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Dikkat Eksikliği ve Hiperaktivite Bozukluğu Bulunan Çocuklarda Vitamin D ile Periferal İnflamatuar Parametreler Arasındaki İlişkinin Araştırılması

Year 2023, Volume: 15 Issue: 1, 116 - 121, 15.03.2023

Erman Esnafoglu

https://doi.org/10.18521/ktd.1179272

Abstract

Amaç: Dikkat eksikliği ve hiperaktivite bozukluğu (DEHB) patogenezinde rol oynayan vitamin D ile vitamin B12, folat ve homosistein, ve ferritin gibi bazı nütrisyonel faktörlerin, yine DEHB patogenezinde rol oynadığı ileri sürülen inflamasyon üzerine olan etkileri araştırılmasını hedefledik.
Gereç ve yöntemler: 39 DEHB bulunan ve 39 sağlıklı kontrol grubu yaş, cinsiyet ve BMI benzer olacak şekilde karşılaştırıldı. Turgay DEHB ölçeği ile hastalığın şiddeti değerlendirildi. Rutin olarak inflamatuar ve nütrisyonel parametreler ölçüldü.
Bulgular: Hasta grubunda, Vitamin D anlamlı olarak düşük bulunurken (p<0.001), homosistein ise anlamlı olarak yüksek bulunmuştur (p=0.003). İnflamatuar parametreler içinde CRP ve MPV değerleri anlamlı olarak yüksek bulunmuştur (ikisi için p<0.001). Nütrisyonel faktörler ile inflamatuar parametreler arasında anlamlı korelasyonlar tespit edilmemiştir (hepsi için p>0.05).
Sonuç: Vitamin D’nin ve tek karbon metabolizması ile ilgili olan homosistein yüksekliğinin DEHB patogenezinde rol oynayabileceği düşünülebilir. Bazı inflamatuar değerlerin yüksek olarak bulunması da DEHB patogenezinde inflamasyonun rolüne işaret edebiliri. Nütrisyonel ve inflamatuar parametreler arasında anlamlı bir ilişki bulunmamıştır. Fakat çalışmanın kısıtlılıkları göz önüne alındığında bu konuda ileri araştırmalara ihtiyaç duyulmaktadır.

Keywords

vitamin D nütrisyon inflamasyon periferal inflamatuar belirteçler dikkat eksikliği ve hiperaktivite bozukluğu tek karbon metabolizması

Supporting Institution

yok

Project Number

yok

References

  • 1.Association AP. Diagnostic and statistical manual of mental disorders. 5th ed. Washington (DC): American Psychiatric Publishing; 2013.
  • 2. Polanczyk G, De Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-948.
  • 3. Biederman J. Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatry 2005;57:1215-20.
  • 4. Esnafoğlu E, Yaman E. Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder. Psychiatry Res. 2017; 254:232-237.
  • 5. Esnafoğlu E. Özgül öğrenme bozukluğu bulunan çocuklarda serum folat, vitamin b12, homosistein ve vitamin d seviyeleri Serum Folate, Vitamin B12, Homocysteine and Vitamin D Levels in Children With Specific Learning Disorder. Bozok Tıp Dergisi. 2018;8(3):59-64.
  • 6. Esnafoglu E, Ozturan DD. The relationship of severity of depression with homocysteine, folate, vitamin B12, and vitamin D levels in children and adolescents. Child Adolesc Ment Health. 2020;25(4);249-255.
  • 7. Esnafoğlu E. Otistik Spektrum Bozukluğu Bulunan Çocuklarda Vitamin B12, Folat ve Vitamin D Seviyelerinin İncelenmesi. Klinik Tıp Aile Hekimliği. 2017;9(4):36-41.
  • 8. Mentch SJ, Locasale JW. One‐carbon metabolism and epigenetics: understanding the specificity. Ann N Y Acad Sci. 2016;1363(1):91-98.
  • 9. Klee GG. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B12 and folate. Clin Chem. 2000;46(8):1277-1283.
  • 10. Sadeghiyeh T, Dastgheib SA, Lookzadeh MH, Noori-Shadkam M, Akbarian-Bafghi, MJ, Zare-Shehneh M, at al. Association of MTHFR 677C> T and 1298A> C polymorphisms with susceptibility to attention deficit and hyperactivity disorder. Fetal Pediatr Pathol. 2020;39(5):422-429.
  • 11. Patrick RP, Ames BN. Vitamin D and the omega‐3 fatty acids control serotonin synthesis and action, part 2: Relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. The FASEB J. 2015;29(6):2207-2222.
  • 12. Cui X, Pertile R, Liu P, Eyles DW. Vitamin D regulates tyrosine hydroxylase expression: N-cadherin a possible mediator. Neuroscience. 2015;304:90-100.
  • 13. Harms LR, Burne TH, Eyles DW, McGrath JJ. Vitamin D and the brain. Best Pract Res Clin Endocrinol Metab. 2011;25(4):657-669.
  • 14. Krishnan AV, Feldman D. Mechanisms of the anti-cancer and anti-inflammatory actions of vitamin D. Annu Rev Pharmacol Toxicol. 2011;51(1):311-336.
  • 15. Koorts AM, Viljoen M. Acute phase proteins: Ferritin and ferritin isoforms. In Acute phase proteins-regulation and functions of acute phase proteins. IntechOpen. 2011.
  • 16. Chang JPC, Mondelli V, Satyanarayanan SK, Chiang YJ, Chen HT, Su KP, Pariante CM. Cortisol, inflammatory biomarkers and neurotrophins in children and adolescents with attention deficit hyperactivity disorder (ADHD) in Taiwan. Brain Behav Immun. 2020;88:105-113.
  • 17. Kumarasamy C, Sabarimurugan S, Madurantakam RM, Lakhotiya K, Samiappan S, Baxi S, at al. Prognostic significance of blood inflammatory biomarkers NLR, PLR, and LMR in cancer—A protocol for systematic review and meta-analysis. Medicine. 2019;98(24).
  • 18. Oztas D, Erdogan S, Benzil A, Nadar O, Erel O. Yeni Bir İnflamatuar Belirteç: vitamin B12. Journal of Immunology and Clinical Microbiology. 2019:4(1);1-12.
  • 19. Hosseinzadeh H, Moallem SA, Moshiri M, Sarnavazi MS, Etemad L. Anti-nociceptive and anti-inflammatory effects of cyanocobalamin (vitamin B12) against acute and chronic pain and inflammation in mice. Arzneimittelforschung. 2012;62(07):324-329.
  • 20. Gori AM, Corsi AM, Fedi S, Gazzini A, Sofi F, Bartali B, at al. A proinflammatory state is associated with hyperhomocysteinemia in the elderly–. Am J Clin Nutr. 2005;82(2):335-341.
  • 21. Ravaglia G, Forti P, Maioli F, Servadei L, Martelli M, Arnone G, at al. Plasma homocysteine and inflammation in elderly patients with cardiovascular disease and dementia. Exp Gerontol. 2004;39(3):443-450.
  • 22. Elsherbiny NM, Sharma I, Kira D, Alhusban S, Samra YA, Jadeja R, at al. Homocysteine induces inflammation in retina and brain. Biomolecules. 2020;10(3):393.
  • 23. Kočovská E, Gaughran F, Krivoy A, Meier UC. Vitamin-D deficiency as a potential environmental risk factor in multiple sclerosis, schizophrenia, and autism. Front Psychiatry. 2017;8:47.
  • 24.Calton EK, Keane KN, Newsholme P, Soares MJ. The impact of vitamin D levels on inflammatory status: a systematic review of immune cell studies. PloS one, 2015;10(11):e0141770.
  • 25. Unal F, Oktem F, Cetin Cuhadaroclu F, Cengel Kultur SE, Akdemir D, Foto Ozdemir D, at al. Reliability and validity of the schedule for affective disorders and schizophrenia for school-age children-present and lifetime version, DSM-5 November 2016-Turkish adaptation (K-SADS-PL-DSM-5-T). 2019
  • 26. Turgay A. The DSM-IV Based child and adolescent behavior rating scale. Ontario, Integrative Therapy Institute, Canada, 1995 (Unpublished form).
  • 27. Ercan ES, Amado S, Somer O, Çıkoğlu S. Development of a test battery for the assessment of attention deficit hyperactivity disorder. Turk C Child Adolesc Ment Health. 2001;8:132-44.
  • 28. Altun H, Kurutaş EB, Şahin N, Güngör O, Fındıklı E. The levels of vitamin D, vitamin D receptor, homocysteine and complex B vitamin in children with autism spectrum disorders. Clin Psychopharmacol Neurosci. 2018;16(4):383.
  • 29. Zhang Y, Hodgson NW, Trivedi MS, Abdolmaleky HM, Fournier M, Cuenod M, at al. Decreased brain levels of vitamin B12 in aging, autism and schizophrenia. PloS one. 2016;11(1):e0146797.
  • 30. Topal Z, Tufan AE, Karadag M, Gokcen C, Akkaya C, Sarp AS, at al. Evaluation of peripheral inflammatory markers, serum B12, folate, ferritin levels and clinical correlations in children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Nord J Psychiatry. 2022;76(2):150-157.
  • 31. Kotsi E, Kotsi E, Perrea DN. Vitamin D levels in children and adolescents with attention-deficit hyperactivity disorder (ADHD): a meta-analysis. ADHD Atten Defic Hyperact Disord. 2019;11(3):221-232.
  • 32. Esnafoglu E, Subaşı B. Association of low 25-OH-vitamin D levels and peripheral inflammatory markers in patients with autism spectrum disorder: Vitamin D and inflammation in Autism. Psychiatry Res. 2022;316:114735.
  • 33. Oner O, Alkar OY, Oner P. Relation of ferritin levels with symptom ratings and cognitive performance in children with attention deficit–hyperactivity disorder. Pediatr Int. 2008;50(1):40-44.
  • 34. Youdim MB. Nutrient deprivation and brain function: iron. Nutrition. 2000;16(7-8):504–508.
  • 35. Anand D, Colpo GD, Zeni G, Zeni CP, Teixeira AL. Attention-deficit/hyperactivity disorder and inflammation: what does current knowledge tell us? A systematic review. Front Psychiatry. 2017;8:228.
  • 36. Avcil S. Evaluation of the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as inflammatory markers in children with attention‐deficit hyperactivity disorder. Psychiatry Clin Neurosci. 2018;72(7):522-530.

Investigation of the relationship between vitamin D and peripheral inflammatory parameters in children with attention deficit and hyperactivity disorder

Year 2023, Volume: 15 Issue: 1, 116 - 121, 15.03.2023

Erman Esnafoglu

https://doi.org/10.18521/ktd.1179272

Abstract

Objective: We aimed to investigate the effects of vitamin D and some nutritional factors such as vitamin B12, folate, homocysteine, and ferritin, which play a role in the pathogenesis of attention deficit and hyperactivity disorder (ADHD), on inflammation, which is also claimed to play a role in the pathogenesis of ADHD.
Materials and methods: 39 ADHD and 39 healthy controls were compared with similar age, gender and BMI. The severity of the disease was evaluated with the Turgay ADHD scale. Inflammatory and nutritional parameters were measured routinely.
Results: In the patient group, Vitamin D was found to be significantly lower (p<0.001), while homocysteine was found to be significantly higher (p=0.003). CRP and MPV values among inflammatory parameters were found to be significantly higher (p<0.001 for both). No significant correlations were found between nutritional factors and inflammatory parameters (p>0.05 for all).
Conclusion: It can be suggested that low levels of vitamin D and high levels of homocysteine, which is related to single carbon metabolism, may play a role in the pathogenesis of ADHD. High levels of some inflammatory values may also indicate the role of inflammation in the pathogenesis of ADHD. No significant relationship was found between nutritional and inflammatory parameters. However, considering the limitations of the study, further research is needed on this subject.

Keywords

vitamin D nutrition inflammation peripheral inflammatory markers attention deficit and hyperactivity disorder one-carbon metabolism

Project Number

yok

References

  • 1.Association AP. Diagnostic and statistical manual of mental disorders. 5th ed. Washington (DC): American Psychiatric Publishing; 2013.
  • 2. Polanczyk G, De Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-948.
  • 3. Biederman J. Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatry 2005;57:1215-20.
  • 4. Esnafoğlu E, Yaman E. Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder. Psychiatry Res. 2017; 254:232-237.
  • 5. Esnafoğlu E. Özgül öğrenme bozukluğu bulunan çocuklarda serum folat, vitamin b12, homosistein ve vitamin d seviyeleri Serum Folate, Vitamin B12, Homocysteine and Vitamin D Levels in Children With Specific Learning Disorder. Bozok Tıp Dergisi. 2018;8(3):59-64.
  • 6. Esnafoglu E, Ozturan DD. The relationship of severity of depression with homocysteine, folate, vitamin B12, and vitamin D levels in children and adolescents. Child Adolesc Ment Health. 2020;25(4);249-255.
  • 7. Esnafoğlu E. Otistik Spektrum Bozukluğu Bulunan Çocuklarda Vitamin B12, Folat ve Vitamin D Seviyelerinin İncelenmesi. Klinik Tıp Aile Hekimliği. 2017;9(4):36-41.
  • 8. Mentch SJ, Locasale JW. One‐carbon metabolism and epigenetics: understanding the specificity. Ann N Y Acad Sci. 2016;1363(1):91-98.
  • 9. Klee GG. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B12 and folate. Clin Chem. 2000;46(8):1277-1283.
  • 10. Sadeghiyeh T, Dastgheib SA, Lookzadeh MH, Noori-Shadkam M, Akbarian-Bafghi, MJ, Zare-Shehneh M, at al. Association of MTHFR 677C> T and 1298A> C polymorphisms with susceptibility to attention deficit and hyperactivity disorder. Fetal Pediatr Pathol. 2020;39(5):422-429.
  • 11. Patrick RP, Ames BN. Vitamin D and the omega‐3 fatty acids control serotonin synthesis and action, part 2: Relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. The FASEB J. 2015;29(6):2207-2222.
  • 12. Cui X, Pertile R, Liu P, Eyles DW. Vitamin D regulates tyrosine hydroxylase expression: N-cadherin a possible mediator. Neuroscience. 2015;304:90-100.
  • 13. Harms LR, Burne TH, Eyles DW, McGrath JJ. Vitamin D and the brain. Best Pract Res Clin Endocrinol Metab. 2011;25(4):657-669.
  • 14. Krishnan AV, Feldman D. Mechanisms of the anti-cancer and anti-inflammatory actions of vitamin D. Annu Rev Pharmacol Toxicol. 2011;51(1):311-336.
  • 15. Koorts AM, Viljoen M. Acute phase proteins: Ferritin and ferritin isoforms. In Acute phase proteins-regulation and functions of acute phase proteins. IntechOpen. 2011.
  • 16. Chang JPC, Mondelli V, Satyanarayanan SK, Chiang YJ, Chen HT, Su KP, Pariante CM. Cortisol, inflammatory biomarkers and neurotrophins in children and adolescents with attention deficit hyperactivity disorder (ADHD) in Taiwan. Brain Behav Immun. 2020;88:105-113.
  • 17. Kumarasamy C, Sabarimurugan S, Madurantakam RM, Lakhotiya K, Samiappan S, Baxi S, at al. Prognostic significance of blood inflammatory biomarkers NLR, PLR, and LMR in cancer—A protocol for systematic review and meta-analysis. Medicine. 2019;98(24).
  • 18. Oztas D, Erdogan S, Benzil A, Nadar O, Erel O. Yeni Bir İnflamatuar Belirteç: vitamin B12. Journal of Immunology and Clinical Microbiology. 2019:4(1);1-12.
  • 19. Hosseinzadeh H, Moallem SA, Moshiri M, Sarnavazi MS, Etemad L. Anti-nociceptive and anti-inflammatory effects of cyanocobalamin (vitamin B12) against acute and chronic pain and inflammation in mice. Arzneimittelforschung. 2012;62(07):324-329.
  • 20. Gori AM, Corsi AM, Fedi S, Gazzini A, Sofi F, Bartali B, at al. A proinflammatory state is associated with hyperhomocysteinemia in the elderly–. Am J Clin Nutr. 2005;82(2):335-341.
  • 21. Ravaglia G, Forti P, Maioli F, Servadei L, Martelli M, Arnone G, at al. Plasma homocysteine and inflammation in elderly patients with cardiovascular disease and dementia. Exp Gerontol. 2004;39(3):443-450.
  • 22. Elsherbiny NM, Sharma I, Kira D, Alhusban S, Samra YA, Jadeja R, at al. Homocysteine induces inflammation in retina and brain. Biomolecules. 2020;10(3):393.
  • 23. Kočovská E, Gaughran F, Krivoy A, Meier UC. Vitamin-D deficiency as a potential environmental risk factor in multiple sclerosis, schizophrenia, and autism. Front Psychiatry. 2017;8:47.
  • 24.Calton EK, Keane KN, Newsholme P, Soares MJ. The impact of vitamin D levels on inflammatory status: a systematic review of immune cell studies. PloS one, 2015;10(11):e0141770.
  • 25. Unal F, Oktem F, Cetin Cuhadaroclu F, Cengel Kultur SE, Akdemir D, Foto Ozdemir D, at al. Reliability and validity of the schedule for affective disorders and schizophrenia for school-age children-present and lifetime version, DSM-5 November 2016-Turkish adaptation (K-SADS-PL-DSM-5-T). 2019
  • 26. Turgay A. The DSM-IV Based child and adolescent behavior rating scale. Ontario, Integrative Therapy Institute, Canada, 1995 (Unpublished form).
  • 27. Ercan ES, Amado S, Somer O, Çıkoğlu S. Development of a test battery for the assessment of attention deficit hyperactivity disorder. Turk C Child Adolesc Ment Health. 2001;8:132-44.
  • 28. Altun H, Kurutaş EB, Şahin N, Güngör O, Fındıklı E. The levels of vitamin D, vitamin D receptor, homocysteine and complex B vitamin in children with autism spectrum disorders. Clin Psychopharmacol Neurosci. 2018;16(4):383.
  • 29. Zhang Y, Hodgson NW, Trivedi MS, Abdolmaleky HM, Fournier M, Cuenod M, at al. Decreased brain levels of vitamin B12 in aging, autism and schizophrenia. PloS one. 2016;11(1):e0146797.
  • 30. Topal Z, Tufan AE, Karadag M, Gokcen C, Akkaya C, Sarp AS, at al. Evaluation of peripheral inflammatory markers, serum B12, folate, ferritin levels and clinical correlations in children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Nord J Psychiatry. 2022;76(2):150-157.
  • 31. Kotsi E, Kotsi E, Perrea DN. Vitamin D levels in children and adolescents with attention-deficit hyperactivity disorder (ADHD): a meta-analysis. ADHD Atten Defic Hyperact Disord. 2019;11(3):221-232.
  • 32. Esnafoglu E, Subaşı B. Association of low 25-OH-vitamin D levels and peripheral inflammatory markers in patients with autism spectrum disorder: Vitamin D and inflammation in Autism. Psychiatry Res. 2022;316:114735.
  • 33. Oner O, Alkar OY, Oner P. Relation of ferritin levels with symptom ratings and cognitive performance in children with attention deficit–hyperactivity disorder. Pediatr Int. 2008;50(1):40-44.
  • 34. Youdim MB. Nutrient deprivation and brain function: iron. Nutrition. 2000;16(7-8):504–508.
  • 35. Anand D, Colpo GD, Zeni G, Zeni CP, Teixeira AL. Attention-deficit/hyperactivity disorder and inflammation: what does current knowledge tell us? A systematic review. Front Psychiatry. 2017;8:228.
  • 36. Avcil S. Evaluation of the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as inflammatory markers in children with attention‐deficit hyperactivity disorder. Psychiatry Clin Neurosci. 2018;72(7):522-530.
There are 36 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Erman Esnafoglu 0000-0001-8685-1153

Project Number yok
Publication Date March 15, 2023
Acceptance Date February 20, 2023
Published in Issue Year 2023 Volume: 15 Issue: 1

Cite

APA Esnafoglu, E. (2023). Investigation of the relationship between vitamin D and peripheral inflammatory parameters in children with attention deficit and hyperactivity disorder. Konuralp Medical Journal, 15(1), 116-121. https://doi.org/10.18521/ktd.1179272
AMA Esnafoglu E. Investigation of the relationship between vitamin D and peripheral inflammatory parameters in children with attention deficit and hyperactivity disorder. Konuralp Medical Journal. March 2023;15(1):116-121. doi:10.18521/ktd.1179272
Chicago Esnafoglu, Erman. “Investigation of the Relationship Between Vitamin D and Peripheral Inflammatory Parameters in Children With Attention Deficit and Hyperactivity Disorder”. Konuralp Medical Journal 15, no. 1 (March 2023): 116-21. https://doi.org/10.18521/ktd.1179272.
EndNote Esnafoglu E (March 1, 2023) Investigation of the relationship between vitamin D and peripheral inflammatory parameters in children with attention deficit and hyperactivity disorder. Konuralp Medical Journal 15 1 116–121.
IEEE E. Esnafoglu, “Investigation of the relationship between vitamin D and peripheral inflammatory parameters in children with attention deficit and hyperactivity disorder”, Konuralp Medical Journal, vol. 15, no. 1, pp. 116–121, 2023, doi: 10.18521/ktd.1179272.
ISNAD Esnafoglu, Erman. “Investigation of the Relationship Between Vitamin D and Peripheral Inflammatory Parameters in Children With Attention Deficit and Hyperactivity Disorder”. Konuralp Medical Journal 15/1 (March 2023), 116-121. https://doi.org/10.18521/ktd.1179272.
JAMA Esnafoglu E. Investigation of the relationship between vitamin D and peripheral inflammatory parameters in children with attention deficit and hyperactivity disorder. Konuralp Medical Journal. 2023;15:116–121.
MLA Esnafoglu, Erman. “Investigation of the Relationship Between Vitamin D and Peripheral Inflammatory Parameters in Children With Attention Deficit and Hyperactivity Disorder”. Konuralp Medical Journal, vol. 15, no. 1, 2023, pp. 116-21, doi:10.18521/ktd.1179272.
Vancouver Esnafoglu E. Investigation of the relationship between vitamin D and peripheral inflammatory parameters in children with attention deficit and hyperactivity disorder. Konuralp Medical Journal. 2023;15(1):116-21.
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