الفهرس 
Aim of The Study .Only 14 pages are availabe for public view
 |  | from | 201 |  |  |
| | | from | 201 | | |
Abstract
SUMMARY
This study aimed to assess vitamin D, VDBP, bone mineral density and calcium status in autistic children, comparing it to typically developing children, also to question the benefit of using oral vitamin D daily supplementation for 4 months on the autistic children’s outcome.
The study was conducted on 30 autistics recruited from the Autism Disorders Clinic, Medical Research Centre of Excellence, and National Research Centre. Their age ranging from 3-7 years. Patients were randomly supplemented with vitamin D in a dose of 600 IU/day for 4 months. Thirty healthy children were included as controls, with matched age, sex and socioeconomic status to the study group.
Exclusion criteria for the patients’ group were known genetic syndromes, static or progressive neurologic conditions, children on dietary restriction, non -ambulatory patients, and patients on drugs that affect vitamin D metabolism.
Regarding the exclusion criteria of the control group, they were not on either vitamin D supplementation or drugs that affect vitamin D metabolism recruited from the siblings of the attendants of the outpatient Pediatric clinic.The study was approved by the Ethics Committee at Faculty of Medicine, Ain Shams University and National Research Center.
All patients were subjected to careful history taking, thorough clinical and neurological examination, other outcomes that included CARS, ADIR, DEXA (lumber and femur neck) and withdrawal of blood sample for 25(OH) D, VDBP and calcium levels. All the above parameters were repeated twice, at the beginning and at the end of the four months supplementation period.
The control group underwent venous sampling for 25(OH) D, VDBP, calcium levels and DEXA (lumber and neck femur) only once.
The results of the study revealed that autistics group had vitamin D deficient, with statistically no significant difference either before or after the intervention trial.
On comparing 25(OH) D levels of autistics. There was no statistically significant difference before and after supplementation. Although there was statistically significant rise in 25(OH) D level in the supplemented group after the 4 months period.
Vitamin D supplementation raised the mean 25(OH) D level in the supplemented group yet it was still deficient in relation to the recent guidelines.
Calcium level was lower in autistics compared to controls with statistically high significant difference and there was significant increase between before and after supplementation.
VDBP level was lower in autistics compared to controls with statistically high significant difference while there was no significant difference between before and after supplementation.
DEXA of both femur neck and lumber regions were lower in autistics compared to controls with statistically high significant difference while there was no significant difference between before and after supplementation.
Regarding the autisitic assessments outcomes (CARS and ADIR), there was an overall improvement in all aspects applied in autistics after the 4 months supplementation period of vitamin D.
The failure of normalization of vitamin D level and VDBP after supplementation could be attributed to; the small dose used or the relatively short duration of supplementation. In the Middle East population, the paradox is astonishing. It is one of the sunniest areas year round worldwide, yet in light of the postulated vitamin D insensitivity; higher doses might be needed guided by blood levels.
Still if the vitamin D hypothesis is true, the significant difference of autistic assessments before and after supplementation could have revealed some outcome differences. The absence of a difference may be attributed to the unknown period of actual brain vulnerability to vitamin D deficiency; it might be during intrauterine life or early infancy rather than during childhood, maximizing the effect of supplementation during the actual period of pathogenesis. on the other hand, the improvement in the outcomes in both groups may return to the genuine course of the disease in which there is improvement over time especially and our patients were undergoing both behavioral and speech therapy allover the period of the trial.
.