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Iron Status in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis.

Abstract

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children. However, the pathogenesis of ADHD remains unclear. Iron, an important trace element, is implicated in brain function and dopaminergic activity. Recent studies have investigated the association between iron deficiency and ADHD, but the results are inconsistent.

METHODS

A systemic search of MEDLINE, EMBASE, Web of Science and Cochrane Library databases was supplemented by manual searches of references of key retrieved articles. Study quality was evaluated using the Newcastle-Ottawa Scale. The standardised mean difference (SMD) and 95% confidence intervals (CIs) were calculated using a random-effects model. H2 and I2 were used to evaluate the heterogeneity, and sensitivity, subgroup and meta-regression analyses were conducted to explore the reason of heterogeneity.

RESULTS

The search yielded 11 studies published before July 25, 2016. Of these, 10 studies, comprising 2191 participants and 1196 ADHD cases, reported serum ferritin levels, and six studies, comprising 617 participants and 369 ADHD cases, reported serum iron levels. Serum ferritin levels were lower in ADHD cases (SMD = -0.40, 95% CI = -0.66 to -0.14). However, we found no correlation between serum iron levels and ADHD (SMD = -0.026, 95% CI = -0.29 to 0.24). Meta-regression analysis indicated that publication year, age, gender, sample size, and Hb levels did not significantly influence the pooled estimates of serum ferritin.

CONCLUSION

Lower serum ferritin rather than serum iron is associated with ADHD in children.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

    ,

    Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

    ,

    Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

    ,

    Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

    Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. Department of Pediatrics, University of California, San Francisco, California, United States of America.

    Source

    PloS one 12:1 2017 pg e0169145

    MeSH

    Attention Deficit Disorder with Hyperactivity
    Brain
    Child
    Dopamine
    Female
    Ferritins
    Humans
    Iron
    Male
    Sample Size

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    28046016

    Citation

    Wang, Yan, et al. "Iron Status in Attention-Deficit/Hyperactivity Disorder: a Systematic Review and Meta-Analysis." PloS One, vol. 12, no. 1, 2017, pp. e0169145.
    Wang Y, Huang L, Zhang L, et al. Iron Status in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. PLoS ONE. 2017;12(1):e0169145.
    Wang, Y., Huang, L., Zhang, L., Qu, Y., & Mu, D. (2017). Iron Status in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. PloS One, 12(1), pp. e0169145. doi:10.1371/journal.pone.0169145.
    Wang Y, et al. Iron Status in Attention-Deficit/Hyperactivity Disorder: a Systematic Review and Meta-Analysis. PLoS ONE. 2017;12(1):e0169145. PubMed PMID: 28046016.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Iron Status in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. AU - Wang,Yan, AU - Huang,Lan, AU - Zhang,Li, AU - Qu,Yi, AU - Mu,Dezhi, Y1 - 2017/01/03/ PY - 2016/09/07/received PY - 2016/12/07/accepted PY - 2017/1/4/entrez PY - 2017/1/4/pubmed PY - 2017/9/7/medline SP - e0169145 EP - e0169145 JF - PloS one JO - PLoS ONE VL - 12 IS - 1 N2 - BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children. However, the pathogenesis of ADHD remains unclear. Iron, an important trace element, is implicated in brain function and dopaminergic activity. Recent studies have investigated the association between iron deficiency and ADHD, but the results are inconsistent. METHODS: A systemic search of MEDLINE, EMBASE, Web of Science and Cochrane Library databases was supplemented by manual searches of references of key retrieved articles. Study quality was evaluated using the Newcastle-Ottawa Scale. The standardised mean difference (SMD) and 95% confidence intervals (CIs) were calculated using a random-effects model. H2 and I2 were used to evaluate the heterogeneity, and sensitivity, subgroup and meta-regression analyses were conducted to explore the reason of heterogeneity. RESULTS: The search yielded 11 studies published before July 25, 2016. Of these, 10 studies, comprising 2191 participants and 1196 ADHD cases, reported serum ferritin levels, and six studies, comprising 617 participants and 369 ADHD cases, reported serum iron levels. Serum ferritin levels were lower in ADHD cases (SMD = -0.40, 95% CI = -0.66 to -0.14). However, we found no correlation between serum iron levels and ADHD (SMD = -0.026, 95% CI = -0.29 to 0.24). Meta-regression analysis indicated that publication year, age, gender, sample size, and Hb levels did not significantly influence the pooled estimates of serum ferritin. CONCLUSION: Lower serum ferritin rather than serum iron is associated with ADHD in children. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28046016/full_citation L2 - http://dx.plos.org/10.1371/journal.pone.0169145 DB - PRIME DP - Unbound Medicine ER -