Impact of iron-deficiency anemia on cognitive functions of children with autism spectrum disorders

Abstract

Background
Many children with autism spectrum disorder (ASD) suffer from iron-deficiency anemia (IDA), and the severity of ASD symptoms may be increased by it. There are limited studies on the relationship between IDA parameters with ASD symptoms and cognitive functions. This study aimed to evaluate the iron profile, soluble transferrin receptor and hepcidin mRNA expression in children with ASD and to assess their correlations with cognitive functions in ASD children.


Patients and methods
This study was a case–control study conducted on 100 children diagnosed with ASD. They were divided into group I which consisted of 50 autistic children without IDA; group II which included 50 autistic children with IDA proved by clinical examination and laboratory investigation; and group III formed from 100 healthy control children, their age-matched and sex-matched with the autistic children. Gallium Autism Rating Scale, 3rd edition, was used to evaluate the severity of autistic symptoms, while Stanford-Beint 5th edition was used to evaluate their cognitive functions. Complete blood count, total iron profile, soluble transferrin receptor and hepcidin mRNA expression were done on all studied children.


Results
This study showed a significant lower iron profile among all studied autistic children than controls. Moreover, severe autistic symptoms and lower total intelligence equivalent were found among autistic children with IDA than autistic children without IDA, cognitive functions of the former children were significantly negatively correlated with serum iron, ferritin, transferrin, and hepcidin mRNA expression.


Conclusions
IDA is negatively impacting the autism symptoms severity and the cognitive functions of autistic children.