Blood biomarker levels of methylation capacity in autism spectrum disorder: a systematic review and meta-analysis Guo B-Q, Ding S-B, Li H-B. Blood biomarker levels of methylation capacity in autism spectrum disorder: a systematic review and metaanalysis.Objective: To compare the peripheral blood levels of methionine (Met), S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), and the SAM/SAH ratio (the most core and predictive indices of cellular methylation ability) between patients with autism spectrum disorder (ASD) and control subjects. Methods: PubMed, Embase, PsycINFO, Web of Science, and Cochrane Library were searched from inception to August 2, 2019, without language restriction. The random-effects model was used to summarize effect sizes. Results: We retrieved 1,493 records, of which 22 studies met inclusion criteria. Our overall analyses revealed that individuals with ASD had significantly decreased levels of Met (22 studies; Hedges' g = À0.62; 95% confidence interval [CI]: À0.89, À0.35), SAM (8 studies; Hedges' g = À0.60; 95% CI: À0.86, À0.34), and the SAM/SAH ratio (8 studies; Hedges' g = À0.98; 95% CI: À1.30, À0.66) and significantly increased levels of SAH (8 studies; Hedges' g = 0.69; 95% CI: 0.43, 0.94). The findings of the overall analyses were quite stable after being verified by sensitivity analyses and in agreement with the corresponding outcomes of subgroup analyses. Additionally, our results from metaanalytic techniques confirmed that the effect estimates of this metaanalysis did not originate from publication bias. Conclusion: Individuals with ASD have substantially aberrant peripheral blood levels of Met, SAM, SAH, and the SAM/SAH ratio, which supports the association between impaired methylation capacity and ASD. Therefore, further investigations into these indices as potential biomarkers for diagnosis and therapeutic targets of ASD are warranted.
Summations• Individuals with ASD had significantly decreased blood levels of Met, SAM, and the SAM/SAH ratio.• Individuals suffering from ASD had significantly increased blood levels of SAH. • These findings support the association between impaired methylation capacity and ASD.
Limitations• The number of studies that analyzed the blood levels of SAM, SAH, and the SAM/SAH ratio in ASD patients was relatively small.• We were unable to exhaustively explore the underlying causes that accounted for the heterogeneity in this meta-analysis.• There were obvious differences in the laboratory operating processes for the analysis of blood samples among studies.