Reed Claire, Cortese Samuele, Golm Dennis, Brandt Valerie
University of Southampton, Southampton, UK.
University of Southampton, Southampton, UK; Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, NY, USA; University Child Study Center, New York, NY, USA; University "Aldo Moro", Bari, Italy.
J Am Acad Child Adolesc Psychiatry. 2024 Nov 5. doi: 10.1016/j.jaac.2024.09.009.
Attention-deficit/hyperactivity disorder (ADHD) is associated with lower birth weight, but also with obesity in childhood. Findings on the direction of this association are mixed. This study investigated the relationship between weight and ADHD from birth across development.
We used data from the Millennium Cohort Study (MCS), collected at 7 time points between age 9 months and 17 years. ADHD diagnosis status and scores on the Strength and Difficulties Questionnaire (SDQ) were used to create an ADHD group and a control group. Random intercept cross-lagged panel models were conducted in female individuals (n = 4,051) and male individuals (n = 3,857) to examine bidirectional associations between body mass index (BMI) z scores and SDQ scores between ages 3 and 17 years. Analyses were adjusted for common risk factors for ADHD and obesity, such as sex assigned at birth, multiple births, and ADHD medication status.
Children in the ADHD group were significantly lighter in weight at birth than the control group (t[5674] = 2.65, 95% CI = 0.02, 0.14, p = .008) and were significantly more likely to have obesity at age 5 years onward (odds ratio range = 1.57-2.46, relative risk range 0.98-2.29). Path analyses conducted separately for male and female individuals showed that higher ADHD symptoms in female individuals at ages 7, 11, and 14 years significantly predicted higher BMI z scores at ages 11, 14, and 17 years, respectively. In male individuals, this association was seen only between ages 11 and 14 years (β = 0.07; 95% CI = 0.04-0.10, p < .001).
Results suggest that interventions for children with ADHD, and their parents, should begin as soon as possible, ideally prenatally. Developmental sex differences should be considered.
注意力缺陷多动障碍（ADHD）与低出生体重有关，但也与儿童期肥胖有关。关于这种关联方向的研究结果不一。本研究调查了从出生到整个发育过程中体重与ADHD之间的关系。
我们使用了千禧队列研究（MCS）的数据，该数据在9个月至17岁之间的7个时间点收集。ADHD诊断状态和优势与困难问卷（SDQ）得分用于创建ADHD组和对照组。对女性个体（n = 4,051）和男性个体（n = 3,857）进行随机截距交叉滞后面板模型分析，以检验3至17岁之间体重指数（BMI）z评分与SDQ评分之间的双向关联。分析针对ADHD和肥胖的常见风险因素进行了调整，如出生时指定的性别、多胞胎和ADHD药物治疗状态。
ADHD组儿童出生时体重明显低于对照组（t[5674] = 2.65，95% CI = 0.02，0.14，p = .008），并且从5岁起肥胖的可能性明显更高（优势比范围 = 1.57 - 2.46，相对风险范围0.98 - 2.29）。分别对男性和女性个体进行的路径分析表明，7岁、11岁和14岁女性个体中较高的ADHD症状分别显著预测了11岁、14岁和17岁时较高的BMI z评分。在男性个体中，这种关联仅在11岁至14岁之间出现（β = 0.07；95% CI = 0.04 - 0.10，p < .001）。
结果表明，对ADHD儿童及其父母的干预应尽早开始，理想情况下是在产前。应考虑发育过程中的性别差异。
