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Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD).
J Trace Elem Med Biol. 2020 Mar; 58:126445.JT

Abstract

BACKGROUND

Essential trace elements and minerals play a significant role in neurodevelopment. Although certain studies demonstrated impaired essential trace element and mineral status in children with ADHD, the existing data are insufficient. The objective of the present study was to assess serum trace element and mineral levels in children with ADHD.

METHODS

Serum trace element and mineral levels in 68 children with ADHD and 68 neurotypical controls were assessed using ICP-MS at NexION 300D (PerkinElmer Inc., USA) equipped with ESI SC-2 DX4 autosampler (Elemental Scientific Inc., USA).

RESULTS

Serum Cr, Mg, and Zn levels in children with ADHD were 21 % (p = 0.010), 4 % (p = 0.005), and 7 % (p = 0. 001) lower as compared to the healthy controls, respectively. In turn, serum Cu/Zn values were 11 % higher than those in the control group. Age and gender had a significant impact on serum element levels in ADHD. Particularly, preschool children were characterized by significantly increased Cu (+8 %; p = 0.034), and Cu/Zn (+19 %; p < 0.001) values, whereas serum Zn (-9 %; p = 0.004) level was decreased. In primary school-aged children only 6 % (p = 0.007) lower Mg levels were observed. Both boys and girls with ADHD were characterized by 8 % (p = 0.016) lower serum Zn levels and 10 % (p = 0.049) higher Cu/Zn values when compared to neurotypical girls. Boys with ADHD also had significantly higher Cu/Zn, exceeding the respective control values by 12 % (p = 0.021), predominantly due to a 7 % (p = 0.035) decrease in serum Zn. Serum Mg levels were also found to be significantly lower than those in neurotypical children by 5 % (p = 0.007). In adjusted regression models serum Cr (β=-0.234; p = 0.009) and Cu/Zn (β = 0.245; p = 0.029) values were significantly associated with ADHD, respectively. Two-way ANOVA revealed a significant impact of ADHD on Cr, Mg, Zn, and Cu/Zn, whereas age was associated with Cu, I, Mg, Mo, and Cu/Zn, whereas gender accounted only for variability in serum Mn levels. Principal component analysis (PCA) also revealed significant contributions of Mg, Zn, and Cu/Zn values to ADHD variability.

CONCLUSIONS

Hypothetically, the observed decrease of essential trace elements, namely Mg and Zn, and elevation of Cu/Zn may significantly contribute to the risk of ADHD or its severity and/or comorbidity.

Authors+Show Affiliations

Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; RUDN University, Moscow, Russia; Taipei Medical University, Taipei, Taiwan.Yaroslavl State University, 150003, Yaroslavl, Russia.Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.Council for Nutritional and Environmental Medicine, Mo I Rana, Norway.IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; RUDN University, Moscow, Russia.Taipei Medical University, Taipei, Taiwan.RUDN University, Moscow, Russia.Kazakh Academy of Nutrition, Almaty, Kazakhstan.IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.Yaroslavl State University, 150003, Yaroslavl, Russia; RUDN University, Moscow, Russia.Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia. Electronic address: tinkov.a.a@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31869738

Citation

Skalny, Anatoly V., et al. "Serum Zinc, Copper, Zinc-to-copper Ratio, and Other Essential Elements and Minerals in Children With Attention Deficit/hyperactivity Disorder (ADHD)." Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS), vol. 58, 2020, p. 126445.
Skalny AV, Mazaletskaya AL, Ajsuvakova OP, et al. Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD). J Trace Elem Med Biol. 2020;58:126445.
Skalny, A. V., Mazaletskaya, A. L., Ajsuvakova, O. P., Bjørklund, G., Skalnaya, M. G., Chao, J. C., Chernova, L. N., Shakieva, R. A., Kopylov, P. Y., Skalny, A. A., & Tinkov, A. A. (2020). Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD). Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS), 58, 126445. https://doi.org/10.1016/j.jtemb.2019.126445
Skalny AV, et al. Serum Zinc, Copper, Zinc-to-copper Ratio, and Other Essential Elements and Minerals in Children With Attention Deficit/hyperactivity Disorder (ADHD). J Trace Elem Med Biol. 2020;58:126445. PubMed PMID: 31869738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD). AU - Skalny,Anatoly V, AU - Mazaletskaya,Anna L, AU - Ajsuvakova,Olga P, AU - Bjørklund,Geir, AU - Skalnaya,Margarita G, AU - Chao,Jane C-J, AU - Chernova,Lyubov N, AU - Shakieva,Roza A, AU - Kopylov,Philippe Yu, AU - Skalny,Andrey A, AU - Tinkov,Alexey A, Y1 - 2019/12/06/ PY - 2019/09/16/received PY - 2019/11/07/revised PY - 2019/12/05/accepted PY - 2019/12/24/pubmed PY - 2020/10/9/medline PY - 2019/12/24/entrez KW - Chromium KW - Copper KW - Magnesium KW - Neurodevelopment KW - Zinc SP - 126445 EP - 126445 JF - Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) JO - J Trace Elem Med Biol VL - 58 N2 - BACKGROUND: Essential trace elements and minerals play a significant role in neurodevelopment. Although certain studies demonstrated impaired essential trace element and mineral status in children with ADHD, the existing data are insufficient. The objective of the present study was to assess serum trace element and mineral levels in children with ADHD. METHODS: Serum trace element and mineral levels in 68 children with ADHD and 68 neurotypical controls were assessed using ICP-MS at NexION 300D (PerkinElmer Inc., USA) equipped with ESI SC-2 DX4 autosampler (Elemental Scientific Inc., USA). RESULTS: Serum Cr, Mg, and Zn levels in children with ADHD were 21 % (p = 0.010), 4 % (p = 0.005), and 7 % (p = 0. 001) lower as compared to the healthy controls, respectively. In turn, serum Cu/Zn values were 11 % higher than those in the control group. Age and gender had a significant impact on serum element levels in ADHD. Particularly, preschool children were characterized by significantly increased Cu (+8 %; p = 0.034), and Cu/Zn (+19 %; p < 0.001) values, whereas serum Zn (-9 %; p = 0.004) level was decreased. In primary school-aged children only 6 % (p = 0.007) lower Mg levels were observed. Both boys and girls with ADHD were characterized by 8 % (p = 0.016) lower serum Zn levels and 10 % (p = 0.049) higher Cu/Zn values when compared to neurotypical girls. Boys with ADHD also had significantly higher Cu/Zn, exceeding the respective control values by 12 % (p = 0.021), predominantly due to a 7 % (p = 0.035) decrease in serum Zn. Serum Mg levels were also found to be significantly lower than those in neurotypical children by 5 % (p = 0.007). In adjusted regression models serum Cr (β=-0.234; p = 0.009) and Cu/Zn (β = 0.245; p = 0.029) values were significantly associated with ADHD, respectively. Two-way ANOVA revealed a significant impact of ADHD on Cr, Mg, Zn, and Cu/Zn, whereas age was associated with Cu, I, Mg, Mo, and Cu/Zn, whereas gender accounted only for variability in serum Mn levels. Principal component analysis (PCA) also revealed significant contributions of Mg, Zn, and Cu/Zn values to ADHD variability. CONCLUSIONS: Hypothetically, the observed decrease of essential trace elements, namely Mg and Zn, and elevation of Cu/Zn may significantly contribute to the risk of ADHD or its severity and/or comorbidity. SN - 1878-3252 UR - https://www.unboundmedicine.com/medline/citation/31869738/Serum_zinc_copper_zinc_to_copper_ratio_and_other_essential_elements_and_minerals_in_children_with_attention_deficit/hyperactivity_disorder__ADHD__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0946-672X(19)30590-5 DB - PRIME DP - Unbound Medicine ER -