Prospective cohort study of vitamin D and autism spectrum disorder diagnoses in early childhood
Ali Y., Anderson LN., Smile S., Chen Y., Borkhoff CM., Koroshegyi C., Lebovic G., Parkin PC., Birken CS., Szatmari P., Maguire JL., Lau E., Laupacis A., Parkin PC., Salter M., Weir S., Dai DWH., Kowal C., Mason D., Abdurrahman M., Anderson B., Anderson K., Arbess G., Baker J., Barozzino T., Bergeron S., Bhagat D., Blanchette N., Bloch G., Bonifacio J., Bowry A., Brown A., Bugera J., Calpin C., Campbell D., Cheema S., Cheng E., Chisamore B., Constantin E., Culbert E., Danayan K., Das P., Beth Derocher M., Do A., Dorey M., Doukas K., Egger A., Farber A., Freedman A., Freeman S., Gazeley S., Guiang C., Ha D., Hafiz S., Handford C., Hanson L., Harrington L., Hatch H., Hughes T., Jacobson S., Jagiello L., Jansz G., Jasuja M., Kadar P., Kiran T., Kitney L., Knowles H., Kwok B., Lakhoo S., Lam-Antoniades M., Leung FH., Li A., Li P., Loo J., Louis J., Mahmoud S., Malach J., Male R., Mascoll V., Meret A., Moodie R., Morinis J., Nader M., Nash K., Naymark S., Owen J., Parry J., Peer M., Pena K., Perlmutar M., Persaud N., Pinto A., Porepa M., Qi V., Ramji N., Ramji N., Rana J., Raza D., Rosenthal A., Rouleau K.
Several studies have suggested an association between vitamin D in childhood and autism spectrum disorder. No prospective studies have evaluated whether lower vitamin D levels precede ASD diagnoses – a necessary condition for causality. The objective of this study was to prospectively evaluate whether vitamin D serum levels in early childhood was associated with incident physician diagnosed ASD. A prospective cohort study was conducted using data from preschool-aged children in the TARGet Kids! practice-based research network in Toronto, Canada, from June 2008 to July 2015. 25-hydroxyvitamin D concentration was measured through blood samples and vitamin D supplementation from parent report. Autism spectrum disorder diagnosis was determined from medical records at follow-up visits. Covariates included age, sex, family history of autism spectrum disorder, maternal ethnicity, and neighborhood household income. Unadjusted and adjusted relative risks and 95% confidence intervals were estimated using Poisson regression with a robust error variance. In this study, 3852 children were included. Autism spectrum disorder diagnosis was identified in 41 children (incidence = 1.1%) over the observation period (average follow-up time = 2.5 years). An association between 25-hydroxyvitamin D concentration and autism spectrum disorder was not identified in the unadjusted (relative risk = 1.04, 95% confidence interval: 0.97, 1.11 per 10 nmol/L increase in 25-hydroxyvitamin D concentration) or adjusted models (adjusted relative risk = 1.06; 95% confidence interval: 0.95, 1.18). An association between vitamin D supplementation in early childhood and autism spectrum disorder was also not identified (adjusted relative risk = 0.86, 95% confidence interval: 0.46, 1.62). Vitamin D in early childhood may not be associated with incident physician diagnoses of autism spectrum disorder.