Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; RUDN University, Moscow, Russia; Taipei Medical University, Taipei, Taiwan.
Yaroslavl State University, 150003, Yaroslavl, Russia.
J Trace Elem Med Biol. 2020 Mar;58:126445. doi: 10.1016/j.jtemb.2019.126445. Epub 2019 Dec 6.
Essential trace elements and minerals play a significant role in neurodevelopment. Although certain studies demonstrated impaired essential trace element and mineral status in children with ADHD, the existing data are insufficient. The objective of the present study was to assess serum trace element and mineral levels in children with ADHD.
Serum trace element and mineral levels in 68 children with ADHD and 68 neurotypical controls were assessed using ICP-MS at NexION 300D (PerkinElmer Inc., USA) equipped with ESI SC-2 DX4 autosampler (Elemental Scientific Inc., USA).
Serum Cr, Mg, and Zn levels in children with ADHD were 21 % (p = 0.010), 4 % (p = 0.005), and 7 % (p = 0. 001) lower as compared to the healthy controls, respectively. In turn, serum Cu/Zn values were 11 % higher than those in the control group. Age and gender had a significant impact on serum element levels in ADHD. Particularly, preschool children were characterized by significantly increased Cu (+8 %; p = 0.034), and Cu/Zn (+19 %; p < 0.001) values, whereas serum Zn (-9 %; p = 0.004) level was decreased. In primary school-aged children only 6 % (p = 0.007) lower Mg levels were observed. Both boys and girls with ADHD were characterized by 8 % (p = 0.016) lower serum Zn levels and 10 % (p = 0.049) higher Cu/Zn values when compared to neurotypical girls. Boys with ADHD also had significantly higher Cu/Zn, exceeding the respective control values by 12 % (p = 0.021), predominantly due to a 7 % (p = 0.035) decrease in serum Zn. Serum Mg levels were also found to be significantly lower than those in neurotypical children by 5 % (p = 0.007). In adjusted regression models serum Cr (β=-0.234; p = 0.009) and Cu/Zn (β = 0.245; p = 0.029) values were significantly associated with ADHD, respectively. Two-way ANOVA revealed a significant impact of ADHD on Cr, Mg, Zn, and Cu/Zn, whereas age was associated with Cu, I, Mg, Mo, and Cu/Zn, whereas gender accounted only for variability in serum Mn levels. Principal component analysis (PCA) also revealed significant contributions of Mg, Zn, and Cu/Zn values to ADHD variability.
Hypothetically, the observed decrease of essential trace elements, namely Mg and Zn, and elevation of Cu/Zn may significantly contribute to the risk of ADHD or its severity and/or comorbidity.
必需微量元素和矿物质在神经发育中起着重要作用。尽管某些研究表明 ADHD 儿童存在必需微量元素和矿物质状态受损，但现有数据仍不充分。本研究旨在评估 ADHD 儿童的血清微量元素和矿物质水平。
使用配备 ESI SC-2 DX4 自动进样器（Elemental Scientific Inc.，美国）的 NexION 300D（PerkinElmer Inc.，美国）ICP-MS 对 68 名 ADHD 儿童和 68 名神经典型对照者的血清微量元素和矿物质水平进行评估。
与健康对照组相比，ADHD 儿童的血清 Cr、Mg 和 Zn 水平分别低 21%（p=0.010）、4%（p=0.005）和 7%（p=0.001）。相反，血清 Cu/Zn 值高 11%。年龄和性别对 ADHD 患者的血清元素水平有显著影响。特别是学龄前儿童的 Cu（+8%；p=0.034）和 Cu/Zn（+19%；p<0.001）值显著增加，而血清 Zn（-9%；p=0.004）水平降低。在小学年龄组，仅观察到血清 Mg 水平降低 6%（p=0.007）。与神经典型女孩相比，ADHD 男孩和女孩的血清 Zn 水平分别低 8%（p=0.016）和 Cu/Zn 水平高 10%（p=0.049）。ADHD 男孩的 Cu/Zn 也明显更高，比相应的对照值高 12%（p=0.021），主要是由于血清 Zn 减少 7%（p=0.035）所致。血清 Mg 水平也明显低于神经典型儿童，低 5%（p=0.007）。在调整后的回归模型中，血清 Cr（β=-0.234；p=0.009）和 Cu/Zn（β=0.245；p=0.029）值与 ADHD 分别显著相关。双向方差分析显示 ADHD 对 Cr、Mg、Zn 和 Cu/Zn 有显著影响，而年龄与 Cu、I、Mg、Mo 和 Cu/Zn 有关，性别仅与血清 Mn 水平的变异性有关。主成分分析（PCA）也显示 Mg、Zn 和 Cu/Zn 值对 ADHD 变异性有显著贡献。
假设观察到的必需微量元素减少，即 Mg 和 Zn，以及 Cu/Zn 升高，可能显著增加 ADHD 的风险或其严重程度和/或共病。
