Association between maternal gestational diabetes mellitus and the risk of autism spectrum disorder in offspring / 中国当代儿科杂志

OBJECTIVES@#To explore the association between maternal gestational diabetes mellitus (GDM) exposure and the development of autism spectrum disorder (ASD) in offspring.@*METHODS@#A case-control study was conducted, recruiting 221 children with ASD and 400 healthy children as controls. Questionnaires and interviews were used to collect information on general characteristics of the children, socio-economic characteristics of the family, maternal pregnancy history, and maternal disease exposure during pregnancy. Multivariate logistic regression analysis was used to investigate the association between maternal GDM exposure and the development of ASD in offspring. The potential interaction between offspring gender and maternal GDM exposure on the development of ASD in offspring was explored.@*RESULTS@#The proportion of maternal GDM was significantly higher in the ASD group compared to the control group (16.3% vs 9.4%, P=0.014). After adjusting for variables such as gender, gestational age, mode of delivery, parity, and maternal education level, maternal GDM exposure was a risk factor for ASD in offspring (OR=2.18, 95%CI: 1.04-4.54, P=0.038). On the basis of adjusting the above variables, after further adjusting the variables including prenatal intake of multivitamins, folic acid intake in the first three months of pregnancy, and assisted reproduction the result trend did not change, but no statistical significance was observed (OR=1.94, 95%CI: 0.74-5.11, P=0.183). There was an interaction between maternal GDM exposure and offspring gender on the development of ASD in offspring (P<0.001). Gender stratified analysis showed that only in male offspring of mothers with GDM, the risk of ASD was significantly increased (OR=3.67, 95%CI: 1.16-11.65, P=0.027).@*CONCLUSIONS@#Maternal GDM exposure might increase the risk of ASD in offspring. There is an interaction between GDM exposure and offspring gender in the development of ASD in offspring.

[Effects of Huatan Tongluo Granule on SOCS-3 and TNF-alpha expressions in patients with acute cerebral infarction].

OBJECTIVE: To observe the effect of Huatan Tongluo Granule (HTG) on the expression of suppressors of cytokine signaling-3 (SOCS-3) and tumor necrosis factor-alpha (TNF-alpha) in patients with acute cerebral infarction (ACI) of phlegm-wind-stasis obstruction (PWSO) syndrome type. METHODS: Sixty-six ACI patients of PWSO type admitted within 72 h were randomized into the treatment group (34 cases) and the control group (32 cases), they were treated with foundational therapeutics, but HTG was given additionally to patients in the treatment group. SOCS-3 expression was detected by ELISA before treatment (d0) and on the 3rd (d3) and 7th day (d7) of treatment; TNF-alpha expression was detected by chemiluminescence at dO and d7. Data were compared with the respective parameters obtained from 20 healthy persons as normal control. Meantime, the degree of neuro-deficit in the two groups was evaluated by NIH Stroke scale and Barthel index on d0, d7, d14 and d21. RESULTS: SOCS-3 expression at d0, d3, d7; and TNF-alpha expression at d0, d7 were higher in the two patients' groups significantly than in normal controls (P < 0.05). As compared with the control group, on d7, SOCS-3 expression was higher (360.98 +/- 123.31 ng/L vs. 281.87 +/- 133.66 ng/L) and TNF-alpha expression was lower (35.72 +/- 19.94 ng/L vs. 49.86 +/- 34.79 ng/L), while the NIHSS score on d7 and d14, as well as the Barthel index on d14 and d21 were lower in the treatment group (all P < 0.05). CONCLUSIONS: The acting mechanism of HTG for promoting nerve function recovery of ACI patients is possibly and closely related with the up-regulation of the inflammation suppressive factor SOCS-3, the down-regulation of the inflammation promoting factor TNF-alpha, and the elimination of secondary inflammatory injury after cerebral ischemia.