Different Levels of Salivary Free N‐Acetylneuraminic Acid (Sialic Acid) Between Children With Autism Spectrum Disorder and Healthy Ones

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AIM: The objective of this investigation is to explore the potential correlation between salivary free Sias and ASD. METHODS: This case-control study enrolled 141 children with ASD and 123 age-matched healthy controls. Utilising an enzymatic assay, we determined the free Sias in saliva. Using the CARS, the behavioural symptoms of children with ASD were evaluated and ranked from mild to severe. A feeding questionnaire was developed and completed by 108 children with ASD and 114 controls. RESULTS: The level of salivary free Sias was significantly lower in the control group than in the ASD group (p < 0.001). The diagnostic value of salivary free Sias for ASD has a sensitivity of 54.6%, specificity of 97.6%, and an area under the ROC curve of 0.803. The level of salivary free Sias, total breastfeeding time, and time of adding solid food are significantly different between the two controls and ASD who completed the feeding questionnaire. ASD children were found to be associated with a high level of Sias (OR 1.007, 95% CI 1.005-1.010) and a reduced total breastfeeding duration (OR 0.887, 95% CI 0.887-0.949) in a subsequent multivariate analysis. The rate of various primary feeding patterns after birth is significantly different between the ASD and control group (p < 0.001). CONCLUSION: The data suggests that free salivary Sias has the potential to be utilised as a biomarker for the diagnosis of ASD. However, a well-designed prospective study is necessary to reach a more definitive conclusion about breastfeeding's ability to protect against ASD.

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