Resting metabolic rate, pulmonary functions, and body composition parameters in children with attention deficit hyperactivity disorder

Exploring the bidirectional associations of ADHD symptomatology, nutritional status, and body composition in childhood: evidence from a Brazilian Birth Cohort Study

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) has been linked to excessive weight; however, the underlying mechanisms of this association are not well understood. To date, the bidirectional associations between ADHD and nutritional status in childhood have been explored in a limited number of studies, with particularly few of those incorporating body composition data. This study aims to evaluate the associations of ADHD symptoms, nutritional status, and body composition in childhood.

METHODS

We analyzed data from 3940 children from the 2015 Pelotas (Brazil) Birth Cohort at 4 and 6-7 years of age. Linear regression was performed to evaluate the association between ADHD symptoms and nutritional status (weight, height, and body mass index [BMI]) at ages 4 and 6-7, as well as body composition, specifically fat mass (FF) and fat-free mass (FFM) at ages 6-7. Moreover, a cross-lagged panel model (CLPM) analysis between ADHD symptoms and BMI was performed to explore the bidirectional associations.

RESULTS

ADHD symptoms were associated with increased height (β 0.01, 95%CI 0.001, 0.026) and FFM (β 0.02, 95%CI 0.008-0.035) at age 4, and increased BMI (β0.02, 95%IC 0.002, 0.038), weight (β 0. 02, 95%CI 0.005, 0.039), height (β 0.01, 95%CI 0.000, 0.024), and FFM (β 0.02, 95%CI 0.012, 0.040) at ages 6-7. Although the CLPM indicated a small effect suggesting a bidirectional relationship between ADHD symptoms and BMI, the observed associations were not statistically significant: ADHD scores at age 4 predicting BMI z-scores at ages 6-7 (β 0.003; 95% CI: -0.026, 0.020), and BMI z-scores at age 4 predicting ADHD scores at ages 6-7 (β 0.013; 95% CI: -0.018, 0.044).

CONCLUSION

Children with higher ADHD symptoms showed increased growth in weight, height, and BMI. The observed increase in weight and BMI was attributed to greater FFM in these children.

Is common carotid artery intima-media thickness (cIMT) a risk assessment marker in children with attention deficit/hyperactivity disorder?

OBJECTIVE

Attention deficit/hyperactivity disorder (ADHD) is associated with impairment in social, academic and job-related functioning in both children and adults. The purpose of this study is to investigate the susceptibility to cardiovascular risk factors in children with ADHD diagnosis through common carotid artery intima-media thickness (cIMT) measurement, to compare cIMT in ADHD and control groups and to evaluate the association between cIMT and ADHD symptom severity.

METHODS

The mean cIMT of 42 children with ADHD, ADHD symptom scales and a semi-structured psychiatric interview, and 42 age and sex matched healthy controls were measured with B-mode Doppler neck ultrasonography.

RESULTS

The median cIMT was significantly higher for the ADHD group compared to the healthy controls. There was a statistically significant, negative, moderate correlation between cIMT and Conners ADHD index score, hyperactivity score, oppositional score and the presence of ODD comorbidity.

CONCLUSIONS

In this study, we found significantly higher cIMT in children with ADHD when compared to healthy controls. Considering that increased cIMT is a sign of atherosclerosis and it can be used as a marker of cardiovascular risk factors, our finding may indicate that children with ADHD are at increased risk for cardiovascular diseases.KeypointscIMT was significantly higher in children with ADHD when compared to healthy controls.Higher cIMT in children with ADHD may indicate that children with ADHD are at increased risk for cardiovascular diseases.cIMT measurement may be studied as a potential tool for risk assessment before a child with ADHD is started on psychostimulant medications.

[Overweight/Obesity of Children and Adolescents and its Association with Internalising and Externalising Disorders]

Overweight/Obesity of Children and Adolescents and its Association with Internalising and Externalising Disorders Research in child and adolescent psychiatry increasingly deals with the association between mental disorder and weight. This paper provides an overview of national and international studies on the relationship between body composition and mental illness in children and adolescents, with a focus on the representation of individual internalizing and externalizing disturbance patterns. The majority of studies in this area are based on the so-called one-compartment model of body composition in terms of the Body Mass Index (BMI) or on the classification as "overweight" or "obese". Associations between mental disorders and body composition were described in two directions: On one hand, both externalising and internalising symptoms are associated with obesity, and on the other hand there are also more psychopathological symptoms among overweight children and adolescents. Longitudinal studies suggest effects in both directions. While externalising symptoms and weight are thought to be related from infancy on, this connection seems to be evident for internalising disorders not earlier than for early school age. It is also known from the literature that psychopharmacological medication affects weight and body growth - especially with psychostimulants, but also with neuroleptics and antidepressants. We found only a few studies describing the relationship between body composition and psyche in more complex models with two or more compartments.

The neurodevelopmental role of dopaminergic signaling in neurological disorders

Dopamine (DA), a critical neurotransmitter of both the central and peripheral nerve system, plays important roles in a series of biological processes. Dysfunction of dopaminergic signalling may lead to a series of developmental disorders, including attention deficit/hyperactivity disorder, autism and schizophrenia. However, the exact roles of dopaminergic signalling in these diseases are far from fully understood. We analyse the roles of dopaminergic signalling in multiple physiological and pathological processes, focusing on brain development and related disorders. By summarizing current research in this area, we provide guidance for future studies. This review seeks to deepen our understanding of dopaminergic signalling in developmental disorders, which may offer clues for developing more effective therapeutic drugs.