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Vitamin D profile in autism spectrum disorder children and its relation to the disease severity

To the Editor,

In their distinguished study, Mansour et al. [1] found that among Egyptian children with autism spectrum disorder (ASD), the prevalence of vitamin D (VD) insufficiency, VD deficiency, and VD sufficiency (normal serum VD levels) were 63.8%, 28.8%, and 7.4% respectively. Moreover, no association was noted between serum VD levels and childhood autism rating scale scores, language age, and diagnostic and statistical manual of mental disorders, fifth edition severity levels. As a result, they concluded that VD deficiency might contribute to ASD occurrence in genetically vulnerable children and VD therapy might be beneficial as an adjuvant treatment modality [1]. It is important to notice that accurate evaluation of the VD profile in the pediatric population to optimize bone health demands using VD reference intervals (VDRI) [2]. In many parts of the world, pediatric VDRI is characterized according to the American academy of pediatrics /LWEPS’s recommendations into the following groups for use in clinical settings and research: normal (20-100 ng/mL), insufficiency (15-20 ng/mL), deficiency (5-15 ng/mL), and severe deficiency (<5 ng/mL) [3]. In the study methodology, Mansour et al. [1] stated that they referred to the VDRI launched by Holick, which is primarily designed for the adult population [4]. The employed VDRI were the following: hazardous levels (>100 ng/ml), normal levels (30-100 ng/ml), insufficiency (20-29 ng/ml), and deficiency (<20 ng/ml) [4]. Indeed, there are significant differences between pediatric [3] and adult VDRI [4] to characterize VD profile. As a result, referring Mansour et al. [1] to adult VDRI rather than pediatric one in their study could call their findings into question.

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  1. Mansour A, Amer A, Sobh A, Zaki M, Abou-Elsaad T (2024) Vitamin D profile in autism spectrum disorder children and its relation to the disease severity. Egypt J Otolaryngol 40:7.

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  2. Antonucci R, Locci C, Clemente MG, Chicconi E, Antonucci L (2018) Vitamin D deficiency in childhood: old lessons and current challenges. J Pediatr Endocrinol Metab 31(3):247–260.

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  3. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M (2008) Drug and therapeutics committee of the lawson wilkins pediatric endocrine society (2008) vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 122(2):398–417.

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  4. Holick MF (2017) The vitamin D deficiency pandemic: approaches for diagnosis, treatment, and prevention. Rev Endocr Metab Disord 18(2):153–165.

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MDA reviewed the literature on vitamin D, wrote and edited the manuscript, and made the final approval.

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Correspondence to Mahmood D. Al-Mendalawi.

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Al-Mendalawi, M.D. Vitamin D profile in autism spectrum disorder children and its relation to the disease severity. Egypt J Otolaryngol 40, 54 (2024).

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