Gülhane Tıp Dergisi (Jun 2024)
Novel low-grade inflammation markers in children with attention deficit hyperactivity disorder
Abstract
Aims: The course of low-grade inflammation markers, including platelet-monocyte ratio (PMR), mean platelet volume-lymphocyte ratio (MPVLR), and the mean platelet volume-platelet ratio (MPVPR), is not known in children with Attention Deficit Hyperactivity Disorder (ADHD). The primary objective of this study was to compare PMR, MPVLR, and MPVPR in children with ADHD versus healthy controls. Methods: A retrospective, case-control, cross-sectional study was performed with children aged 6-18 years with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. An age, gender, and body mass index-matched healthy control group was formed. Platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), basophil-lymphocyte ratio (BLR), PMR, MPVLR, MPVPR, and systemic immunity-inflammation index (SII) were compared between the two groups. Results: The study included 79 children with ADHD and 70 controls. NLR, BLR, SII, PMR, and MPVPR were not significantly different between the two groups. However, the PLR was higher in the ADHD group than in the control group (p<0.001). Additionally, the MLR (p=0.048) and the MPVLR (p=0.018) were higher in the ADHD group than in the control group. Receiver operating characteristic analysis demonstrated that the MPVLR level was not significantly associated with predicting the presence of ADHD [area under the curve (AUC): 0.58, p=0.077]. However, PLR (AUC: 0.68, p<0.001) and MLR (AUC: 0.59, p=0.048) values showed predictive potential for ADHD, with cut-off values of 110.23 and 0.19, respectively. Conclusions: Of the variables evaluated, significant increases in PLR and MLR support the hypothesis that an altered inflammatory response may be associated with ADHD. Further research is needed to confirm these findings in prospectively designed studies.
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