Attention deficit hyperactivity disorder in the diabetic population: relationship with metabolic syndrome and atherogenic index of plasma
Abstract
Aims: The objective of the current study is to investigate the prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) among individuals diagnosed with diabetes mellitus (DM). Additionally, this study aims to evaluate the potential association between ADHD and metabolic syndrome (MetS), atherogenic index of plasma (AIP), and other lipid parameters, considering the different types of DM.
Methods: The study comprised 213 adult patients diagnosed with diabetes mellitus, consisting of 120 females and 93 males. Participants completed the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) as a screening tool for symptoms. The study assessed many physiological indicators, including body mass index, waist circumference, blood pressure, glucose levels, cholesterol levels, high-density lipoprotein levels, low-density lipoprotein levels, triglyceride levels, uric acid levels, and glycated hemoglobin levels.
Results: The study yielded a prevalence rate of 10.7% for ADHD among diabetes individuals. The prevalence of ADHD was found to be more common in individuals diagnosed with type 1 diabetes mellitus (T1DM) compared to those with type 2 diabetes mellitus (T2DM), with rates of 15.4% and 9.8% respectively. The study revealed that individuals diagnosed with T2DM who also had MetS, organ involvement, concurrent disorders, and stress-related eating had significantly higher scores on the ASRS/T scale. There was a correlation observed between the ASRS-HI and AIP levels in individuals diagnosed with T2DM. The statistical analysis revealed that ADHD-HI and T scores significantly influenced the severity of MetS. A progressive increase in ASRS/T and ASRS/I scores was observed with the duration of DM.
Conclusion: In conclusion, by recognizing and treating accompanying neuropsychiatric conditions such as ADHD symptoms in diabetic patients, individuals may exhibit improved adherence to lifestyle modifications and antidiabetic therapies. This approach potentially reduces the risks of acute and chronic complications, including cardiovascular risk, through the enhanced management of DM.
Keywords
Diabetes mellitus attention deficit hyperactivity disorder metabolic syndrome atherogenic index of plasma
Ethical Statement
The study protocol was approved by the Erzurum Training and Research Hospital Ethics Committee (02/16 numbered Decision, Date: 14.06.2023).
References
- Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157:107843.
- Landau Z, Pinhas-Hamiel O. Attention deficit/hyperactivity, the metabolic syndrome, and type 2 diabetes. Curr Diab Rep. 2019;19(8):46.
- Matthews M, Nigg JT, Fair DA. Attention deficit hyperactivity disorder. Curr Top Behav Neurosci. 2014;16:235-266.
- Faraone SV, Doyle AE. Genetic influences on attention deficit hyperactivity disorder. Curr Psychiatry Rep. 2000;2(2):143-146.
- Florez JC, Hirschhorn J, Altshuler D. The inherited basis of diabetes mellitus: implications for the genetic analysis of complex traits. Annu Rev Genomics Hum Genet. 2003;4(1):257-291.
- Song P, Zha M, Yang Q, Zhang Y, Li X, Rudan I. The prevalence of adult attention-deficit hyperactivity disorder: a global systematic review and meta-analysis. J Glob Health. 2021;11:04009. doi: 10.7189/jogh.11.04009
- Fayyad J, De Graaf R, Kessler R, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190(5):402-409.
- Tannock R. Rethinking ADHD and LD in DSM-5: proposed changes in diagnostic criteria. J Learn Disabil. 2013;46(1):5-25.
- Arnsten AF. Fundamentals of attention-deficit/hyperactivity disorder: circuits and pathways. J Clin Psychiatry. 2006;67(Suppl 8):7-12.
- Robbins TW. Chemistry of the mind: neurochemical modulation of prefrontal cortical function. J Comp Neurol. 2005;493(1):140-146.
- Pérez-Taboada I, Alberquilla S, Martín ED, et al. Diabetes causes dysfunctional dopamine neurotransmission favoring nigrostriatal degeneration in mice. Mov Disord. 2020;35(9):1636-1648.
- Hansen F, Pandolfo P, Galland F, et al. Methylglyoxal can mediate behavioral and neurochemical alterations in rat brains. Physiol Behav. 2016;164(Pt A):93-101.
- Akhter F, Chen D, Akhter A, et al. High dietary advanced glycation end products impair mitochondrial and cognitive function. J Alzheimers Dis. 2020;76(1):165-178.
- Pignalosa FC, Desiderio A, Mirra P, et al. Diabetes and cognitive impairment: a role for glucotoxicity and dopaminergic dysfunction. Int J Mol Sci. 2021;22(22):12366.
- Barzilay JI, Lovato JF, Murray AM, et al. Albuminuria and cognitive decline in people with diabetes and normal renal function. Clin J Am Soc Nephrol. 2013;8(11):1907-1914.
- Xu Y, Bao L, Liu C. The relationship between blood lipid and attention-deficit/hyperactivity disorder (ADHD) in an obese population of Chinese children: an obesity-stratified cross-sectional study. Int J Gen Med. 2021;14:10503-10509.
- Chen MH, Pan TL, Hsu JW, et al. Risk of type 2 diabetes in adolescents and young adults with attention-deficit/hyperactivity disorder: a nationwide longitudinal study. J Clin Psychiatry. 2018;79(3):17m11607.
- Kapellen TM, Reimann R, Kiess W, Kostev K. Prevalence of medically treated children with ADHD and type 1 diabetes in Germany - analysis of two representative databases. J Pediatr Endocrinol Metab. 2016;29(11):1293-1297.
- Butwicka A, Frisén L, Almqvist C, Zethelius B, Lichtenstein P. Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study [published correction appears in Diabetes Care. 2016;39(3):495]. Diabetes Care. 2015;38(3):453-459.
- Hilgard D, Konrad K, Meusers M, et al. Comorbidity of attention deficit hyperactivity disorder and type 1 diabetes in children and adolescents: analysis based on the multicentre DPV registry. Pediatr Diabetes. 2017;18(8):706-713.
- Hsu JL, Chen YL, Leu JG, et al. Microstructural white matter abnormalities in type 2 diabetes mellitus: a diffusion tensor imaging study. Neuroimage. 2012;59(2):1098-1105.
- Novak V, Last D, Alsop DC, et al. Cerebral blood flow velocity and periventricular white matter hyperintensities in type 2 diabetes. Diabetes Care. 2006;29(7):1529-1534.
- Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):e297.
- Doğan S, Öncü B, Varol Saraçoğlu G, Küçükgöncü S. Erişkin dikkat eksikliği hiperaktivite bozukluğu kendi bildirim ölçeği (ASRS-v1. 1): Türkçe formunun geçerlilik ve güvenilirliği. Anadolu Psikiyatri Derg. 2009;10(2):77-87.
- Pazvantoğlu O, Akbaş S, Sarısoy G, Baykal S, Zabun Korkmaz I, Bekiroğlu K. DEHB tanılı çocukların ebeveynlerinde DEHB ile ilişkili bazı sorunlu yaşam olayları. Düşünen Adam. 2014;27:61-68.
- Chen Q, Hartman CA, Haavik J, et al. Common psychiatric and metabolic comorbidity of adult attention-deficit/hyperactivity disorder: a population-based cross-sectional study. PLoS One. 2018;13(9):e0204516.
- Xu G, Liu B, Yang W, Snetselaar LG, Jing J. Association of attention-deficit/hyperactivity disorder with diabetes mellitus in US adults. J Diabetes. 2021;13(4):299-306.
- Xie XN, Lei X, Xiao CY, Li YM, Lei XY. Association between type 1 diabetes and neurodevelopmental disorders in children and adolescents: a systematic review and meta-analysis. Front Psychiatry. 2022;13:982696.
- Vinker-Shuster M, Eldor R, Green I, Golan-Cohen A, Manor I, Merzon E. Glycemic control and diabetes related complications in adults with type 1 diabetes mellitus and ADHD. J Atten Disord. 2022;26(9):1235-1244.
- Li L, Chang Z, Sun J, et al. Attention-deficit/hyperactivity disorder as a risk factor for cardiovascular diseases: a nationwide population-based cohort study. World Psychiatry. 2022;21(3):452-459.
- Kannel WB, McGee DL. Diabetes and cardiovascular risk factors: the Framingham study. Circulation. 1979;59(1):8-13.
- Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health. 2017;17(1):101.
- Tan MC, Ng OC, Wong TW, Joseph A, Chan Y, Hejar A. Prevalence of metabolic syndrome in type 2 diabetic patients: a comparative study using WHO, NCEP ATP III, IDF and harmonized definitions. Health. 2013;5(10):1689-1696.
- Pambianco G, Costacou T, Orchard TJ. The prediction of major outcomes of type 1 diabetes: a 12-year prospective evaluation of three separate definitions of the metabolic syndrome and their components and estimated glucose disposal rate: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes Care. 2007;30(5):1248-1254.
Abstract
Ethical Statement
The study protocol was approved by the Erzurum Training and Research Hospital Ethics Committee (02/16 numbered Decision, Date: 14.06.2023).
References
- Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157:107843.
- Landau Z, Pinhas-Hamiel O. Attention deficit/hyperactivity, the metabolic syndrome, and type 2 diabetes. Curr Diab Rep. 2019;19(8):46.
- Matthews M, Nigg JT, Fair DA. Attention deficit hyperactivity disorder. Curr Top Behav Neurosci. 2014;16:235-266.
- Faraone SV, Doyle AE. Genetic influences on attention deficit hyperactivity disorder. Curr Psychiatry Rep. 2000;2(2):143-146.
- Florez JC, Hirschhorn J, Altshuler D. The inherited basis of diabetes mellitus: implications for the genetic analysis of complex traits. Annu Rev Genomics Hum Genet. 2003;4(1):257-291.
- Song P, Zha M, Yang Q, Zhang Y, Li X, Rudan I. The prevalence of adult attention-deficit hyperactivity disorder: a global systematic review and meta-analysis. J Glob Health. 2021;11:04009. doi: 10.7189/jogh.11.04009
- Fayyad J, De Graaf R, Kessler R, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190(5):402-409.
- Tannock R. Rethinking ADHD and LD in DSM-5: proposed changes in diagnostic criteria. J Learn Disabil. 2013;46(1):5-25.
- Arnsten AF. Fundamentals of attention-deficit/hyperactivity disorder: circuits and pathways. J Clin Psychiatry. 2006;67(Suppl 8):7-12.
- Robbins TW. Chemistry of the mind: neurochemical modulation of prefrontal cortical function. J Comp Neurol. 2005;493(1):140-146.
- Pérez-Taboada I, Alberquilla S, Martín ED, et al. Diabetes causes dysfunctional dopamine neurotransmission favoring nigrostriatal degeneration in mice. Mov Disord. 2020;35(9):1636-1648.
- Hansen F, Pandolfo P, Galland F, et al. Methylglyoxal can mediate behavioral and neurochemical alterations in rat brains. Physiol Behav. 2016;164(Pt A):93-101.
- Akhter F, Chen D, Akhter A, et al. High dietary advanced glycation end products impair mitochondrial and cognitive function. J Alzheimers Dis. 2020;76(1):165-178.
- Pignalosa FC, Desiderio A, Mirra P, et al. Diabetes and cognitive impairment: a role for glucotoxicity and dopaminergic dysfunction. Int J Mol Sci. 2021;22(22):12366.
- Barzilay JI, Lovato JF, Murray AM, et al. Albuminuria and cognitive decline in people with diabetes and normal renal function. Clin J Am Soc Nephrol. 2013;8(11):1907-1914.
- Xu Y, Bao L, Liu C. The relationship between blood lipid and attention-deficit/hyperactivity disorder (ADHD) in an obese population of Chinese children: an obesity-stratified cross-sectional study. Int J Gen Med. 2021;14:10503-10509.
- Chen MH, Pan TL, Hsu JW, et al. Risk of type 2 diabetes in adolescents and young adults with attention-deficit/hyperactivity disorder: a nationwide longitudinal study. J Clin Psychiatry. 2018;79(3):17m11607.
- Kapellen TM, Reimann R, Kiess W, Kostev K. Prevalence of medically treated children with ADHD and type 1 diabetes in Germany - analysis of two representative databases. J Pediatr Endocrinol Metab. 2016;29(11):1293-1297.
- Butwicka A, Frisén L, Almqvist C, Zethelius B, Lichtenstein P. Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study [published correction appears in Diabetes Care. 2016;39(3):495]. Diabetes Care. 2015;38(3):453-459.
- Hilgard D, Konrad K, Meusers M, et al. Comorbidity of attention deficit hyperactivity disorder and type 1 diabetes in children and adolescents: analysis based on the multicentre DPV registry. Pediatr Diabetes. 2017;18(8):706-713.
- Hsu JL, Chen YL, Leu JG, et al. Microstructural white matter abnormalities in type 2 diabetes mellitus: a diffusion tensor imaging study. Neuroimage. 2012;59(2):1098-1105.
- Novak V, Last D, Alsop DC, et al. Cerebral blood flow velocity and periventricular white matter hyperintensities in type 2 diabetes. Diabetes Care. 2006;29(7):1529-1534.
- Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):e297.
- Doğan S, Öncü B, Varol Saraçoğlu G, Küçükgöncü S. Erişkin dikkat eksikliği hiperaktivite bozukluğu kendi bildirim ölçeği (ASRS-v1. 1): Türkçe formunun geçerlilik ve güvenilirliği. Anadolu Psikiyatri Derg. 2009;10(2):77-87.
- Pazvantoğlu O, Akbaş S, Sarısoy G, Baykal S, Zabun Korkmaz I, Bekiroğlu K. DEHB tanılı çocukların ebeveynlerinde DEHB ile ilişkili bazı sorunlu yaşam olayları. Düşünen Adam. 2014;27:61-68.
- Chen Q, Hartman CA, Haavik J, et al. Common psychiatric and metabolic comorbidity of adult attention-deficit/hyperactivity disorder: a population-based cross-sectional study. PLoS One. 2018;13(9):e0204516.
- Xu G, Liu B, Yang W, Snetselaar LG, Jing J. Association of attention-deficit/hyperactivity disorder with diabetes mellitus in US adults. J Diabetes. 2021;13(4):299-306.
- Xie XN, Lei X, Xiao CY, Li YM, Lei XY. Association between type 1 diabetes and neurodevelopmental disorders in children and adolescents: a systematic review and meta-analysis. Front Psychiatry. 2022;13:982696.
- Vinker-Shuster M, Eldor R, Green I, Golan-Cohen A, Manor I, Merzon E. Glycemic control and diabetes related complications in adults with type 1 diabetes mellitus and ADHD. J Atten Disord. 2022;26(9):1235-1244.
- Li L, Chang Z, Sun J, et al. Attention-deficit/hyperactivity disorder as a risk factor for cardiovascular diseases: a nationwide population-based cohort study. World Psychiatry. 2022;21(3):452-459.
- Kannel WB, McGee DL. Diabetes and cardiovascular risk factors: the Framingham study. Circulation. 1979;59(1):8-13.
- Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health. 2017;17(1):101.
- Tan MC, Ng OC, Wong TW, Joseph A, Chan Y, Hejar A. Prevalence of metabolic syndrome in type 2 diabetic patients: a comparative study using WHO, NCEP ATP III, IDF and harmonized definitions. Health. 2013;5(10):1689-1696.
- Pambianco G, Costacou T, Orchard TJ. The prediction of major outcomes of type 1 diabetes: a 12-year prospective evaluation of three separate definitions of the metabolic syndrome and their components and estimated glucose disposal rate: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes Care. 2007;30(5):1248-1254.
Details
| Primary Language | English |
|---|---|
| Subjects | Endocrinology, Psychiatry |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | January 15, 2024 |
| Submission Date | October 19, 2023 |
| Acceptance Date | December 15, 2023 |
| Published in Issue | Year 2024 Volume: 6 Issue: 1 |
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