Department of Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
Prog Neuropsychopharmacol Biol Psychiatry. 2019 Mar 2;90:134-141. doi: 10.1016/j.pnpbp.2018.11.012. Epub 2018 Nov 26.
The pathophysiology of attention deficient hyperactivity disorder (ADHD) is still obscure. Some studies have discussed that magnesium levels are lower in the serum and erythrocytes of children with ADHD. However, these findings are controversial. The aim of our study is to identify whether magnesium levels are in fact lower in children with ADHD. We conducted a thorough search of the literature and examined the connection between magnesium insufficiency and ADHD. A total of twelve studies were included into the current meta-analysis. The results of our meta-analysis found that peripheral blood magnesium levels, either in plasma, serum, or whole blood, of children diagnosed with ADHD were significantly lower than those in controls (k = 8, Hedges' g = -0.547, 95% CI = -0.818 to -0.276, p < .001). The subgroup meta-analysis with serum sample sources also suggested that peripheral serum magnesium levels of children diagnosed with ADHD were significantly lower than those in controls (k = 6, Hedges' g = -0.733, 95% CI = -0.911 to -0.555, p < .001). The subgroup meta-analysis focusing on subjects with ADHD diagnosed by definite diagnostic criteria also suggested significantly lower peripheral serum magnesium levels in ADHD children than those in controls (k = 4, Hedges' g = -0.780, 95% CI = -0.985 to -0.574, p < .001). We also noted that magnesium levels in the hair of children diagnosed with ADHD were significantly lower than those in controls (k = 4, Hedges' g = -0.713, 95% CI = -1.359 to -0.067, p = .031). In this meta-analysis, we found that children diagnosed with ADHD have lower serum and hair magnesium levels than children without ADHD. Further study may be needed to investigate the behavioral influence on ADHD due to lower magnesium levels, the association between brain and serum magnesium levels, and the effects brought about by larger longitudinal cohort studies.
注意缺陷多动障碍(ADHD)的病理生理学仍然不清楚。一些研究表明,ADHD 儿童的血清和红细胞中的镁水平较低。然而,这些发现存在争议。我们的研究目的是确定 ADHD 儿童的镁水平是否确实较低。我们进行了全面的文献检索,并检查了镁不足与 ADHD 之间的联系。共有 12 项研究纳入了本次荟萃分析。我们的荟萃分析结果发现,诊断为 ADHD 的儿童的外周血镁水平(血浆、血清或全血)明显低于对照组(k=8,Hedges'g=-0.547,95%CI=-0.818 至-0.276,p<0.001)。采用血清样本来源的亚组荟萃分析也表明,诊断为 ADHD 的儿童的外周血清镁水平明显低于对照组(k=6,Hedges'g=-0.733,95%CI=-0.911 至-0.555,p<0.001)。关注的是根据明确诊断标准诊断为 ADHD 的受试者的亚组荟萃分析也表明,ADHD 儿童的外周血清镁水平明显低于对照组(k=4,Hedges'g=-0.780,95%CI=-0.985 至-0.574,p<0.001)。我们还注意到,诊断为 ADHD 的儿童的头发中的镁水平明显低于对照组(k=4,Hedges'g=-0.713,95%CI=-1.359 至-0.067,p=0.031)。在这项荟萃分析中,我们发现诊断为 ADHD 的儿童的血清和头发镁水平低于没有 ADHD 的儿童。可能需要进一步的研究来调查由于镁水平降低对 ADHD 的行为影响、大脑和血清镁水平之间的关系以及更大的纵向队列研究带来的影响。