Altern Ther Health Med. 2024 Jan;30(1):13-17.
Atopic dermatitis (AD) is a chronic inflammatory skin disease and commonly affects children. AD is associated with a high incidence of ADHD, the most common psychological and neurobehavioral disorder in children and adolescents. If clinicians don't identify ADHD and intervene early, preschool children can experience adverse effects.
The study intended to investigate the prevalence of attention deficit hyperactivity disorder (ADHD) in preschool children with AD, analyze the associated factors, and provide insights for early identification of risk factors and the development of interventions to reduce the likelihood of ADHD occurrence.
The research team performed a prospective, observational, case-control study.
The study took place at the Zhoushan branch of Ruijin Hospital at the Shanghai Jiaotong University School of Medicine in Zhoushan, Zhejiang, China.
Participants were 80 school-aged children diagnosed with AD and admitted to the hospital between May 2019 and May 2023.
Based on the presence or absence of ADHD, the research team divided the children into two groups: (1) the Simple AD group with 71 participants with AD only, and the AD + ADHD group, with 9 participants with AD and ADHD.
The research team: (1) collected and analyzed participants' demographic and clinical data, including an assessment of the AD severity using the SCORing Atopic Dermatitis (SCORAD) scale and the presence of sleep disorders using the Children's Sleep Habits Questionnaire (CSHQ); (2) assessed the presence of ADHD using the Swanson, Nolan, and Pelham-IV rating scales (SNAP-IV); (3) analyzed the factors influencing the occurrence of ADHD in AD children, using univariate and multivariate logistic regression analysis.
Among the 80 school-age children with AD, 9 participants (11.25%) had received a diagnosis of ADHD. The AD + ADHD group's age (P < .001); body mass index (BMI), with P < .001; AD severity (P = .013); rate of sleep disorders (P = .001); and levels of serum interleukin 6 (IL-6), with (P < .001), interleukin 4 (IL-4), with (P < .001), and nerve growth factor (NGF), with (P < .001) were all significantly greater than those of the Simple AD group. The univariate logistic regression analysis indicated that age (P = .014), BMI (P = .024), AD severity (P = .022), sleep disorders (P = .042), and levels of IL-6 (P = .044), IL-4 (P = .045), and NGF (P = .046) were all significantly related to the development of ADHD in school-age children with AD. The multivariate logistic regression analysis revealed that sleep disorders (P = .018) and elevated levels of serum IL-6 (P = .032), IL-4 (P = .021), and NGF (P = .016 ) were independent risk factors for ADHD (OR = 2.651, 3.074, 2.686, 3.340).
School-aged children with AD are more likely to develop ADHD, which is mainly associated with sleep disorders and elevated levels of serum IL-6, IL-4, and NGF. Clinicians should give attention to these risk factors and implement early interventions to reduce the risk of children with AD developing ADHD.
特应性皮炎（AD）是一种慢性炎症性皮肤病，常见于儿童。AD 与 ADHD 的发病率很高，ADHD 是儿童和青少年最常见的心理和神经行为障碍。如果临床医生没有识别出 ADHD 并及早进行干预，学龄前儿童可能会出现不良影响。
研究旨在调查学龄前 AD 儿童 ADHD 的患病率，分析相关因素，为早期识别危险因素和制定干预措施提供依据，以降低 ADHD 发生的可能性。
研究团队进行了一项前瞻性、观察性、病例对照研究。
中国浙江舟山，上海交通大学医学院附属瑞金医院舟山分院。
2019 年 5 月至 2023 年 5 月期间，80 名被诊断为 AD 并住院的学龄儿童。
根据是否存在 ADHD，将儿童分为两组：（1）单纯 AD 组，71 名仅患有 AD；（2）AD+ADHD 组，9 名患有 AD 和 ADHD。
80 名 AD 学龄儿童中，9 名（11.25%）被诊断为 ADHD。AD+ADHD 组的年龄（P<0.001）、体重指数（BMI）（P<0.001）、AD 严重程度（P=0.013）、睡眠障碍发生率（P=0.001）、血清白细胞介素 6（IL-6）（P<0.001）、白细胞介素 4（IL-4）（P<0.001）和神经生长因子（NGF）（P<0.001）水平均显著高于单纯 AD 组。单因素 logistic 回归分析显示，年龄（P=0.014）、BMI（P=0.024）、AD 严重程度（P=0.022）、睡眠障碍（P=0.042）和血清 IL-6（P=0.044）、IL-4（P=0.045）和 NGF（P=0.046）水平与 AD 学龄儿童 ADHD 的发生均显著相关。多因素 logistic 回归分析显示，睡眠障碍（P=0.018）和血清 IL-6（P=0.032）、IL-4（P=0.021）和 NGF（P=0.016）水平升高是 ADHD 的独立危险因素（OR=2.651、3.074、2.686、3.340）。
AD 学龄儿童更易发生 ADHD，主要与睡眠障碍和血清 IL-6、IL-4 和 NGF 水平升高有关。临床医生应关注这些危险因素，并实施早期干预措施，以降低 AD 儿童发生 ADHD 的风险。
