Schab David W, Trinh Nhi-Ha T
Columbia University, Department of Psychiatry & The New York State Psychiatric Institute, New York, New York 10032, USA.
J Dev Behav Pediatr. 2004 Dec;25(6):423-34. doi: 10.1097/00004703-200412000-00007.
Burgeoning estimates of the prevalence of childhood attention-deficit/hyperactivity disorder (ADHD) raise the possibility of a widespread risk factor. We seek to assess whether artificial food colorings (AFCs) contribute to the behavioral symptomatology of hyperactive syndromes. We searched ten electronic databases for double-blind placebo-controlled trials evaluating the effects of AFCs. Fifteen trials met the primary inclusion criteria. Meta-analytic modeling determined the overall effect size of AFCs on hyperactivity to be 0.283 (95% CI, 0.079 to 0.488), falling to 0.210 (95% CI, 0.007 to 0.414) when the smallest and lowest quality trials were excluded. Trials screening for responsiveness before enrollment demonstrated the greatest effects. Despite indications of publication bias and other limitations, this study is consistent with accumulating evidence that neurobehavioral toxicity may characterize a variety of widely distributed chemicals. Improvement in the identification of responders is required before strong clinical recommendations can be made.
对儿童注意力缺陷多动障碍（ADHD）患病率的预估不断增加，这引发了存在广泛风险因素的可能性。我们旨在评估人工食用色素（AFCs）是否会导致多动综合征的行为症状。我们在十个电子数据库中搜索了评估AFCs作用的双盲安慰剂对照试验。十五项试验符合主要纳入标准。荟萃分析模型确定AFCs对多动的总体效应大小为0.283（95%置信区间，0.079至0.488），排除最小且质量最低的试验后降至0.210（95%置信区间，0.007至0.414）。在入组前筛查反应性的试验显示出最大效果。尽管存在发表偏倚迹象和其他局限性，但本研究与越来越多的证据一致，即神经行为毒性可能是多种广泛分布的化学物质的特征。在能够提出强有力的临床建议之前，需要改进对反应者的识别。
