血清促甲状腺激素水平与注意力缺陷/多动障碍儿童的多动行为有关。
Serum TSH Levels are Associated with Hyperactivity Behaviors in Children with Attention Deficit/Hyperactivity Disorder.
作者信息
Chen Guanru, Gao Wenfan, Xu Yayun, Chen Huiying, Cai Heping
机构信息
Department of Clinical Pharmacy, Anhui Provincial Children's Hospital, Hefei, Anhui, People's Republic of China.
Psychopharmacology Research Laboratory, Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
出版信息
Neuropsychiatr Dis Treat. 2023 Mar 7;19:557-564. doi: 10.2147/NDT.S402530. eCollection 2023.
OBJECTIVE
Previous studies indicated that maternal thyroid dysfunction increase the offspring's risk for attention deficit/hyperactivity disorder (ADHD). However, the relationship between thyroid function and symptoms in children with ADHD remains unclear.
METHODS
A total of 49 children with ADHD were enrolled. The Conners 3 scale was used to estimate the symptoms associated with ADHD. Correlation between thyroid hormones and the scores of the Conners 3 scale was evaluated by Pearson correlation analysis. Then, ADHD children were divided into two groups according to the hyperactivity index (HI) of the Conners 3 scale: ADHD children with hyperactivity behaviors (HB) (HI > 1.5) and ADHD children without HB (HI < 1.5). The demographic characteristics, thyroid hormones, and routine laboratory parameters between the two groups were collected. To distinguish HI-related factors, a univariate analysis and a binary logistic regression predictive model were used. The discriminative ability of thyroid stimulating hormone (TSH) in predicting ADHD children with HB from ADHD children without HB was investigated using the receiver operating characteristic (ROC) curve method.
RESULTS
The levels of TSH were positively correlated to the scores of the Conners 3 scale (r = 0.338, = 0.033) and HI (r = 0.371, = 0.019). Moreover, the levels of TSH, serum ferritin, and lactic acid were significantly increased in ADHD children with HB compared to ADHD children without HB (all < 0.05). Furthermore, the results of binary logistic regression found that TSH (OR 2.243 (CL 1.052-4.783)) and lactic acid (OR 1.018 (CI 1.003-1.032)) were independently associated with HI. Additionally, ROC analysis indicated the potential diagnostic value of TSH in discriminating ADHD children with HB from ADHD children without HB with an AUC of 0.684.
CONCLUSION
These results suggested that the serum TSH levels may be related to the HB in children with ADHD.
目的
先前的研究表明，母亲甲状腺功能障碍会增加后代患注意力缺陷多动障碍（ADHD）的风险。然而，甲状腺功能与ADHD患儿症状之间的关系仍不明确。
方法
共纳入49例ADHD患儿。使用康纳斯3量表评估与ADHD相关的症状。通过Pearson相关分析评估甲状腺激素与康纳斯3量表得分之间的相关性。然后，根据康纳斯3量表的多动指数（HI）将ADHD患儿分为两组：有多动行为（HB）的ADHD患儿（HI>1.5）和无HB的ADHD患儿（HI<1.5）。收集两组之间的人口统计学特征、甲状腺激素和常规实验室参数。为了区分与HI相关的因素，使用单因素分析和二元逻辑回归预测模型。采用受试者工作特征（ROC）曲线法研究促甲状腺激素（TSH）在区分有HB的ADHD患儿和无HB的ADHD患儿中的判别能力。
结果
TSH水平与康纳斯3量表得分呈正相关（r=0.338，P=0.033），与HI呈正相关（r=0.371，P=0.019）。此外，与无HB的ADHD患儿相比，有HB的ADHD患儿的TSH、血清铁蛋白和乳酸水平显著升高（均P<0.05）。此外，二元逻辑回归结果发现TSH（比值比2.243（可信区间1.052-4.783））和乳酸（比值比1.018（可信区间1.003-1.032））与HI独立相关。此外，ROC分析表明TSH在区分有HB的ADHD患儿和无HB的ADHD患儿方面具有潜在诊断价值，曲线下面积为0.684。
结论
这些结果表明，血清TSH水平可能与ADHD患儿的HB有关。
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