Neuropsychiatric Disease and Treatment (Mar 2023)
Serum TSH Levels are Associated with Hyperactivity Behaviors in Children with Attention Deficit/Hyperactivity Disorder
Abstract
Guanru Chen,1,* Wenfan Gao,2– 4,* Yayun Xu,5 Huiying Chen,1 Heping Cai1 1Department of Clinical Pharmacy, Anhui Provincial Children’s Hospital, Hefei, Anhui, People’s Republic of China; 2Psychopharmacology Research Laboratory, Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Department of Pharmacy, Hefei Fourth People’s Hospital, Hefei, Anhui, People’s Republic of China; 4Anhui Clinical Research Center for Mental Disorders, Anhui Mental Health Center, Hefei, Anhui, People’s Republic of China; 5Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guanru Chen, Department of Clinical Pharmacy, Anhui Provincial Children’s Hospital, 39 Wangjiang Road, Hefei, 230000, People’s Republic of China, Email [email protected]: 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 (OR 2.243 (CL 1.052– 4.783)) 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.Keywords: thyroid function, children, attention deficit/hyperactivity disorder, thyroid stimulating hormone, lactic acid, hyperactivity behaviors
