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注意缺陷多动障碍患者的甲状腺和皮质醇激素:病例对照研究。

Thyroid and Cortisol hormones in Attention Deficit Hyperactivity Disorder: A case-control study.

机构信息

Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry 605006, India.

Department of Psychiatry, AIIMS , New Delhi, India.

出版信息

Asian J Psychiatr. 2017 Aug;28:73-77. doi: 10.1016/j.ajp.2017.03.005. Epub 2017 Mar 22.

DOI:10.1016/j.ajp.2017.03.005
PMID:28784401
Abstract

AIM

There is paucity of research in the putative role of hormonal biomarkers in Attention Deficit Hyperactivity Disorder (ADHD). The current study aimed to analyze the clinical profile, socio-demographic status, co-morbidity, hormonal biomarkers namely Thyroid hormones and Cortisol in children with ADHD and compare them with healthy controls and to explore the association of the hormonal biomarkers with severity of ADHD.

METHODS

Thirty children with DSM-IV TR diagnosis of ADHD were assessed using semi structured proforma, Conners' Parent Rating Scale revised short (CPRS - R: S) , Mini international neuropsychiatric interview for children and adolescents and Childrens' Global Assessment Scale as well as serum levels of total Triiodothyronine (T3) ,total Thyroxine (T4) , Thyroid Stimulating Hormone (TSH) and Cortisol using chemiluminescent immunometric assay and compared with 30 age- and gender -matched controls.

RESULTS

The typical profile of cases of ADHD was of a male with mean age of 9.47 years (S.D=2.43) belonging to Hyperactive subtype of ADHD. Serum T4 was significantly lower in cases compared to controls. No significant difference was found in serum T3, TSH and Cortisol levels. No significant correlation between the CPRS : R-S scores and the hormonal biomarkers.

CONCLUSIONS

There is need for exploration of Serum T4 as putative biomarker for ADHD with replication in future studies. It may also be important to report the negative finding of Cortisol as a biomarker of ADHD in the context of effective utilization of resources for research with special relevance to resource deficit developing countries.

摘要

目的

在注意力缺陷多动障碍(ADHD)中,激素生物标志物的作用研究甚少。本研究旨在分析ADHD 患儿的临床特征、社会人口统计学状况、共病情况、甲状腺激素和皮质醇等激素生物标志物,并与健康对照组进行比较,并探讨这些激素生物标志物与 ADHD 严重程度的关系。

方法

使用半结构式问卷、康纳斯父母评定量表修订版短表(CPRS-R:S)、儿童国际神经精神访谈和儿童总体评估量表对 30 名符合 DSM-IV-TR 诊断的 ADHD 儿童进行评估,并检测其血清总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、促甲状腺激素(TSH)和皮质醇水平,采用化学发光免疫分析。将这些结果与 30 名年龄和性别匹配的对照组进行比较。

结果

ADHD 患儿的典型特征是男性,平均年龄为 9.47 岁(S.D=2.43),属于 ADHD 多动冲动型。与对照组相比,病例组的血清 T4 明显降低。血清 T3、TSH 和皮质醇水平无显著差异。CPRS-R:S 评分与激素生物标志物之间无显著相关性。

结论

需要进一步探索血清 T4 是否可作为 ADHD 的潜在生物标志物,未来需要进一步研究。在有效利用研究资源的背景下,报告皮质醇作为 ADHD 生物标志物的阴性发现可能也很重要,这对资源匮乏的发展中国家具有特殊意义。

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