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Iron status in children with autism spectrum disorder.

TitleIron status in children with autism spectrum disorder.
Publication TypeJournal Article
Year of Publication2012
AuthorsReynolds, AM, Krebs, NF, Stewart, PA, Austin, H, Johnson, SL, Withrow, NL, Molloy, CA, S. James, J, Johnson, CR, Clemons, TE, Schmidt, BL, Hyman, SL
JournalPediatrics
Volume130
PaginationS154-9
Date PublishedNov
KeywordsAIM, Child, Child Development Disorders, Cross-Sectional Studies, Deficiency Diseases/et [Etiology], Female, Humans, IM, Iron/df [Deficiency], Male, Nutritional Status, Pervasive/co [Complications], Preschool, Prevalence
Abstract

BACKGROUND AND OBJECTIVES: Children with autism spectrum disorders (ASDs) often have food selectivity and restricted diets, putting them at risk for nutritional deficiencies. Previous studies have demonstrated a high prevalence of iron deficiency (ID) in children with ASDs living in Wales, Canada, and Turkey. The objectives of this study were to determine the prevalence of ID and the adequacy of iron intake in children with ASD in the United States. METHODS: Participants (age 2-11 years recruited from the Autism Treatment Network Diet and Nutrition Study) completed a 3-day diet record (n = 368) and had laboratory measures of serum ferritin (SF), complete blood count, iron, total iron binding capacity, and transferrin saturation (TS) (n = 222). RESULTS: Of the 222 participants with laboratory data, 18 (8%) had SF <12 g/L and 2 (1%) had ID defined by both low SF and TS (3 children with low SF had missing TS data). One subject had iron deficiency anemia. Fewer than 2% of subjects had iron intake below the estimated average requirement. CONCLUSIONS: Although the determination of iron status is complex, these data do not support previous reports that children with ASD are at greater risk for ID than the general population; however, 8% percent of the sample did demonstrate low SF despite <2% of the sample demonstrating iron intake below the estimated average requirement. The prevalence of low SF may be an underestimate, because SF is an acute phase reactant and the study included no measure of inflammation.

Summary

Lead Author
Ann Reynolds

Study Aims and Objectives
To determine the prevalence of iron deficiency and the adequacy of iron intake in children with Autism Spectrum Disorder (ASD) in the United States.

Methods - Sample, Procedure, Study Measures, Analysis
Participants completed a 3-day diet record and had laboratory measures of complete blood count, iron, and the blood levels of two proteins: ferritin (deals with iron storage) and transferrin (helps with iron transport). In total, data on 222 children with ASD (87% male, 13% female), aged 2 to 11 years, were examined.

Results – Main Finding(s)
Of the 222 participants who completed the diet record, 18 (8%) were found to have low levels of ferritin in their blood. 3 children were deemed iron deficient, since they had low ferritin and low transferrin. One subject had a lack of healthy red blood cells due to iron deficiency. Fewer than 2% of the children had iron intake below the estimated average requirement.

Conclusion – Summary Statement
This results of this study do not support previous reports that children with ASD are at greater risk for iron deficiency than the general population. While only 2% of subjects demonstrated iron intake below the estimated average requirement, 8% showed low amounts of ferritin in the blood. The prevalence of low ferritin may actually be underestimated in this study.

PubMed ID23118246