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Serum folate and brain-derived neurotrophic factor in pediatric autism spectrum disorder and their predictive role in illness severity
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DOI：10.5498/wjp.v16.i3.112418.png)
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Abstract
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BACKGROUND Autism spectrum disorder (ASD) involves social and neurological impairment, and affected individuals have an elevated risk of bullying. AIM To clarify serum folate (SF) and brain-derived neurotrophic factor (BDNF) expression in ASD-affected children and evaluate their prediction value for illness severity. METHODS From February 2023 to February 2025, 53 ASD-affected children and 50 healthy controls visiting Fuzhou University Affiliated Provincial Hospital were enrolled as the research and control groups, respectively. SF and BDNF levels were measured in all children. The Childhood Autism Rating Scale (CARS) was used to assess ASD symptom severity. In ASD cases, SF and BDNF expression differences were compared across illness-severity subgroups and before versus after treatment. Pearson r was used to assess correlations between SF/BDNF and CARS in the research group. Receiver operating characteristic (ROC) curves were used to assess their predictive value for ASD severity. Univariate and multivariate binary Logistic models were used to identify ASD progression determinants. RESULTS ASD children showed significantly lower SF and higher BDNF higher than controls. Severe cases had lower SF and higher BDNF than mild-to-moderate cases. SF correlated inversely with the CARS score, whereas BDNF correlated positively. For predicting ASD severity, the area under the ROC curve (AUC) of SF and BDNF was 0.700-0.750, and their combined use increased the AUC to 0.823. Both markers were confirmed to be independent determinants of ASD aggravation. CONCLUSION SF is down-regulated and BDNF is up-regulated in ASD-affected children, SF correlates negatively with ASD severity and BDNF correlates positively. Low SF and high BDNF are risk factors for ASD deterioration in children.
Keywords:
Serum folate
Brain-derived neurotrophic factor
Autism spectrum disorder
Children
Illness severity
Receiver operating characteristic curve
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