Turkiye Klinikleri Journal of Pediatrics

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Otizm Spektrum Bozukluğunda D Vitamini
Vitamin D in Autism Spectrum Disorder
Tuğçe ÖZLÜa, Ezgi ARSLANa, Emre Batuhan KENGERa, Can ERGÜNa
aBahçeşehir Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, İstanbul, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2020;29(2):107-14
doi: 10.5336/pediatr.2020-74191
Article Language: TR
Full Text
ÖZET
 Otizm spektrum bozukluğu (OSB); sosyo-iletişimsel işlevsellikteki bozulma, sınırlı ilgi alanları, tekrarlayan veya kalıplaşmış davranışlar ile karakterize olarak görülen bir nörogelişimsel bozukluktur. Epidemiyolojik çalışmalar, OSB farkındalığının artması ve tanı kriterleri ve teşhis yöntemlerinin genişletilmesiyle birlikte OSB prevalansının son 50 yılda arttığını göstermiştir. Yapılan çalışmalar, OSB görülme riski ile D vitamini yetersizliği arasında ilişki olduğunu göstermektedir. Bu derlemede D vitamini ve OSB arasındaki ilişkiyi inceleyen çalışmalar ele alınmıştır. İncelenen sekiz kesitsel çalışmanın tümünde OSB'li çocuklarda serum D vitamini düzeyinin düşük olduğu saptanmıştır. D vitamininin OSB'li çocuklarda tedavi amaçlı kullanımına yönelik incelenen beş çalışmanın dördünde olumlu etkileri olduğu belirlenmiştir. Ayrıca değerlendirilen çalışmalar, gebelik sırasında maternal D vitamini seviyelerinin düşmesinin ve güneş ışığına olan maruziyetin azalmasının OSB riskini arttırabileceğini göstermiştir. D vitamini eksikliğinin, mutasyona uğramış genlerin onarılmaması ile birçok de novo gen mutasyonu oluşumu sonucu OSB patogenezine etki ettiği düşünülmektedir. Başka bir görüşe göre, D vitamini yetersizliği sonucu azalan antioksidan savunmanın OSB olan bireylerin beyninde gerçekleşen nöroglial aktivasyon ve nöroinflamasyon sürecine etki ettiği düşünülmektedir. D vitaminin OSB ile ilişkisi göz önüne alındığında, yetersizlik riski olan gebelerin ve OSB'li çocukların D vitamini eksikliği yönünden taranması ve gerekli durumlarda uygun tedavinin planlanması önem arz etmektedir. OSB'nin önlenmesi ve/veya tedavisinde yapılacak olan randomize kontrollü çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler: Otizm spektrum bozukluğu; D vitamini; tedavi; maternal
ABSTRACT
 Autism spectrum disorder (ASD) is a neurodevelopmental disorder which is characterized by impaired socio-communicative functionality, limited interests, recurrent or stereotyped behaviors. Epidemiological studies have shown that the prevalence of ASD has increased in the last 50 years even if the increase of awareness of ASD and the expansion of diagnostic criteria and diagnostic methods of ASD. Many studies demonstrated that there is an association between the risk of ASD and vitamin D deficiency. In this, review, studies examined the relationship between vitamin D and ASD were considered. All of the examined cross-sectional studies showed that the serum vitamin D level was low among children with ASD. In addition, it was determined that as a therapeutic purpose, vitamin D had positive impacts on children with ASD. On the other hand, investigated studies demonstrated that reduced maternal vitamin D levels during pregnancy and exposure to sunlight may increase the risk of ASD. It has been believed that vitamin D deficiency affects ASD pathogenesis due to the formation of many de novo gene mutations by not repairing the mutated genes. According to another opinion, it has been suggested that the decreased antioxidant defenses as a result of vitamin D deficiency affect the neuroglial activation and neuroinflammation process in the brain of individuals with ASD. As the relationship of vitamin D with ASD, it is crucial to screen pregnant women who are at risk of deficiency and children with ASD in terms of vitamin D deficiency and to plan appropriate treatment if necessary. Randomized controlled trials are required to be carried out in the prevention and/or treatment of ASD.

Keywords: Autism spectrum disorders; vitamin D; treatment; maternal
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