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埃及儿童的营养模式与注意缺陷多动障碍:基于同胞和社区匹配的病例对照研究。

Nutrients patterns and attention deficit hyperactivity disorder among Egyptian children: a sibling and community matched case-control study.

机构信息

Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Department of Neuropsychiatry, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Eur J Clin Nutr. 2024 Jan;78(1):64-71. doi: 10.1038/s41430-023-01345-0. Epub 2023 Sep 26.

Abstract

BACKGROUND

Attention Deficit Hyperactive Disorder (ADHD) diagnosis has been growing among children, with great public health concern. The relationship between nutrient intake pattern and ADHD remains unclear.

AIM

To identify the nutrient intake patterns and its association with ADHD in children.

SUBJECTS AND METHODS

The study involved 146 children with ADHD, 141 control sibling, and 146 community controls. ADHD diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) criteria following the assessment by the long-form Conner's Scale. Dietary intakes were assessed using a semi-quantitative food frequency questionnaire. Nutrients patterns were identified using the principal component analysis (PCA).

RESULTS

ADHD children have significantly higher mean total energy intake than community controls and siblings (8867.9, 4481.9 and 7308.2 KJ, respectively, p < 0.001). Four nutrient patterns extracted by the PCA explained 75.9% of the total variance. Lower tertiles of "predominantly calcium-phosphorus; pattern 1" and "predominantly-vitamins; pattern 3" were significantly associated with increasing odds of ADHD, compared to community controls (p for trend: 0.002 and 0.005, respectively), while the same associations were noted in "predominantly-vitamins" and "predominantly Zinc-Iron; pattern 2" when compared to siblings (p for trend: <0.001 and <0.001, respectively). However, Higher tertiles of macronutrients; pattern 4" were associated with increased ADHD odds, compared to either community controls or siblings (p for trend: 0.017 and <0.001, respectively).

CONCLUSION

Lower intakes of nutrients patterns of minerals and vitamins, and higher intakes of macronutrients were associated with increased likelihood of ADHD in children.

摘要

背景

注意缺陷多动障碍(ADHD)在儿童中的诊断率不断上升,引起了公众的高度关注。营养摄入模式与 ADHD 之间的关系尚不清楚。

目的

确定儿童的营养摄入模式及其与 ADHD 的关系。

研究对象和方法

本研究纳入了 146 名 ADHD 患儿、141 名对照同胞和 146 名社区对照。ADHD 的诊断采用第五版《精神障碍诊断与统计手册》(DSM-V)标准,并通过长型康纳氏量表进行评估。采用半定量食物频率问卷评估膳食摄入量。采用主成分分析(PCA)确定营养素模式。

结果

与社区对照和同胞相比,ADHD 患儿的平均总能量摄入明显更高(分别为 8867.9、4481.9 和 7308.2KJ,p<0.001)。通过 PCA 提取的 4 种营养素模式解释了总方差的 75.9%。与社区对照相比,“主要为钙磷;模式 1”和“主要为维生素;模式 3”的低三分位数与 ADHD 风险增加显著相关(趋势检验 p 值分别为 0.002 和 0.005),而在与同胞相比时,同样也观察到“主要为维生素”和“主要为锌铁;模式 2”的情况(趋势检验 p 值分别为 <0.001 和 <0.001)。然而,与社区对照或同胞相比,较高三分位的“宏量营养素;模式 4”与 ADHD 风险增加相关(趋势检验 p 值分别为 0.017 和 <0.001)。

结论

矿物质和维生素的营养摄入模式较低,以及宏量营养素的摄入较高,与儿童 ADHD 的可能性增加相关。

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