Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in China
Abstract Background High serotonin (5-hydroxytryptamine [5-HT]) blood levels are the most reliable and frequently replicated biomarker for autism spectrum disorders (ASDs). However, their differential influence on core ASD symptoms in males and females remains unclear. This study aimed to investigat...
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BMC
2025-03-01
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| Series: | Child and Adolescent Psychiatry and Mental Health |
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| Online Access: | https://doi.org/10.1186/s13034-025-00892-7 |
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| author | Qiu-hong Mou Qian Zhang Li Chen Ying Dai Hua Wei Fei-Yong Jia Yan Hao Ling Li Jie Zhang Li-Jie Wu Xiao-Yan Ke Ming-Ji Yi Qi Hong Jin-Jin Chen Shuan-Feng Fang Yi-Chao Wang Qi Wang Jie Chen Ting-Yu Li Ting Yang |
| author_facet | Qiu-hong Mou Qian Zhang Li Chen Ying Dai Hua Wei Fei-Yong Jia Yan Hao Ling Li Jie Zhang Li-Jie Wu Xiao-Yan Ke Ming-Ji Yi Qi Hong Jin-Jin Chen Shuan-Feng Fang Yi-Chao Wang Qi Wang Jie Chen Ting-Yu Li Ting Yang |
| author_sort | Qiu-hong Mou |
| collection | DOAJ |
| description | Abstract Background High serotonin (5-hydroxytryptamine [5-HT]) blood levels are the most reliable and frequently replicated biomarker for autism spectrum disorders (ASDs). However, their differential influence on core ASD symptoms in males and females remains unclear. This study aimed to investigate the changes in 5-HT levels in children with ASD to assess and compare its influence on the core symptoms and neurodevelopment of boys and girls. Methods Herein, 1,457 ASD children and 1,305 typically developing (TD) controls (age = 2–7 years) were enrolled from 13 cities across China. Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS) were used to evaluate the ASD symptoms in children, and the revised Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was used to evaluate their neurodevelopment. The 5-HT serum levels were measured by high-performance liquid chromatography-tandem mass spectrometry. Results In boys with ASD, increased serum 5-HT levels correlated with high scores on SRS and CARS and with communication warning behavior of CNBS-R2016. Conversely, concomitant decline was observed in the scores on the general, language, gross motor, adaptive behavior, and personal-social quotients. Notably, no differences were found in girls with ASD. Conclusions Children with ASD, especially boys, presented higher serum 5-HT levels compared with TD children. Additionally, increased 5-HT content is considerably positively associated with core ASD symptoms and negatively associated with neurodevelopment in boys with ASD. Overall, this study highlights the gender bias in patients with ASD regarding 5-HT serum levels, underscoring its influence on ASD prevalence in a sex-specific manner. Trial registration This study has been approved by the Ethics Committee of the Children’s Hospital of Chongqing Medical University (approval number: (2018) IRB (STUDY) NO.121). Additionally, this study is registered with the China Clinical Trial Registry (Registration Number: ChiCTR2000031194). |
| format | Article |
| id | doaj-art-7ba461bfc39f4b33b4f6522d8ad894a2 |
| institution | DOAJ |
| issn | 1753-2000 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | Child and Adolescent Psychiatry and Mental Health |
| spelling | doaj-art-7ba461bfc39f4b33b4f6522d8ad894a22025-08-20T02:49:33ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002025-03-0119111010.1186/s13034-025-00892-7Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in ChinaQiu-hong Mou0Qian Zhang1Li Chen2Ying Dai3Hua Wei4Fei-Yong Jia5Yan Hao6Ling Li7Jie Zhang8Li-Jie Wu9Xiao-Yan Ke10Ming-Ji Yi11Qi Hong12Jin-Jin Chen13Shuan-Feng Fang14Yi-Chao Wang15Qi Wang16Jie Chen17Ting-Yu Li18Ting Yang19Growth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityGrowth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityGrowth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityGrowth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityGrowth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityDepartment of developmental and behavioral pediatrics, The First Hospital of Jilin UniversityDepartment of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Children Rehabilitation, Hainan Women and Children’S Medical CenterChildren Health Care Center, Xi’an Children’S HospitalDepartment of Children’S and Adolescent Health, Public Health College of Harbin Medical UniversityChild Mental Health Research Center of Nanjing Brain HospitalDepartment of Child Health Care, The Affiliated Hospital of Qingdao UniversityMaternal and Child Health Hospital of BaoanDepartment of Child Healthcare, Shanghai Children’S Hospital, Shanghai Jiao Tong UniversityChildren’S Hospital Affiliated to Zhengzhou UniversityNHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDeyang Maternity & Child Healthcare HospitalGrowth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityGrowth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityGrowth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children’S Hospital of Chongqing Medical UniversityAbstract Background High serotonin (5-hydroxytryptamine [5-HT]) blood levels are the most reliable and frequently replicated biomarker for autism spectrum disorders (ASDs). However, their differential influence on core ASD symptoms in males and females remains unclear. This study aimed to investigate the changes in 5-HT levels in children with ASD to assess and compare its influence on the core symptoms and neurodevelopment of boys and girls. Methods Herein, 1,457 ASD children and 1,305 typically developing (TD) controls (age = 2–7 years) were enrolled from 13 cities across China. Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS) were used to evaluate the ASD symptoms in children, and the revised Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was used to evaluate their neurodevelopment. The 5-HT serum levels were measured by high-performance liquid chromatography-tandem mass spectrometry. Results In boys with ASD, increased serum 5-HT levels correlated with high scores on SRS and CARS and with communication warning behavior of CNBS-R2016. Conversely, concomitant decline was observed in the scores on the general, language, gross motor, adaptive behavior, and personal-social quotients. Notably, no differences were found in girls with ASD. Conclusions Children with ASD, especially boys, presented higher serum 5-HT levels compared with TD children. Additionally, increased 5-HT content is considerably positively associated with core ASD symptoms and negatively associated with neurodevelopment in boys with ASD. Overall, this study highlights the gender bias in patients with ASD regarding 5-HT serum levels, underscoring its influence on ASD prevalence in a sex-specific manner. Trial registration This study has been approved by the Ethics Committee of the Children’s Hospital of Chongqing Medical University (approval number: (2018) IRB (STUDY) NO.121). Additionally, this study is registered with the China Clinical Trial Registry (Registration Number: ChiCTR2000031194).https://doi.org/10.1186/s13034-025-00892-7Autism spectrum disorder5-HTNeurological developmentClinical symptomsSex differences |
| spellingShingle | Qiu-hong Mou Qian Zhang Li Chen Ying Dai Hua Wei Fei-Yong Jia Yan Hao Ling Li Jie Zhang Li-Jie Wu Xiao-Yan Ke Ming-Ji Yi Qi Hong Jin-Jin Chen Shuan-Feng Fang Yi-Chao Wang Qi Wang Jie Chen Ting-Yu Li Ting Yang Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in China Child and Adolescent Psychiatry and Mental Health Autism spectrum disorder 5-HT Neurological development Clinical symptoms Sex differences |
| title | Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in China |
| title_full | Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in China |
| title_fullStr | Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in China |
| title_full_unstemmed | Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in China |
| title_short | Gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders: A multicenter study in China |
| title_sort | gender specific influence of serotonin on core symptoms and neurodevelopment of autism spectrum disorders a multicenter study in china |
| topic | Autism spectrum disorder 5-HT Neurological development Clinical symptoms Sex differences |
| url | https://doi.org/10.1186/s13034-025-00892-7 |
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