Kaşak Meryem, Günal Okumuş Hande, Çelik Yusuf Selman, Kırşan Fatma Zehra, Öztürk Yusuf, Efe Ayşegül
Department of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, Ankara, Türkiye.
Department of Child and Adolescent Psychiatry, Uşak Training and Research Hospital, Uşak, Türkiye.
Front Psychiatry. 2025 Jul 16;16:1621767. doi: 10.3389/fpsyt.2025.1621767. eCollection 2025.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, and recent research suggests systemic inflammation contributes to its pathophysiology. This study aimed to evaluate novel inflammatory markers-neutrophil-to-HDL ratio (NHR), lymphocyte-to-HDL ratio (LHR), monocyte-to-HDL ratio (MHR), platelet-to-HDL ratio (PHR), and systemic immune-inflammation index (SII)-in children with ADHD compared to healthy controls. Additionally, it assessed changes in these markers after 12 weeks of long-acting methylphenidate treatment and potential differences among ADHD subtypes.
This prospective study included 114 newly diagnosed, treatment-naive ADHD patients (aged 6-12) and 52 matched controls. Blood samples were obtained at baseline and after 12 weeks of treatment. Inflammatory markers were calculated from complete blood count and HDL levels. ADHD symptom severity was assessed using the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S), and anxiety and depression were measured with the Revised Child Anxiety and Depression Scale (RCADS).
ADHD patients showed significantly elevated baseline levels of NHR, LHR, MHR, PHR, and SII compared to controls (Cohen's d range = 0.17-0.69). NHR independently predicted ADHD. Post-treatment, all inflammatory markers significantly decreased, suggesting a potential anti-inflammatory effect of methylphenidate (Cohen's d range = 0.17-0.91). Post-treatment LHR was higher in the combined ADHD subtype.
This study underscores inflammation's role in ADHD and suggests these markers may reflect systemic inflammation in ADHD, but their clinical utility requires further investigation.
注意力缺陷多动障碍（ADHD）是一种常见的神经发育障碍，近期研究表明全身炎症参与其病理生理过程。本研究旨在评估与健康对照相比，ADHD儿童的新型炎症标志物——中性粒细胞与高密度脂蛋白比值（NHR）、淋巴细胞与高密度脂蛋白比值（LHR）、单核细胞与高密度脂蛋白比值（MHR）、血小板与高密度脂蛋白比值（PHR）以及全身免疫炎症指数（SII）。此外，还评估了长效哌甲酯治疗12周后这些标志物的变化以及ADHD各亚型之间的潜在差异。
这项前瞻性研究纳入了首批确诊的114例未经治疗的ADHD患者（6至12岁）以及年龄匹配的52例对照。在基线和治疗12周后采集血样。根据全血细胞计数和高密度脂蛋白水平计算炎症标志物。使用修订版Conners父母评定量表简表（CPRS-R:S）评估ADHD症状严重程度，使用修订版儿童焦虑抑郁量表（RCADS）测量焦虑和抑郁症状。
与对照组相比，ADHD患者的NHR、LHR、MHR、PHR和SII基线水平显著升高（Cohen's d范围为0.17至0.69）。NHR可独立预测ADHD。治疗后，所有炎症标志物均显著降低，提示哌甲酯具有潜在抗炎作用（Cohen's d范围为0.17至0.91）。联合型ADHD亚型治疗后的LHR较高。
本研究强调了炎症在ADHD中的作用，并提示这些标志物可能反映ADHD中的全身炎症，但它们的临床应用价值仍需进一步研究。
