Soy Infant Formula and Seizures in Children with Autism: A Retrospective Study

自闭症儿童中含大豆婴儿配方乳粉与癫痫：一项回顾性研究

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0080488

Cara J. Westmark westmark@wisc.edu

作者：卡拉·J·维斯特马克

Affiliation: Department of Neurology, University of Wisconsin, Madison, Wisconsin, United States of America

就职机构：美国威斯康辛大学麦迪逊分校神经学系。

Seizures are a common phenotype in many neurodevelopmental disorders including fragile X syndrome, Down syndrome and autism.

癫痫是脆性X综合征,唐氏综合症和自闭症在内许多神经发育失调症中一种通常的常见的表型。

We hypothesized that phytoestrogens in soy-based infant formula were contributing to lower seizure threshold in these disorders.

我们假设大豆婴儿配方乳粉中的植物雌激素是导致这些疾病发作阈值较低。

Herein, we evaluated the dependence of seizure incidence on infant formula in a population of autistic children. Medical record data were obtained on 1,949 autistic children from the SFARI Simplex Collection.

在此，我们评价了一个自闭症患者群中癫痫发生率对婴儿配方乳粉的依赖。从《塞蒙斯基金会自闭症研究倡议》（SFARI）的单纯形集合获得了1,949位自闭症儿童的医学记录数据。

An autism diagnosis was determined by scores on the ADI-R and ADOS exams.

自闭症诊断依据ADI-R和ADOS测试的成绩确定。

The database included data on infant formula use, seizure incidence, the specific type of seizure exhibited and IQ.

数据库包括喂食的婴儿配方乳粉、癫痫发生率、显示的癫痫类型与智商（IQ）。

Soy-based formula was utilized in 17.5% of the study population.

研究的自闭症儿童群体的17.5%食用大豆蛋白为基础婴儿配方乳粉。

Females comprised 13.4% of the subjects. There was a 2.6-fold higher rate of febrile seizures [4.2% versus 1.6%, OR = 2.6, 95% CI = 1.3–5.3], a 2.1-fold higher rate of epilepsy comorbidity [3.6% versus 1.7%, OR = 2.2, 95% CI = 1.1–4.7] and a 4-fold higher rate of simple partial seizures [1.2% versus 0.3%, OR = 4.8, 95% CI = 1.0–23] in the autistic children fed soy-based formula.

研究对象的13.4%为女性儿童。喂食大豆蛋白为基础婴儿配方乳粉自闭症儿童中，发热性癫痫发作率高2.6倍[4.2%对1.6%，OR = 2.6，95% CI = 1.3–5.3]，简单部分癫痫发作高4倍[1.2%对0.3%, OR = 4.8, 95% CI = 1.0–23]。

No statistically significant associations were found with other outcomes including: IQ, age of seizure onset, infantile spasms and atonic, generalized tonic clonic, absence and complex partial seizures.

没有发现与其他结果其他统计显著关联，包括：智商、癫痫发作年龄情况、婴儿痉挛症和清音、广义强直性阵挛性、没有和复杂部分癫痫发作。

Limitations of the study included: infant formula and seizure data were based on parental recall, there were significantly less female subjects, and there was lack of data regarding critical confounders such as the reasons the subjects used soy formula, age at which soy formula was initiated and the length of time on soy formula.

该项研究的局限性包括：婴儿配方奶粉和癫痫数据基于父母的回忆，研究对象中女性显著较少，缺乏某些重要干扰因素的数据，例如研究对象使用大豆蛋白为基础配方乳粉的原因，开始食用的年龄以及食用时间长短。

Despite these limitations, our results suggest that the use of soy-based infant formula may be associated with febrile seizures in both genders and with a diagnosis of epilepsy in males in autistic children.

尽管有这些限制，我们的结果认为，食用大豆婴儿配方奶粉可能与自闭症男女童发热性癫痫发作关联，而且与自闭症儿童中男童的一项癫痫症诊断相关。

Given the lack of data on critical confounders and the retrospective nature of the study, a prospective study is required to confirm the association.

考虑到缺乏干扰因素的数据以及该项研究的回顾性性质，需要进行前瞻性研究来确认这些关联。

Editor: Stephen D. Ginsberg, Nathan Kline Institute and New York University School of Medicine, United States of America

编者：Stephen D. Ginsberg，Nathan Kline研究所与纽约医学大学。

Received: July 8, 2013; Accepted: January 8, 2014; Published: March 12, 2014

收稿日期：2013年7月8日；接受日期：2014年1月8日；发表：2014年3月12日。

Copyright: © 2014 Cara J. Westmark. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

版权：© 2014 Cara J. Westmark。这是一篇开放式文章，依照《知识共享归属许可》条款提供，允许在任何媒体上无限制使用、分布、与复制，条件是列出原作者与出处。

Funding: This work was supported by FRAXA Research Foundation (www.fraxa.org) and National Institutes of Health (NIH) (www.nih.gov) [1UL1RR025011 and 9U54TR000021]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

经费提供：该项研究得到FRAXA研究基金会（www.fraxa.org）与国家健康研究院（NIH）（www.nih.gov）[1UL1RR025011与9U54TR000021]。资金提供方对该项研究的设计、数据收集与分析、决定发表、或论文撰写不发挥任何作用。

Competing interests: The author has declared that no competing interests exist.

竞争性利益：作者宣布不存在任何竞争性的利益。