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Merzon E, Magen E, Ashkenazi S, Weizman A, Manor I, Krone B, Green I, Golan-Cohen A, Vinker S, Faraone SV, Israel A. The Association between Glucose 6-Phosphate Dehydrogenase Deficiency and Attention Deficit/Hyperactivity Disorder. Nutrients 2023; 15:4948. [PMID: 38068806 PMCID: PMC10708268 DOI: 10.3390/nu15234948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/09/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency, impacting 4.9% of the population and more prevalent in Mediterranean communities, is a common enzymopathy with potential relevance to Attention Deficit/Hyperactivity Disorder (ADHD). This study investigated this association. METHODS The clinical characteristics of 7473 G6PD-deficient patients and 29,892 matched case-controls (selected at a 1:4 ratio) from a cohort of 1,031,354 within the Leumit Health Services database were analyzed using Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables. RESULTS In total, 68.7% were male. The mean duration of follow-up was 14.3 ± 6.2 years at a mean age of 29.2 ± 22.3 years. G6PD deficiency was associated with an increased risk of being diagnosed with ADHD (Odds Ratio (OR) = 1.16 [95% CI, 1.08-1.25], p < 0.001), seeking care from adult neurologists (OR = 1.30 [95% CI, 1.22-1.38], p < 0.001), and consulting adult psychiatrists (OR = 1.12 [95% CI, 1.01-1.24], p = 0.048). The use of stimulant medications among G6PD-deficient individuals was 17% higher for the methylphenidate class of drugs (OR = 1.17 [95% CI, 1.08, 1.27], p < 0.001), and there was a 16% elevated risk for amphetamine use (OR = 1.16 [95% CI, 1.03, 1.37], p = 0.047). CONCLUSIONS G6PD deficiency signals an increased risk of ADHD diagnosis, more severe presentations of ADHD and a greater need for psychiatric medications to treat ADHD.
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Affiliation(s)
- Eugene Merzon
- Adelson School of Medicine, Ariel University, Ariel 40776, Israel;
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
| | - Eli Magen
- Department of Medicine A, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University, Beer Sheba 84990, Israel;
| | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel 40776, Israel;
| | - Abraham Weizman
- ADHD Unit, Geha Mental Health Center, Petah Tikva 49100, Israel; (A.W.); (I.M.)
- Department of Psychiatry, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Laboratory of Molecular and Biological Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Iris Manor
- ADHD Unit, Geha Mental Health Center, Petah Tikva 49100, Israel; (A.W.); (I.M.)
- Department of Psychiatry, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Beth Krone
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Ilan Green
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Avivit Golan-Cohen
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Shlomo Vinker
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Stephen V. Faraone
- Department of Psychiatry, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA;
| | - Ariel Israel
- Leumit Health Services, Tel Aviv 64738, Israel; (I.G.); (A.G.-C.); (S.V.); (A.I.)
- Department of Epidemiology and Disease Prevention, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Kwok MK, Leung GM, Au Yeung SL, Schooling CM. Glucose-6-phosphate dehydrogenase deficiency and metabolic profiling in adolescence from the Chinese birth cohort: "Children of 1997". Int J Cardiol 2019; 281:146-149. [PMID: 30739801 DOI: 10.1016/j.ijcard.2019.01.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/16/2019] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency affects 6.0% of the global population. G6PD deficiency has been associated with lower risk of cardiovascular disease and higher risk of diabetes, which could be etiologically informative, but these relations are uncertain. To clarify, we assessed the associations of G6PD deficiency with serum metabolite profiles in late adolescence. METHODS In a nested case-control study of 50 G6PD-deficient late adolescents (~17.5 years) and 150 sex-matched non-G6PD-deficient controls from a Chinese birth cohort: "Children of 1997", we compared 80 serum metabolites analyzed by nuclear magnetic resonance spectrometry using adjusted linear regression with Bonferroni correction for testing 12 traits (p < 0.0042). RESULTS G6PD-deficiency was inversely associated with serum levels of total cholesterol (-0.27 mmol, 95% confidence interval (CI) -0.46, -0.09, p = 0.004), free cholesterol (-0.08 mmol, 95% CI -0.13, -0.03, p = 0.003) and creatinine (-0.004 mmol, 95% CI -0.007, -0.001, p = 0.003), adjusted for sex and parental education. G6PD deficiency was not associated with fatty acids, amino acids, glucose or related metabolites, ketone bodies or glycoprotein. CONCLUSIONS G6PD deficiency is associated with lower serum levels of cholesterol and creatinine, but not other serum metabolites. Whether such differences are transient or become more evident in adulthood warrant further investigations.
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Affiliation(s)
- Man Ki Kwok
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Shiu Lun Au Yeung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; City University of New York School of Public Health and Health Policy, New York, United States.
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