The association between thyroid function biomarkers and attention deficit hyperactivity disorder

Albrecht, Diana; Ittermann, Till; Thamm, Michael; Grabe, Hans‐Jörgen; Bahls, Martin; Völzke, Henry

doi:10.1038/s41598-020-75228-w

Cited by 19 publications

(14 citation statements)

References 57 publications

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“…20 Another study has demonstrated that in children, but not in adolescents, increased serum TSH levels were associated with a decreased risk of ADHD diagnosis. 8 More recently, no significant correlation was found between serum TSH levels and the symptoms of ADHD in India. 21 This finding is not in concordance with our results.…”

Section: Discussionmentioning

confidence: 98%

“…7 Several lines of evidence indicate that fetal brain development may be harmed by maternal thyroid dysfunction. 8 Specifically, the risk of ADHD in the offspring is increased by maternal (overt) hyperthyroidism, 9,10 high TSH concentration during pregnancy, 11 and maternal autoimmune thyroiditis 12 in the early stages of pregnancy. More recently, it has been reported that in contrast to children without hyperthyroidism, the prevalence ratio of ADHD in children who have hyperthyroidism is 1.7.…”

Section: Introductionmentioning

confidence: 99%

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Serum TSH Levels are Associated with Hyperactivity Behaviors in Children with Attention Deficit/Hyperactivity Disorder

Chen¹,

Gao²,

Xu³

et al. 2023

NDT

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Previous studies indicated that maternal thyroid dysfunction increase the offspring's risk for attention deficit/hyperactivity disorder (ADHD). However, the relationship between thyroid function and symptoms in children with ADHD remains unclear. Methods: A total of 49 children with ADHD were enrolled. The Conners 3 scale was used to estimate the symptoms associated with ADHD. Correlation between thyroid hormones and the scores of the Conners 3 scale was evaluated by Pearson correlation analysis. Then, ADHD children were divided into two groups according to the hyperactivity index (HI) of the Conners 3 scale: ADHD children with hyperactivity behaviors (HB) (HI > 1.5) and ADHD children without HB (HI < 1.5). The demographic characteristics, thyroid hormones, and routine laboratory parameters between the two groups were collected. To distinguish HI-related factors, a univariate analysis and a binary logistic regression predictive model were used. The discriminative ability of thyroid stimulating hormone (TSH) in predicting ADHD children with HB from ADHD children without HB was investigated using the receiver operating characteristic (ROC) curve method. Results: The levels of TSH were positively correlated to the scores of the Conners 3 scale (r = 0.338, P = 0.033) and HI (r = 0.371, P = 0.019). Moreover, the levels of TSH, serum ferritin, and lactic acid were significantly increased in ADHD children with HB compared to ADHD children without HB (all P < 0.05). Furthermore, the results of binary logistic regression found that TSH ) and lactic acid (OR 1.018 (CI 1.003-1.032)) were independently associated with HI. Additionally, ROC analysis indicated the potential diagnostic value of TSH in discriminating ADHD children with HB from ADHD children without HB with an AUC of 0.684. Conclusion: These results suggested that the serum TSH levels may be related to the HB in children with ADHD.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Serum TSH Levels are Associated with Hyperactivity Behaviors in Children with Attention Deficit/Hyperactivity Disorder

Chen¹,

Gao²,

Xu³

et al. 2023

NDT

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“…Based on these findings, we postulated that the SDQ score has utility in studies that focus on the risk of mental health, prior to an actual disease diagnosis. Along with our studies, the SDQ scores have also been used in earlier biomarker analyses to assess the risk of emotional and behavioral difficulties among children or adolescents [ 34 , 35 ]. Goodman and Goodman showed in their studies that children with higher total difficulty SDQ scores have greater psychopathology, which can be predictive of a disorder status three years later [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

The Interaction between Circulating Cell-Free Mitochondrial DNA and Inflammatory Cytokines in Predicting Human Mental Health Issue Risk in Adolescents: An Explorative Study

et al. 2023

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Adolescence is often a challenging time in which psychiatric issues have a strong connection to mental health disorders later in life. The early identification of the problems can reduce the burden of disease. To date, the effective identification of adolescents at risk of developing mental health problems remains understudied. Altogether, the interaction between circulating cell-free mtDNA (ccf-mtDNA) and inflammatory cytokines in adolescents is insufficiently understood regarding experienced mental health difficulties. Our study selected the participants based on the Strength and Difficulty Questionnaire (SDQ) score using the cut-off points of 3 and 18 for the low and the high score groups, respectively. The answers of the SDQ at the age of 12.2–15.7 years contributed to the investigation of (i) whether ccf-mtDNA units are associated with cytokines, and (ii) if an interaction model for predicting risk of mental health issues is observed. We discovered a sex-specific correlation between the screened markers associated with mental health problems in the low and high SDQ score groups among the male participants and in the low SDQ score group among the female participants. The mitochondrial MT-ND4 and MT-CO1 genes correlated significantly with interleukin-12p70 (IL-12p70) in males and with monocyte chemoattractant protein-1 (MCP-1) in females. Due to the nature of the explorative study, the studied markers alone did not indicate statistical significance for the prediction of mental health problems. Our analysis provided new insight into potential plasma-based biomarkers to predict mental health issues.

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“…Small intrapersonal changes in thyroid function, within the normal reference range, have been linked to adverse health outcomes [5]. Furthermore, TH dysregulation or disease might also influence cognitive functions [6] and mental health, including dysregulated mood [7], depression [8, 9], behavior [10], and attention-deficit hyperactivity disorder in children [11, 12]. The most relevant mechanisms of thyroid dysfunction due to endocrine-disrupting chemicals are: disturbance of overall thyroid gland activity via interference with the TH or TSH receptors through stimulation, inhibition or interference with other receptors on the thyrocyte; stimulation or inhibition of the enzyme functions that mediate the thyroid gland iodine uptake in the synthesis of T3 and T4; and competitive displacement of THs on their binding protein [4].…”

Section: Introductionmentioning

confidence: 99%

Persistent Organic Pollutant Exposure and Thyroid Function among 12-Year-Old Children

et al. 2022

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Introduction Polychlorobiphenyls (PCBs), organochlorine pesticides (OCPs) and per- and polyfluoroalkyl substances (PFASs) are persistent organic pollutants (POPs) having numerous toxicological properties, including thyroid endocrine disruption. Our aim was to assess the impact of POPs on thyroid hormones among 12-years children, while taking puberty into consideration Methods Exposure to 7 PCBs, 4 OCPs and 6 PFASs (in µg/L), and free triiodothyronine (fT3, pg/mL), free thyroxine (fT4, ng/dL) and thyroid-stimulating hormones (TSH, mIU/L) were assessed through blood-serum measurements at age 12 in 249 boys and 227 girls of the PELAGIE mother-child cohort (France). Pubertal status was clinically rated using the Tanner stages. For each POP, associations were estimated using linear regression, adjusted for potential confounders. Results Among boys, hexachlorobenzene and perfluorodecanoic acid were associated with decreased fT3 (log-scale; β (95% Confidence Interval) =-0.07 (-0.12,-0.02) and β=-0.03 (-0.06,-0.00) respectively). Intermediate levels of perfluorohexanesulfonic acid (PFHxS) and PCB180 were associated, respectively, with increased and decreased fT4. After stratification on pubertal status, PCBs and OCPs were associated with decreased TSH only in the more advanced Tanner stages (3, 4 and 5) and with decreased fT3 among early Tanner stages (1-2). Among girls, PFHxS was associated with decreased TSH (log-scale; β=-0.15 (-0.29,-0.00)), and perfluorooctanoic acid was associated with decreased fT3 (β2nd_tercile=-0.06 (-0.10,-0.03) and β3rd_tercile=-0.04 (-0.08,-0.00), vs 1st tercile). Discussion / Conclusion This cross-sectional study highlights associations between some POPs and thyroid function disruption, which appears consistent with the literature. Considering that the associations were sex-specific and moderated by pubertal status in boys, complex endocrine interactions are likely involved.

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The association between thyroid function biomarkers and attention deficit hyperactivity disorder

Cited by 19 publications

References 57 publications

Serum TSH Levels are Associated with Hyperactivity Behaviors in Children with Attention Deficit/Hyperactivity Disorder

Serum TSH Levels are Associated with Hyperactivity Behaviors in Children with Attention Deficit/Hyperactivity Disorder

The Interaction between Circulating Cell-Free Mitochondrial DNA and Inflammatory Cytokines in Predicting Human Mental Health Issue Risk in Adolescents: An Explorative Study

Persistent Organic Pollutant Exposure and Thyroid Function among 12-Year-Old Children

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