Department of Medicine, University of Alberta, 260 Heritage Medical Research Centre, Edmonton, Alberta T6G2S2, Canada.
Eat Weight Disord. 2010 Sep;15(3):e144-51. doi: 10.3275/6888. Epub 2010 Mar 8.
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequently reported neuropsychiatric disorders in childhood. However, there is limited data on the biological basis for this disorder. Disturbances in neurotransmitters have been suggested to play a pathophysiologic role. Phenotypically an increased prevalence of obesity has been reported.
To investigate resting energy expenditure (REE) and diet-induced thermogenesis in stimulant medication-naïve children with ADHD.
Case control study of 12 pre-pubertal boys with ADHD of the hyperactive-impulsive type and 12 control boys without ADHD. Anthropometric testing and indirect calorimetry were performed before and after a standardized meal. REE and thermogenesis were measured in each subject at 2 time points. In an independent group of 60 boys with ADHD, BMI standard deviation scores (BMI-SDS) were compared to age-adapted reference values.
REE was on average 6.5 kcal/kg fat free mass/day higher in the ADHD compared to the control group (p<0.01). In contrast, the thermogenic effect of food was not different between the two groups (average increase by 16%, p=n.s.). The repeat measurements, an average of 5±1 months apart, were highly reproducible in all subjects. Age and restlessness did not explain the differences in REE. Boys with ADHD had similar BMI-SDS values (mean BMI-SDS -0.10±0.98) as reference groups.
REE, in contrast to diet-induced thermogenesis, is higher in medication-naïve boys with ADHD. The normal BMI levels suggest increased energy intake in these children.
注意力缺陷多动障碍（ADHD）是儿童期最常见的神经精神疾病之一。然而，关于这种疾病的生物学基础的数据有限。有研究表明，神经递质的紊乱可能在发病机制中发挥作用。表型上，肥胖的发病率也有所增加。
研究未经兴奋剂药物治疗的 ADHD 患儿的静息能量消耗（REE）和饮食诱导产热。
对 12 名患有多动冲动型 ADHD 的青春期前男孩和 12 名无 ADHD 的对照男孩进行病例对照研究。在标准餐前后进行人体测量学和间接测热法检测。在每个受试者的两个时间点测量 REE 和产热。在另一组 60 名患有 ADHD 的男孩中，将 BMI 标准差评分（BMI-SDS）与年龄适应的参考值进行比较。
与对照组相比，ADHD 组的 REE 平均高出 6.5 kcal/kg 去脂体重/天（p<0.01）。相比之下，两组的食物产热效应没有差异（平均增加 16%，p=n.s.）。两次测量之间的平均间隔为 5±1 个月，在所有受试者中均具有高度可重复性。年龄和烦躁不安并不能解释 REE 的差异。患有 ADHD 的男孩的 BMI-SDS 值与参考组相似（平均 BMI-SDS -0.10±0.98）。
与饮食诱导产热相比，未经药物治疗的 ADHD 男孩的 REE 更高。这些儿童的 BMI 水平正常，表明他们的能量摄入增加。
