 gene in peripheral blood was measured before and after the 6-month intervention.

Results

The WD-VAS program increased VA levels better than the RNI-VAS program did (P < 0.01), and it significantly decreased SRS scores (P < 0.05). In addition, the change in VA was positively correlated with the change in mRNA levels in RARβ (r = 0.2441, P = 0.0092), the CD38 in PBMC (r = 0.2729, P = 0.0033), and the change in OXT concentration in serum (r = 0.3735, P < 0.0001). VA was also negatively correlated with changes in SRS scores across the three groups (r = −0.2615, P = 0.0026).

Conclusion

The WD-VAS might be more suitable for children with ASD and VAD than other interventions to improve both VA and social functioning, which may be mediated through the RARβ-CD38-OXT axis.

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Fig. 1: Participant’s flow diagram throughout the study.
Fig. 2: Variations in the serum retinol (VA) concentrations of the three groups of children, all of whom had ASD.
Fig. 3: Changes in OXT concentrations and SRS scores of children with ASD between baseline and the end of the study (the 6-month intervention).
Fig. 4: Correlations between VA changes and changes in other outcomes in children with ASD after the intervention.

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Funding

This research was funded by the National Nature Science of Foundation of China (81770526, 81771223), the Key Project of Guangdong Province (2018B030335001) and Guangzhou City (202007030002), and the Scientific research innovation program for graduate students of Chongqing (CYB 17107).

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Authors and Affiliations

  1. Department of Children’s Nutrition Research Center; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China

    Xi Lai, Qian Zhang, Jiang Zhu, Ting Yang, Min Guo, Qiu Li, Huan Liu, Qiong-Hui Wu, Jie Chen & Ting-Yu Li

  2. Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, China

    Xi Lai, Qian Zhang, Jiang Zhu, Ting Yang, Min Guo, Qiu Li, Huan Liu, Qiong-Hui Wu, Jie Chen & Ting-Yu Li

  3. Department of Child Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China

    Xi Lai

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  1. Xi Lai
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Correspondence to Jie Chen or Ting-Yu Li.

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Lai, X., Zhang, Q., Zhu, J. et al. A weekly vitamin A supplementary program alleviates social impairment in Chinese children with autism spectrum disorders and vitamin A deficiency. Eur J Clin Nutr 75, 1118–1125 (2021). https://doi.org/10.1038/s41430-020-00827-9

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