Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2022; 10(22): 7749-7759
Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7749
Serum ferritin levels in children with attention deficit hyperactivity disorder and tic disorder
Cai-Yun Tang, Fang Wen
Cai-Yun Tang, Fang Wen, Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
Author contributions: Wen F gave suggestions for writing, analysis and revised the manuscript; Tang CY did substantial contributions to the conception and design of the work; and the acquisition, analysis, or interpretation of data for the work and drafted the manuscript.
Institutional review board statement: This study was in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of Beijing Children's Hospital, No. IEC-C-006-A04-V.06.
Conflict-of-interest statement: All of the authors declare that they have no competing interests.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at wenfang0812@163.com. Participants gave informed consent for data sharing, but the presented data are anonymized and risk of identification is low. No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang Wen, MM, Chief Doctor, Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nanlishi Road, Beijing 100045, China. wenfang0812@163.com
Received: February 8, 2022
Peer-review started: February 8, 2022
First decision: March 23, 2022
Revised: May 1, 2022
Accepted: June 27, 2022
Article in press: June 27, 2022
Published online: August 6, 2022
Processing time: 164 Days and 0.2 Hours
Abstract
BACKGROUND

Iron plays an important role in neurodevelopmental functions in the brain. Serum ferritin levels are different in children with attention deficit hyperactivity disorder and tic disorder than in healthy children.

AIM

To explore the current status of iron deficiency in children with neurodevelopmental disorders and its sex and age effects.

METHODS

A total of 1565 children with attention deficit hyperactivity disorder (ADHD), 1694 children with tic disorder (TD), 93 children with ASD and 1997 healthy control children were included between January 1, 2020, and December 31, 2021 at Beijing Children's Hospital. We describe the differences in age levels and ferritin levels between different disease groups and their sex differences. The differences between the sexes in each disease were analyzed using the t test. The incidence rate of low serum ferritin was used to describe the differences between different diseases and different age groups. A chi-square test was used to analyze the difference in the incidence of low serum ferritin between the disease group and the control group. Analysis of variance was used for comparisons between subgroups, and regression analysis was used for confounding factor control.

RESULTS

A total of 1565 ADHD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 36.82 ± 20.64 μg/L and 35.64 ± 18.56 μg/L, respectively. A total of 1694 TD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 35.72 ± 20.15 μg/L and 34.54 ± 22.12 μg/L, respectively. As age increased, the incidence of low serum ferritin in ADHD and TD first decreased and then increased, and 10 years old was the turning point of rising levels. The incidence of ADHD with low serum ferritin was 8.37%, the incidence of TD with low serum ferritin was 11.04%, and the incidence of the healthy control group with low serum ferritin was 8.61%, among which male children with TD accounted for 9.25% and female children with TD accounted for 11.62%. There was a significant difference among the three groups (P < 0.05). In addition, there were 93 children with ASD with an average serum ferritin level of 30.99 ± 18.11 μg/L and a serum ferritin incidence of 15.05%.

CONCLUSION

In conclusion, low serum ferritin is not a risk factor for ADHD or TD. The incidence of low serum ferritin levels in children with ADHD and TD between 5 and 12 years old decreases first and then increases with age.

Keywords: Iron deficiency, Attention deficit hyperactivity disorder, Tic disorder, Serum ferritin levels, Retrospective study

Core Tip: By investigating the status of iron deficiency in children with neurodevelopmental disorders and its influence on gender and age, it is suggested to check the serum ferritin level and related hematological indexes of children with neurodevelopmental disorders at the age of 5-10 years, and make necessary iron supplementation.