Serum Levels of Vitamin A and Vitamin D and Their Association With Symptoms in Children With Attention Deficit Hyperactivity Disorder

Hong-Hua Li,Jun-Yan Feng,Fei-Yong Jia,Bing Wang,Xiao-Jing Yue,Cheng-Xin Wang

doi:10.3389/fpsyt.2020.599958

Hong-Hua Li, Jun-Yan Feng + Show 4 more

Open Access

https://doi.org/10.3389/fpsyt.2020.599958

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Abstract

Objective: To measure levels of vitamin A (VA) and vitamin D (VD) and the symptomatic association of their co-deficiencies on attention deficit hyperactivity disorder (ADHD) in Chinese children (6–9 years).Methods: Eighty-two children (69 boys and 13 girls; mean age = 7.1 ± 0.9 years at the time of the diagnosis) with ADHD were recruited as ADHD group. A total of 106 healthy children were recruited as the healthy control (HC) group. Serum levels of retinol and 25-hydroxyvitamin D (25(OH)D) of all children were evaluated using high-performance liquid chromatography (HPLC) and HPLC-tandem mass spectrometry. The Swanson, Nolan, and Pelham IV Rating Scale (SNAP-IV) was employed to assess the clinical symptoms of ADHD.Results: Children suffering from ADHD had significantly reduced serum levels of retinol and 25(OH)D compared with those of HCs, and the prevalence of VA deficiency and VD deficiency were higher in children suffering from ADHD. Serum concentrations of 25(OH)D and retinol were linked closely with the presence or absence of ADHD after adjustment for age, body mass index, season of blood sampling, and sun exposure. Serum concentrations of 25(OH)D and retinol showed a negative correlation with the total scores of SNAP-IV. Children with ADHD as well as VA and VD co-deficiency had increased SNAP-IV total scores and ADHD inattention subscale scores.Conclusion: VA deficiency and VD deficiency in children with ADHD were increased in comparison with that in HCs. VA and VD co-deficiency associated with ADHD symptom severity. Attention should be paid to regular testing of VA levels and VD levels. However, the mechanism of VA and VD in ADHD needs to be further studied. Interventional studies on VA and VD supplementation are recommended to further verify the relationship between VA and VD co-deficiency and ADHD.

Highlights

Attention deficit hyperactivity disorder (ADHD) is considered to be the most common childhood-onset neurodevelopmental ailment [1]
Significant differences in sex, age, body mass index (BMI), parents’ level of education, residential area, season of blood collection, daily intake of dairy products, and sun exposure between children living with ADHD and healthy control (HC) were not found
Children living with ADHD had significantly reduced serum levels of retinol and 25(OH)D than those of HCs, and that the prevalence of Vitamin A (VA) deficiency and vitamin D (VD) deficiency was higher in ADHD children

Summary

Introduction

Attention deficit hyperactivity disorder (ADHD) is considered to be the most common childhood-onset neurodevelopmental ailment [1]. In ADHD, hyperactivity, impulsivity, and impaired attention are increased, and are inappropriate to the level of development in children [1]. 65% of children suffering from ADHD will have symptoms and impairment throughout adolescence and into adulthood [3]. Studies have shown that low maternal levels of VD during pregnancy can lead to an increased risk of offspring with ADHD [7, 8]. Studies have shown that children suffering from ADHD have a reduced serum concentration of 25-hydroxyvitamin D (25(OH)D) as compared with that in healthy children [9,10,11]. VD supplementation is an adjunct therapy used to overcome symptoms of ADHD and has comparatively few side effects [12]

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