Status of essential elements in autism spectrum disorder: systematic review and meta-analysis

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children. It is considered a multifactorial condition, where trace elements are among environmental factors that may contribute to ASD. Meanwhile, the...

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Published in	Reviews in the neurosciences Vol. 28; no. 7; pp. 783 - 809
Main Authors	Saghazadeh, Amene, Ahangari, Narges, Hendi, Kasra, Saleh, Fatemeh, Rezaei, Nima
Format	Journal Article
Language	English
Published	Germany De Gruyter 26.10.2017 Walter de Gruyter GmbH
Subjects	Asia Asian People Autism Autism Spectrum Disorder - blood Autism Spectrum Disorder - ethnology Autism Spectrum Disorder - metabolism Blood levels Children Chromium Cobalt copper Environmental factors Etiology Hair Hair - metabolism Health risk assessment Humans Iodine iron Magnesium Meta-analysis Neurodevelopmental disorders Systematic review Trace elements Trace Elements - blood Trace Elements - metabolism zinc Zinc - blood Zinc - metabolism chromium trace elements Asia environmental factors copper iron iodine zinc autism
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Abstract	Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children. It is considered a multifactorial condition, where trace elements are among environmental factors that may contribute to ASD. Meanwhile, the between-study variance is high. The present systematic review was designed to investigate the difference in trace element measures between patients with ASD and control subjects. Meta-analyses showed that the hair concentrations of chromium ( =0.024), cobalt ( =0.012), iodine ( =0.000), iron ( =0.017), and magnesium ( =0.007) in ASD patients were significantly lower than those of control subjects, while there were higher magnesium levels in the hair of ASD patients compared to that of controls ( =0.010). Patients with ASD had higher blood levels of copper ( =0.000) and lower levels of zinc compared to controls ( =0.021). Further urinary iodine levels in patients with ASD were decreased in comparison with controls ( =0.026). Sensitivity analyses showed that ASD patients in non-Asian but not in Asian countries had lower hair concentrations of chromium compared to controls. Also, such analyses indicated that ASD patients in Asian countries had lower hair zinc concentrations, whereas ASD patients in non-Asian countries had higher hair zinc concentrations in comparison with control subjects. This study found significant differences in the content of trace elements between patients with ASD compared to controls. The findings help highlighting the role of trace elements as environmental factors in the etiology of ASD.
AbstractList	Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children. It is considered a multifactorial condition, where trace elements are among environmental factors that may contribute to ASD. Meanwhile, the between-study variance is high. The present systematic review was designed to investigate the difference in trace element measures between patients with ASD and control subjects. Meta-analyses showed that the hair concentrations of chromium (p=0.024), cobalt (p=0.012), iodine (p=0.000), iron (p=0.017), and magnesium (p=0.007) in ASD patients were significantly lower than those of control subjects, while there were higher magnesium levels in the hair of ASD patients compared to that of controls (p=0.010). Patients with ASD had higher blood levels of copper (p=0.000) and lower levels of zinc compared to controls (p=0.021). Further urinary iodine levels in patients with ASD were decreased in comparison with controls (p=0.026). Sensitivity analyses showed that ASD patients in non-Asian but not in Asian countries had lower hair concentrations of chromium compared to controls. Also, such analyses indicated that ASD patients in Asian countries had lower hair zinc concentrations, whereas ASD patients in non-Asian countries had higher hair zinc concentrations in comparison with control subjects. This study found significant differences in the content of trace elements between patients with ASD compared to controls. The findings help highlighting the role of trace elements as environmental factors in the etiology of ASD.Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children. It is considered a multifactorial condition, where trace elements are among environmental factors that may contribute to ASD. Meanwhile, the between-study variance is high. The present systematic review was designed to investigate the difference in trace element measures between patients with ASD and control subjects. Meta-analyses showed that the hair concentrations of chromium (p=0.024), cobalt (p=0.012), iodine (p=0.000), iron (p=0.017), and magnesium (p=0.007) in ASD patients were significantly lower than those of control subjects, while there were higher magnesium levels in the hair of ASD patients compared to that of controls (p=0.010). Patients with ASD had higher blood levels of copper (p=0.000) and lower levels of zinc compared to controls (p=0.021). Further urinary iodine levels in patients with ASD were decreased in comparison with controls (p=0.026). Sensitivity analyses showed that ASD patients in non-Asian but not in Asian countries had lower hair concentrations of chromium compared to controls. Also, such analyses indicated that ASD patients in Asian countries had lower hair zinc concentrations, whereas ASD patients in non-Asian countries had higher hair zinc concentrations in comparison with control subjects. This study found significant differences in the content of trace elements between patients with ASD compared to controls. The findings help highlighting the role of trace elements as environmental factors in the etiology of ASD. Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children. It is considered a multifactorial condition, where trace elements are among environmental factors that may contribute to ASD. Meanwhile, the between-study variance is high. The present systematic review was designed to investigate the difference in trace element measures between patients with ASD and control subjects. Meta-analyses showed that the hair concentrations of chromium ( =0.024), cobalt ( =0.012), iodine ( =0.000), iron ( =0.017), and magnesium ( =0.007) in ASD patients were significantly lower than those of control subjects, while there were higher magnesium levels in the hair of ASD patients compared to that of controls ( =0.010). Patients with ASD had higher blood levels of copper ( =0.000) and lower levels of zinc compared to controls ( =0.021). Further urinary iodine levels in patients with ASD were decreased in comparison with controls ( =0.026). Sensitivity analyses showed that ASD patients in non-Asian but not in Asian countries had lower hair concentrations of chromium compared to controls. Also, such analyses indicated that ASD patients in Asian countries had lower hair zinc concentrations, whereas ASD patients in non-Asian countries had higher hair zinc concentrations in comparison with control subjects. This study found significant differences in the content of trace elements between patients with ASD compared to controls. The findings help highlighting the role of trace elements as environmental factors in the etiology of ASD. Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children. It is considered a multifactorial condition, where trace elements are among environmental factors that may contribute to ASD. Meanwhile, the between-study variance is high. The present systematic review was designed to investigate the difference in trace element measures between patients with ASD and control subjects. Meta-analyses showed that the hair concentrations of chromium ([p]=0.024), cobalt ([p]=0.012), iodine ([p]=0.000), iron ([p]=0.017), and magnesium ([p]=0.007) in ASD patients were significantly lower than those of control subjects, while there were higher magnesium levels in the hair of ASD patients compared to that of controls ([p]=0.010). Patients with ASD had higher blood levels of copper ([p]=0.000) and lower levels of zinc compared to controls ([p]=0.021). Further urinary iodine levels in patients with ASD were decreased in comparison with controls ([p]=0.026). Sensitivity analyses showed that ASD patients in non-Asian but not in Asian countries had lower hair concentrations of chromium compared to controls. Also, such analyses indicated that ASD patients in Asian countries had lower hair zinc concentrations, whereas ASD patients in non-Asian countries had higher hair zinc concentrations in comparison with control subjects. This study found significant differences in the content of trace elements between patients with ASD compared to controls. The findings help highlighting the role of trace elements as environmental factors in the etiology of ASD. Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children. It is considered a multifactorial condition, where trace elements are among environmental factors that may contribute to ASD. Meanwhile, the between-study variance is high. The present systematic review was designed to investigate the difference in trace element measures between patients with ASD and control subjects. Meta-analyses showed that the hair concentrations of chromium ( p =0.024), cobalt ( p =0.012), iodine ( p =0.000), iron ( p =0.017), and magnesium ( p =0.007) in ASD patients were significantly lower than those of control subjects, while there were higher magnesium levels in the hair of ASD patients compared to that of controls ( p =0.010). Patients with ASD had higher blood levels of copper ( p =0.000) and lower levels of zinc compared to controls ( p =0.021). Further urinary iodine levels in patients with ASD were decreased in comparison with controls ( p =0.026). Sensitivity analyses showed that ASD patients in non-Asian but not in Asian countries had lower hair concentrations of chromium compared to controls. Also, such analyses indicated that ASD patients in Asian countries had lower hair zinc concentrations, whereas ASD patients in non-Asian countries had higher hair zinc concentrations in comparison with control subjects. This study found significant differences in the content of trace elements between patients with ASD compared to controls. The findings help highlighting the role of trace elements as environmental factors in the etiology of ASD.
Author	Saghazadeh, Amene Hendi, Kasra Rezaei, Nima Saleh, Fatemeh Ahangari, Narges
Author_xml	– sequence: 1 givenname: Amene surname: Saghazadeh fullname: Saghazadeh, Amene organization: MetaCognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran – sequence: 2 givenname: Narges surname: Ahangari fullname: Ahangari, Narges organization: NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran – sequence: 3 givenname: Kasra surname: Hendi fullname: Hendi, Kasra organization: NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran – sequence: 4 givenname: Fatemeh surname: Saleh fullname: Saleh, Fatemeh organization: NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran – sequence: 5 givenname: Nima surname: Rezaei fullname: Rezaei, Nima email: Rezaei_nima@tums.ac.ir organization: Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Boston, MA, USA
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Snippet	Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that imposes heavy financial burden on governments and families of affected children....
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SubjectTerms	Asia Asian People Autism Autism Spectrum Disorder - blood Autism Spectrum Disorder - ethnology Autism Spectrum Disorder - metabolism Blood levels Children Chromium Cobalt copper Environmental factors Etiology Hair Hair - metabolism Health risk assessment Humans Iodine iron Magnesium Meta-analysis Neurodevelopmental disorders Systematic review Trace elements Trace Elements - blood Trace Elements - metabolism zinc Zinc - blood Zinc - metabolism
Title	Status of essential elements in autism spectrum disorder: systematic review and meta-analysis
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