Uzun Necati, Akıncı Mehmet Akif, Alp Hayrullah
Department of Child and Adolescent Psychiatry, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
Department of Child and Adolescent Psychiatry, Dr.Ali Kemal Belviranlı Maternity and Children Hospital, Konya, Turkey.
Clin Psychopharmacol Neurosci. 2023 Feb 28;21(1):77-87. doi: 10.9758/cpn.2023.21.1.77.
The aim of this case-controlled study is to evaluate chronic inflammation, subclinical atherosclerosis and cardiovascular disease risk in children and adolescents with ADHD.
A total of 51 medication-free children and adolescents with ADHD and 51 healthy controls were included in this study. K-SADS-PL was used to determine the diagnosis of ADHD and other psychiatric disorders. Conners' Parent Rating Scale-Revised Short Form and the Conners' Teacher Rating Scale-Revised Short Form severity of ADHD was used to evaluate severity of ADHD. In order to evaluate subclinical atherosclerosis, common carotid intima media thickness (IMT), epicardial adipose tissue thickness (EAT), and periaortic adipose tissue thickness (PAT) were assessed as well as clinical parameters.
The IMT (0.037 ± 0.005 cm vs. 0.026 ± 0.003 cm), EAT (0.472 ± 0.076 cm vs. 0.355 ± 0.051 cm), and PAT (0.135 ± 0.016 cm vs. 0.118 ± 0.009 cm) measurements were significantly higher in the ADHD group than in the control group. Additionally, partial correlation analyses revealed that a positive correlation was observed between IMT and EAT, and PAT measurements separately. Multivariate linear regression analysis revealed that, body mass index (BMI) positively predicted IMT. Also, age and BMI positively predicted the EAT levels of the subjects with ADHD.
Our results suggest that children and adolescents with ADHD have a risk for cardiovascular disease. For this reason, subclinical atherosclerosis should be taken into consideration in the follow-up and treatment of ADHD for cardiovascular disease risk.
本病例对照研究旨在评估患有注意力缺陷多动障碍（ADHD）的儿童和青少年的慢性炎症、亚临床动脉粥样硬化及心血管疾病风险。
本研究共纳入51名未服用药物的ADHD儿童和青少年以及51名健康对照者。使用儿童版情感障碍和精神分裂症问卷（K-SADS-PL）来确定ADHD及其他精神疾病的诊断。采用修订版康纳斯父母评定量表简式版和修订版康纳斯教师评定量表简式版来评估ADHD的严重程度。为了评估亚临床动脉粥样硬化，对颈总动脉内膜中层厚度（IMT）、心外膜脂肪组织厚度（EAT）和主动脉周围脂肪组织厚度（PAT）以及临床参数进行了评估。
ADHD组的IMT（0.037±0.005厘米对0.026±0.003厘米）、EAT（0.472±0.076厘米对0.355±0.051厘米）和PAT（0.135±0.016厘米对0.118±0.009厘米）测量值显著高于对照组。此外，偏相关分析显示，IMT与EAT以及PAT测量值之间分别存在正相关。多变量线性回归分析显示，体重指数（BMI）正向预测IMT。而且，年龄和BMI正向预测ADHD患者的EAT水平。
我们的结果表明，患有ADHD的儿童和青少年存在心血管疾病风险。因此，在ADHD的随访和治疗中应考虑亚临床动脉粥样硬化以评估心血管疾病风险。
