Perspective Biological Markers for Autism Spectrum Disorders: Advantages of the Use of Receiver Operating Characteristic Curves in Evaluating Marker Sensitivity and Specificity

Table 6

Toxic biomarkers, metals and cations. AUC: Area Under the Curve; ASD: Autistic Spectrum Disorders; HC: healthy controls; and SD: standard deviation.

Lab test

Increase

Decrease

values

Receiver Operating Characteristic (ROC)

Diagnosis

Age (Y): range (mean ± SD)

Number; M/F

Control group

Country

Biologic sample

Technique

Reference

Cut-off values

Sensitivity

Specificity

AUC

Urinary phthalate (µg/mL); 5-OH-MEHP

<0.05

0.177

52.1%

75.6%

0.638

Urinary phthalate (µg/mL); 5-Oxo-MEHP

<0.01

0.142

46.0

91.1

0.666

ASD

(11 ± 5)

36/12

HC

Italy

Urine

HPLC electrospray ionization MS

[52]

Urinary phthalate (µg/mL); MEHP

<0.05

0.01

79.2

44.2

0.631

Urinary phthalate (µg/mL); ALL

0.724

39.2

97.8

0.671

Zinc/copper; (μg/dL)

<0.001

0.665

90.0%

91.7%

0.968

ASD

(3.78 ± 1.22)

48/12

HC

China

Serum

[53]

Lead; (mmol/L)

0.001

High level of sensitivity and specificity

Autism

4–12

25

HC

Saudi Arabia

RBC

HCL

[54]

Amyloid beta; (1–40) (pg/mL)

<0.05

165.00

82.7%

75.0%

0.773

Autism

3–16

52

HC

Saudi Arabia

Plasma

ELISA

[55]

Amyloid beta; (1–42) (pg/mL)

<0.05

60.29

82.4%

80.6%

0.905

Ca2+; (mmol/L)

<0.001

8.17

100.0%

100.0%

1.000

Na+; (mmol/L)

<0.05

124.50

100.0%

71.4%

0.786

K+; (mmol/L)

<0.001

7.00

84.0%

85.7%

0.900

ASD

4–12

25 male

HC

Saudi Arabia

Plasma

[46]

Ca2+/Mg2+

<0.001

4.41

95.8%

100.0%

0.981

Na+/K+

<0.01

17.14

93.8%

78.6%

0.888