Vitamin D status in children with attention-deficit–hyperactivity disorder
Corresponding Author
Sevil Bilir Goksugur
Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Correspondence: Sevil Bilir Goksugur, MD, Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, 14280 Golkoy – Bolu, Turkey. Email: [email protected]Search for more papers by this authorAli Evren Tufan
Department of Child and Adolescent Psychiatry, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorMurat Semiz
Department of Psychiatry, Sivas State Hospital, Sivas, Turkey
Search for more papers by this authorCemalettin Gunes
Department of Pediatrics, Medical Faculty, Duzce University, Duzce, Turkey
Search for more papers by this authorMervan Bekdas
Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorMehmet Tosun
Department of Biochemistry, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorFatih Demircioglu
Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorCorresponding Author
Sevil Bilir Goksugur
Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Correspondence: Sevil Bilir Goksugur, MD, Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, 14280 Golkoy – Bolu, Turkey. Email: [email protected]Search for more papers by this authorAli Evren Tufan
Department of Child and Adolescent Psychiatry, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorMurat Semiz
Department of Psychiatry, Sivas State Hospital, Sivas, Turkey
Search for more papers by this authorCemalettin Gunes
Department of Pediatrics, Medical Faculty, Duzce University, Duzce, Turkey
Search for more papers by this authorMervan Bekdas
Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorMehmet Tosun
Department of Biochemistry, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorFatih Demircioglu
Department of Pediatrics, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Search for more papers by this authorAbstract
Background
Attention-deficit–hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood, has an early onset, affecting 2–18% of children worldwide. The etiopathogenesis of ADHD is obscure. In recent studies, a low level of vitamin D has been found in association with many disorders as well as in neuropsychiatric diseases. The aim of this study was therefore to investigate serum vitamin D level in pediatric ADHD patients.
Methods
A total of 60 ADHD patients and 30 healthy controls were included in the study. The age of both groups was in the 7–18-year-old range. Serum 25-OH-vitamin D, calcium, phosphorus and alkaline phosphatase were investigated.
Results
Serum 25-OH-vitamin D was found to be significantly lower in children and adolescents with ADHD compared to healthy controls, and no significant differences were found between the groups in terms of other variables. 25-OH-vitamin D level in the ADHD group and control group was, respectively, 20.9 ± 19.4 ng/mL and 34.9 ± 15.4 ng/mL (P = 0.001).
Conclusion
There is an association between lower 25-OH-vitamin D concentration and ADHD in childhood and adolescence. To the authors' knowledge this is the first study to investigate the relationship between vitamin D and ADHD in children.
References
- 1 Hodgkins P, Setyawan J, Mitra D et al. Management of ADHD in children across Europe: Patient demographics, physician characteristics and treatment patterns. Eur. J. Pediatr. 2013; 172: 895–906.
- 2 Skounti M, Philalithis A, Galanakis E. Variations in prevalence of attention deficit hyperactivity disorder worldwide. Eur. J. Pediatr. 2007; 166: 117–123.
- 3 Faraone SV, Biederman J, Milberger S. An exploratory study of ADHD among second-degree relatives of ADHD children. Biol. Psychiatry 1994; 35: 398–402.
- 4 Sciutto MJ, Eisenberg M. Evaluating the evidence for and against the overdiagnosis of ADHD. J. Atten. Disord. 2007; 11: 106–113.
- 5 Cantwell DP. Attention deficit disorder: A review of the past 10 years. J. Am. Acad. Child Adolesc. Psychiatry 1996; 35: 978–987.
- 6 Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers and cardiovascular disease. Am. J. Clin. Nutr. 2004; 80: 1678S–1688.
- 7 Holick MF. Vitamin D deficiency. N. Engl. J. Med. 2007; 357: 266–281.
- 8 Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J. Chem. Neuroanat. 2005; 29: 21–30.
- 9 Armstrong DJ, Meenagh GK, Bickle I, Lee AS, Curran ES, Finch MB. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin. Rheumatol. 2007; 26: 551–554.
- 10 Hoogendijk WJ, Lips P, Dik MG, Deeg DJ, Beekman AT, Penninx BW. Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch. Gen. Psychiatry 2008; 65: 508–512.
- 11 Gracious BL, Finucane TL, Friedman-Campbell M, Messing S, Parkhurst MN. Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study. BMC Psychiatry 2012; 12: 38.
- 12 Hyman SL, Stewart PA, Schmidt B et al. Nutrient intake from food in children with autism. Pediatrics 2012; 130 (Suppl. 2): S145–153.
- 13 Llewellyn DJ, Lang IA, Langa KM, Melzer D. Vitamin D and cognitive impairment in the elderly U.S. population. J. Gerontol. A. Biol Sci. Med. Sci. 2011; 66: 59–65.
- 14
Thys-Jacobs S, Silverton M, Alvir J, Paddison P, Rico M, Goldsmith S. Reduced bone mass in women with premenstrual syndrome. J. Womens Health 1995; 4: 161–168.
10.1089/jwh.1995.4.161 Google Scholar
- 15 Tolppanen AM, Sayers A, Fraser WD, Lawlor DA. Association of serum 25-hydroxyvitamin D(3) and D(2) with academic performance in childhood: Findings from a prospective birth cohort. J. Epidemiol. Community Health 2012; 66: 1137–1142.
- 16 Tolppanen AM, Sayers A, Fraser WD, Lewis G, Zammit S, Lawlor DA. The association of 25-hydroxyvitamin D3 and D2 with behavioural problems in childhood. PLoS ONE 2012; 7: e40097.
- 17 Turgay A. Disruptive Behavior Disorders: Child and Adolescent Screening and Rating Scales for Children, Adolescents, Parents and Teachers. West Blomfield Michigan Integrative Therapy Institute Publication, Michigan, 1994.
- 18 Ercan E, Amado S, Somer O, Çıkoğlu S. Development of a test battery for the assessment of attention deficit hyperactivity disorder. Turk. J. Child. Adolesc. Ment. Health 2001; 8: 132–144.
- 19 Savaşır L, Şahin N. Manual for the Wechsler Intelligence Scale for Children–Revised (WISC-R). Turkish Psychology Association Publication, Ankara, 1995.
- 20 Hoang MT, Defina LF, Willis BL, Leonard DS, Weiner MF, Brown ES. Association between low serum 25-hydroxyvitamin D and depression in a large sample of healthy adults: The Cooper Center longitudinal study. Mayo Clin. Proc. 2011; 86: 1050–1055.
- 21 Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front. Neuroendocrinol. 2013; 34: 47–64.
- 22 Brown J, Bianco JI, McGrath JJ, Eyles DW. 1,25-dihydroxyvitamin D3 induces nerve growth factor, promotes neurite outgrowth and inhibits mitosis in embryonic rat hippocampal neurons. Neurosci. Lett. 2003; 343: 139–143.
- 23 Kalueff AV, Eremin KO, Tuohimaa P. Mechanisms of neuroprotective action of vitamin D(3). Biochemistry (Mosc) 2004; 69: 738–741.
- 24 Cass WA, Smith MP, Peters LE. Calcitriol protects against the dopamine- and serotonin-depleting effects of neurotoxic doses of methamphetamine. Ann. N. Y. Acad. Sci. 2006; 1074: 261–271.
- 25 Harms LR, Eyles DW, McGrath JJ, Mackay-Sim A, Burne TH. Developmental vitamin D deficiency alters adult behaviour in 129/SvJ and C57BL/6J mice. Behav. Brain Res. 2008; 187: 343–350.
- 26 Berk M, Ng F, Dean O, Dodd S, Bush AI. Glutathione: A novel treatment target in psychiatry. Trends Pharmacol. Sci. 2008; 29: 346–351.
- 27 Partonen T. Vitamin D and serotonin in winter. Med. Hypotheses 1998; 51: 267–268.
- 28 Levy F. The dopamine theory of attention deficit hyperactivity disorder (ADHD). Aust. N. Z. J. Psychiatry 1991; 25: 277–283.
- 29 Schuchardt J, Huss M, Stauss-Grabo M, Hahn A. Significance of long-chain polyunsaturated fatty acids (PUFAs) for the development and behaviour of children. Eur. J. Pediatr. 2010; 169: 149–164.
- 30 Brookes KJ, Chen W, Xu X, Taylor E, Asherson P. Association of fatty acid desaturase genes with attention-deficit/hyperactivity disorder. Biol. Psychiatry 2006; 60: 1053–1061.
- 31 Bulut M, Selek S, Gergerlioglu HS et al. Malondialdehyde levels in adult attention-deficit hyperactivity disorder. J. Psychiatry Neurosci. 2007; 32: 435–438.
- 32 Ellison-Wright I, Ellison-Wright Z, Bullmore E. Structural brain change in attention deficit hyperactivity disorder identified by meta-analysis. BMC Psychiatry 2008; 8: 51.
- 33 Semrud-Clikeman M, Pliszka SR, Lancaster J, Liotti M. Volumetric MRI differences in treatment-naive vs chronically treated children with ADHD. Neurology 2006; 67: 1023–1027.
- 34 Eyles DW, Feron F, Cui X et al. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology 2009; 34 (Suppl. 1): S247–257.
- 35 Lamberg-Allardt C, Wilska M, Saraste KL, Gronlund T. Vitamin D status of ambulatory and nonambulatory mentally retarded children with and without carbamazepine treatment. Ann. Nutr. Metab. 1990; 34: 216–220.
- 36 Mostafa GA, Al-Ayadhi LY. Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: Relation to autoimmunity. J. Neuroinflammation 2012; 9: 201.
- 37 Smith BA, Cogswell A, Garcia G. Vitamin D and depressive symptoms in children with cystic fibrosis. Psychosomatics 2014; 55: 76–81.
- 38 Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: Randomized double blind trial. J. Intern. Med. 2008; 264: 599–609.
- 39 Khoraminya N, Tehrani-Doost M, Jazayeri S, Hosseini A, Djazayery A. Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Aust. N. Z. J. Psychiatry 2013; 47: 271–275.
- 40 Dean AJ, Bellgrove MA, Hall T et al. Effects of vitamin D supplementation on cognitive and emotional functioning in young adults: A randomised controlled trial. PLoS ONE 2011; 6: e25966.
- 41 Tolppanen AM, Sayers A, Fraser WD, Lewis G, Zammit S, Lawlor DA. The association of serum 25-hydroxyvitamin D3 and D2 with depressive symptoms in childhood: A prospective cohort study. J. Child. Psychol. Psychiatry 2012; 53: 757–766.
- 42 Schram MT, Trompet S, Kamper AM et al. Serum calcium and cognitive function in old age. J. Am. Geriatr. Soc. 2007; 55: 1786–1792.
- 43 Parfitt A. Bone and plasma calcium homeostasis. Bone 1987; 8: S1.