Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis

There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the...

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Published inScientific reports Vol. 8; no. 1; pp. 788 - 11
Main Authors Tseng, Ping-Tao, Cheng, Yu-Shian, Yen, Cheng-Fang, Chen, Yen-Wen, Stubbs, Brendon, Whiteley, Paul, Carvalho, Andre F., Li, Dian-Jeng, Chen, Tien-Yu, Yang, Wei-Cheng, Tang, Chia-Hung, Chu, Che-Sheng, Yang, Wei-Chieh, Liang, Hsin-Yi, Wu, Ching-Kuan, Lin, Pao-Yen
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 15.01.2018
Nature Publishing Group
Subjects
692/499
692/699/476
Attention Deficit Disorder with Hyperactivity - metabolism
Attention Deficit Disorder with Hyperactivity - pathology
Attention deficit hyperactivity disorder
Child
Children
Databases, Factual
Ferritin
Ferritins - blood
Humanities and Social Sciences
Humans
Hyperactivity
Iron
Iron - blood
Iron deficiency
Meta-analysis
multidisciplinary
Nutrient deficiency
Odds Ratio
Science
Science (multidisciplinary)
Severity of Illness Index
Systematic review
Transferrins
Online AccessGet full text

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Abstract There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9 th , 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges’ g ) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges’ g  = −0.246, p  = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges’ g  = 0.888, p  = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p  = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.
AbstractList Abstract There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9 th , 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges’ g ) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges’ g  = −0.246, p  = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges’ g  = 0.888, p  = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p  = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.
There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9 th , 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges’ g ) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges’ g  = −0.246, p  = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges’ g  = 0.888, p  = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p  = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.
There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9th, 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges’ g) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges’ g = −0.246, p = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges’ g = 0.888, p = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.
There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9th, 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges' g) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges' g = -0.246, p = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges' g = 0.888, p = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.
There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9 , 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges' g) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges' g = -0.246, p = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges' g = 0.888, p = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.
ArticleNumber 788
Author Tseng, Ping-Tao
Chu, Che-Sheng
Yen, Cheng-Fang
Lin, Pao-Yen
Tang, Chia-Hung
Whiteley, Paul
Yang, Wei-Chieh
Stubbs, Brendon
Chen, Tien-Yu
Li, Dian-Jeng
Liang, Hsin-Yi
Carvalho, Andre F.
Cheng, Yu-Shian
Yang, Wei-Cheng
Wu, Ching-Kuan
Chen, Yen-Wen
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  email: py1029@adm.cgmh.org.tw
  organization: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29335588$$D View this record in MEDLINE/PubMed
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Issue 1
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SSID ssj0000529419
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SecondaryResourceType review_article
Snippet There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies,...
Abstract There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient...
SourceID pubmedcentral
proquest
crossref
pubmed
springer
SourceType Open Access Repository
Aggregation Database
Index Database
Publisher
StartPage 788
SubjectTerms 692/499
692/699/476
Attention Deficit Disorder with Hyperactivity - metabolism
Attention Deficit Disorder with Hyperactivity - pathology
Attention deficit hyperactivity disorder
Child
Children
Databases, Factual
Ferritin
Ferritins - blood
Humanities and Social Sciences
Humans
Hyperactivity
Iron
Iron - blood
Iron deficiency
Meta-analysis
multidisciplinary
Nutrient deficiency
Odds Ratio
Science
Science (multidisciplinary)
Severity of Illness Index
Systematic review
Transferrins
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Title Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis
URI https://link.springer.com/article/10.1038/s41598-017-19096-x
https://www.ncbi.nlm.nih.gov/pubmed/29335588
https://www.proquest.com/docview/1987709871
https://search.proquest.com/docview/1989582742
https://pubmed.ncbi.nlm.nih.gov/PMC5768671
Volume 8
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