Children with autism commonly suffer from comorbid functional gastrointestinal disorders (FGID) and anxiety. The raised prevalence of both conditions in autism suggests complex reciprocal relationships, which are seldom explored in non-treatment-seeking FGID. The relationships between subtypes of FGID and anxiety are also unclear. This study recruited boys with autism and age-matched typically developing (TD) boys, aged 4–11 years, who were not actively seeking help for gastrointestinal problems. Their parents completed the Rome IV Diagnostic Questionnaires for Pediatric FGID. Four groups of children with and without autism/FGID were identified and compared on their anxiety level using the Spence children's anxiety scale. In 69 boys with autism and 69 age-matched TD boys, FGID were identified in 22 and 16 boys, respectively. ANCOVA demonstrated a significant interaction effect of autism and FGID on anxiety (F[1, 129] = 5.43, p = 0.021), while conditional logistic regression identified an interaction effect of autism and anxiety on the odds of FGID (OR 1.038, 95% CI 1.002–1.075, p = 0.038). Explorative post hoc analysis showed higher anxiety in functional nausea and vomiting disorder (p = 0.033) and functional abdominal pain disorder (p = 0.029) among boys with autism than TD boys with the same respective subtypes of FGID. In summary, among prepubertal boys with autism, the presence of FGID that are non-treatment-seeking in nature, has a significantly stronger association with higher levels of anxiety than TD boys. The strength of association may be more prominent in subtypes of FGID. Possible pathomechanisms including the underlying microbiota spectra and inflammatory paths should be explored in future studies.

中文翻译：

---

患有非寻求治疗的功能性胃肠病的青春期前自闭症男孩的焦虑水平升高：病例对照研究

自闭症儿童通常同时患有功能性胃肠道疾病 (FGID) 和焦虑症。自闭症中这两种疾病的患病率升高表明复杂的相互关系，这在非寻求治疗的 FGID 中很少被探索。FGID 亚型与焦虑之间的关系也不清楚。该研究招募了患有自闭症的男孩和年龄匹配的典型发育 (TD) 男孩，年龄在 4-11 岁之间，他们没有积极寻求胃肠道问题的帮助。他们的父母完成了罗马 IV 儿科 FGID 诊断问卷。使用 Spence 儿童焦虑量表确定并比较了四组患有和不患有自闭症/FGID 的儿童的焦虑水平。在 69 名自闭症男孩和 69 名年龄匹配的 TD 男孩中，分别有 22 名和 16 名男孩患有 FGID。p  = 0.021），而条件逻辑回归确定了自闭症和焦虑对 FGID 几率的交互作用（OR 1.038，95% CI 1.002–1.075，p  = 0.038）。探索性事后分析显示功能性恶心和呕吐障碍 ( p  = 0.033) 和功能性腹痛障碍 ( p ) 的焦虑程度更高 = 0.029) 在自闭症男孩中，与具有相同 FGID 各自亚型的 TD 男孩相比。总之，在患有自闭症的青春期前男孩中，与 TD 男孩相比，本质上非寻求治疗的 FGID 的存在与更高水平的焦虑具有显着更强的关联。在 FGID 的亚型中，关联的强度可能更为突出。未来的研究应探索可能的病理机制，包括潜在的微生物群谱和炎症途径。