Meng Zhuo, Ao Bo, Wang Wei, Niu Tongtong, Chen Yanan, Ma Xiaoqing, Huang Youliang
School of Management, Beijing University of Chinese Medicine, Beijing, China.
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.
Front Psychiatry. 2024 Sep 23;15:1441191. doi: 10.3389/fpsyt.2024.1441191. eCollection 2024.
In previous observational studies and meta-analyses, childhood attention deficit hyperactivity disorder (ADHD) is found to have a significant association with screen time. However, the causal associations between them remain unclear.
This study performed a bidirectional two-sample Mendelian randomization (MR) analysis to confirm the causality between screen time and childhood ADHD. Large-scale genome-wide association studies (GWAS) datasets derived from the Psychiatric Genomics Consortium (PGC) and the UK Biobank were used to identify single nucleotide polymorphisms (SNPs) associated with exposure and outcome. Four categories of datasets were selected to represent screen time. The SNPs that are significantly associated with exposure data (P < 5e-08) and have a strong correlation with the exposure in the F-statistic (F > 10) were selected as instrumental variables. This study also used the PhenoScanner V2 database and the LDlink webtool to exclude confounding factors, and the MR-PRESSO method (p < 0.05) was employed to eliminate outliers with bias. Five commonly used methods were employed to assess the interaction and the Inverse Variance Weighted (IVW) method was utilized as the primary basis for determining the MR estimates in this study.
The MR analysis revealed that the length of mobile phone use (OR, 1.848; 95% CI, 1.3360-2.5558; p=2.07e-4) and the time spent watching television (OR, 2.104; 95% CI, 1.3958-3.1703; p=3.8e-4) increased the risk of childhood ADHD. Although the causal relationships were exclusively identified through the IVW and weighted median methods, the results retained their statistical significance following correction. In the reverse analysis, no evidence was found to support an effect of childhood ADHD on screen time. The sensitivity analysis conducted on the significant findings revealed no evidence of horizontal pleiotropy or heterogeneity.
This study provides some evidence for the causality of screen time and childhood ADHD. Given the limitations of our study, further research is required to comprehensively investigate this relationship.
在之前的观察性研究和荟萃分析中，发现儿童注意力缺陷多动障碍（ADHD）与屏幕使用时间存在显著关联。然而，它们之间的因果关系仍不明确。
本研究进行了双向双样本孟德尔随机化（MR）分析，以证实屏幕使用时间与儿童ADHD之间的因果关系。使用来自精神基因组学联盟（PGC）和英国生物银行的大规模全基因组关联研究（GWAS）数据集来识别与暴露和结局相关的单核苷酸多态性（SNP）。选择四类数据集来代表屏幕使用时间。将与暴露数据显著相关（P < 5e - 08）且在F统计量中与暴露有强相关性（F > 10）的SNP选为工具变量。本研究还使用PhenoScanner V2数据库和LDlink网络工具排除混杂因素，并采用MR - PRESSO方法（p < 0.05）消除有偏差的异常值。采用五种常用方法评估相互作用，并将逆方差加权（IVW）方法作为本研究确定MR估计值的主要依据。
MR分析显示，使用手机的时长（OR，1.848；95% CI，1.3360 - 2.5558；p = 2.07e - 4）和看电视的时长（OR，2.104；95% CI，1.3958 - 3.1703；p = 3.8e - 4）会增加儿童患ADHD的风险。尽管因果关系仅通过IVW和加权中位数方法确定，但校正后结果仍具有统计学意义。在反向分析中，未发现证据支持儿童ADHD对屏幕使用时间有影响。对显著结果进行的敏感性分析未发现水平多效性或异质性的证据。
本研究为屏幕使用时间与儿童ADHD之间的因果关系提供了一些证据。鉴于本研究的局限性，需要进一步研究以全面调查这种关系。
