Investigation on allergic diseases in children with attention deficit hyperactivity disorder

doi:10.11852/zgetbjzz2021-0165

Abstract

Abstract: Objective To investigate the prevalence of allergic diseases in children with attention deficit hyperactivity disorder(ADHD) aged 4 to 12 years,in order to provide theoretical basis for the prevention and treatment of ADHD. Methods A case-control study was adopted. From October 2019 to April 2020,800 children with ADHD in the Department of Child Healthcare of Shanghai Children's Hospital were enrolled in the ADHD group,meanwhile 800 healthy children were selected as the control group. Demographic data and clinical disease data of the two groups were collected by questionnaire. Univariate analysis was used to compare the prevalence of allergic diseases between ADHD group and control group. Logistic regression analysis was used to analyze the risk of ADHD in children with co-morbidities of allergic diseases and the effect of anti-allergic treatment on the symptoms of ADHD. Results There was significant difference in the prevalence of allergic diseases between ADHD group and control group(χ²=23.220,P<0.001). The risk of ADHD in single allergic disease group was 1.681(95%CI: 1.163 - 2.375),which was 2.494(95% CI:1.912 - 3.254) in the mixed allergic disease group. When children with ADHD developed allergic symptoms,58.2% of them had worse ADHD symptoms than before. The proportion of ADHD in children with mixed allergic diseases was higher than that in children with single allergic diseases(60.6% vs. 53.7%,χ²=434.161,P<0.001). Conclusion Allergic diseases may increase the risk of ADHD in children,and the more co-morbidities of allergic diseases,the higher the risk of ADHD.

Key words: attention deficit hyperactivity disorder, allergic diseases, brain-gut axis, children

摘要： 目的调查注意缺陷多动障碍(ADHD)儿童过敏性疾病的发生情况,为ADHD的治疗和预防提供理论依据。方法采用病例对照研究,选择2019年10月-2020年4月上海市儿童医院儿童保健科就诊的800例ADHD儿童为ADHD组,同时选取800例健康体检儿童设为对照组,通过调查问卷的形式,收集两组儿童的人口学资料及临床病史资料,采用单因素χ²检验比较ADHD组和对照组儿童过敏性疾病的患病率,采用Logistic回归模型分析不同过敏性疾病共患时儿童ADHD患病风险及抗过敏治疗对ADHD症状的影响。结果 ADHD组儿童过敏性疾病患病率与对照组差异有统计学意义(χ²=23.220,P<0.001);单一过敏性疾病组儿童ADHD患病风险OR值为1.681(95%CI:1.163~2.375),混合过敏性疾病组儿童ADHD患病风险OR值为2.494(95%CI:1.912~3.254);当ADHD患儿出现过敏症状时,58.2%的患儿ADHD症状较前加重,其中混合过敏性疾病组ADHD症状较前加重的患儿比例高于单一过敏性疾病组(60.6% vs.53.7%,χ²＝434.161,P<0.001)。结论 ADHD儿童过敏性疾病患病率高于对照组;过敏性疾病增加儿童 ADHD的患病风险,过敏性疾病共患种类越多,ADHD患病风险越高。

关键词: 注意缺陷多动障碍, 过敏性疾病, 脑-肠轴, 儿童

CLC Number:

R749.94

FANG Yuan, KONG Wei-yan, MA Chen-huan, PAN Li-zhu, ZHU Pei-ying, WANG Yu. Investigation on allergic diseases in children with attention deficit hyperactivity disorder[J]. Chinese Journal of Child Health Care, 2022, 30(4): 431-435.

方圆, 孔维延, 马晨欢, 潘丽珠, 朱佩滢, 王瑜. 注意缺陷多动障碍儿童过敏性疾病发生情况的调查[J]. 中国儿童保健杂志, 2022, 30(4): 431-435.

References

[1] Polanczy KG,de Lima MS,Horta BL,et al.The worldwide prevalence of ADHD:A systematic review and meta regres-sion analysis[J].Psychiatry,2007,164(6):942-948.
[2] 刘靖,郑毅.《中国注意缺陷多动障碍防治指南》第二版解读[J].中华精神科杂志,2016,49(3):132-135.
[3] Sanders S,Doust J,Beller E,et al.Prevalence of attention-deficit/hyperactivity disorder:a systemic review and meta-analysis[J].Pediatrics,2015,135(4):994-1001.
[4] Wang T,Liu K,Li Z,et al.Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China:A systematic review and meta-analysis[J].BMC Psychiatry,2017,17(1):32.
[5] Costa-Pinto FA,Basso AS.Neural and behavioral correlates of food allergy[J].Chem Immunol Allergy,2012,98:222-239.
[6] Louveau A,Smirnov I,Keyes TJ,et al.Structural and functional features of central nervous system lymphatic vessels[J].Nature,2016,523:337-341.
[7] Shyu CS,Lin HK,Lin CH,et al.Prevalence of attention deficit hyperactivity disorder in patients with pediatric allergic disorders:a nationwide,population—based study[J].J Microbiol Immunol Infect,2012,45(3):237-242.
[8] Strom MA,Fishbein AB,Paller AS,et al.Assocoation bewteen atopic dermatitis and attention-deficit/hpperactivity disorder in US.children and adult[J].Br J Dermatol,2016,175(5):920-929.
[9] 刘欣,季忆婷,李生慧,等.小学生注意缺陷多动障碍的危险因素分析[J].上海交通大学学报(医学版),2016,36(8):1191-1195.
[10] 江晓东,沈春,李珂,等.气道过敏性疾病对学龄儿童注意缺陷多动障碍患病风险的影响[J].中华儿科杂志,2017,55(7):509-513.
[11] Miyazaki C,Koyama M,Ota E,et al.Allergic diseases in children with attention deficit hyperactivity disorder:A systematic review and meta-analysis[J].BMC Psychiatry,2017,17(1):120.
[12] 钱兴国,曾小周,王培席,等.儿童注意缺陷多动障碍与哮喘及过敏性疾病关系的病例对照研究[J].中国儿童保健杂志,2014,22(7):699-701.
[13] Ferro MA,van Lieshout RJ,Ohayon J,et al.Emotional and behavioral problems in adolescents and young adults with food allergy[J].Allergy,2016,71:532-540.
[14] Topal E,Catal F,Soylu N,et al.Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy[J].Allergologia Et Immunopathologia,2016,44(5):445-449.
[15] Schans JV,Cicek R,de Vries TW,et al.Association of atopic diseases and attention-deficit/hyperactivity disorder:A systematic review and meta-analyses[J].Neurosci Biobehav Rev,2017,74(Pt A):139-148.
[16] Lin YT,Chen YC,Gau SS,et al.Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children[J].Pediatr Res,2016,80:480-485.
[17] Liao TC,Lien YT,Wang S,et al.Comorbidity of atopic disorders with autism spectrum disorder and attention deficit/hyperactivity disorder[J].J Pediatr,2016,171:248-255.
[18] Ishiuii Y,Coghitl RC,Patel TS,et al.Distinct patterns of brain activity evoked by histamine-induced itch reveal an association with itch intensity and disease severity in atopic dermatitis[J].Br J Dennatol,2009,161(5):1072-1090.
[19] Matucci A,Vultaggio A,Maggi E,et al.Is IgE or eosinophils the key player in allergic asthma pathogenesis?Are we asking the right question[J].Respir Res,2018,19(1):113.
[20] Yang C,Yang CC,Wang I.Association between allergic diseases sensitization and attention-deficit/hpperactivity disorder in children:A large-scale,population-based study[J].J Chen Med Assoc,2018,81(3):277-283.
[21] Wu J,de Theije CG,Lopes d SS,et al.Dietary interventions that reduce mTOR activity rescue autistic-like behavioral deficits in mice[J].Brain Behav Immun,2016,59:273.
[22] Farzi A,Frhlich EE,Holzer P.Gut microbiota and the neuroendocrine system[J].Neurotherapeutics,2018,15(1):5-22.
[23] Bonaz B,Bazin T,Pellissier S.The vagus nerve at the interface of the microbiota-gut-brain axis[J].Front Neurosci,2018,12:49.
[24] Rea K,Dinan TG,Cryan JF.The microbiome:A key regulator of stress and neuroinflammation[J].Neurobiol Stress,2016,4:23-33.
[25] Peroni DG,Nuzzi G,Trambusti I,et al.Microbiome composition and its impact on the development of allergic diseases[J].Front Immunol,2020,11:700.
[26] Prehn-Kristensen A,Zimmermann A,Tittmann L,et al.Reduced microbiome alpha diversity in young patients with ADHD[J].PLoS One,2018,13(7):e0200728.6.
[27] Chen CB,Liu LS,Zhou J,et al.Up-regulation of HMGB1 exacerbates renal ischemia-reperfusion injury by stimulating inflammatory and immune responses through the TLR4 signaling pathway in mice[J].Cell Physiol Biochem,2017,41(6):2447-2460.
[28] 郭平,杜亚松,郭华.儿童注意缺陷多动障碍的病因及治疗研究进展[J].心理医生,2017,23(30):2-3.
[29] Melamed I,Heffron M.Attention deficit disorder and allergic rhinitis:Are they related[J].Immunol Res,2016,2016:1596828.
[30] Yang MT,Chen CC,Lee WT,et al.Attention-deficit/hyperactivity disorder-related symptoms improved with allergic rhinitis treatment in children[J].Am J Rhinol Allergy,2016,30(3):209.