Evaluation of Iron Status in Children with Autism Spectral Disorder: A Case-control Study

Abstract

Introduction: Iron is an important factor in neural development. Iron Deficiency (ID) and Iron Deficiency Anaemia (IDA) anaemia is highly prevalent in patients of autism. There are a very small number of studies to show association between iron profile and autism. Aim: To investigate factors affecting iron status such as hemoglobin (%), serum iron, ferritin, and Total Iron Binding Capacity (TIBC) level in children with Autism Spectral Disorder (ASD) and healthy control. Materials and Methods: It was a case-control study done from April 2018 to April 2019. Total 100 participants were recruited of which 50 autistic patients were taken as cases, and 50 healthy subjects were taken as control. Childhood Autism Rating Scale (CARS) was used to evaluate the severity of autistic symptoms. Cut-off value of serum ferritin was <10 ng/mL for preschoolers (<6 years) and <12 ng/mL for school-aged (>6 years) children to evaluate ID. Anaemia was defined as haemoglobin <11.0 g/dL for preschoolers and <12.0 g/dL for school-aged categorical variables and were compared by using chi-square test. Normally distributed parametric variables were compared between groups by using independent samples t-test. Serum ferritin, iron, TIBC values were compared between severe, mild-moderate and control groups with ANOVA. The p-value <0.05 was accepted to be statistically significant. Results: Mean serum levels of ferritin iron TIBC were significantly reduced in ASD patients (p<0.001). The level of haemoglobin was also lower in ASD patients but it was not significant. Risk of ID and IDA was higher than normal subjects (RR for ID 1.74). Level of serum ferritin, iron and TIBC was lowest in severe autism as compared to mild-moderate autism and control groups. Conclusion: These findings suggest iron and ferritin levels should be measured in autistic patients as a baseline investigation and it may be used as a screening test for ASD.