leptin and Attention-Deficit-Disorder-with-Hyperactivity

We aimed to explore whether the use of methylphenidate relates leptin, ghrelin, adiponectin, and brain-derived neurotrophic factor (BDNF). In addition, the relationship between methylphenidate-related weight loss in attention deficit hyperactivity disorder (ADHD) patients and these biomolecules were evaluated.. Thirty ADHD patients receiving methylphenidate and 20 healthy controls were included. Leptin, ghrelin, adiponectin, and BDNF levels were measured at baseline and after two-month treatment in both groups.. At baseline, leptin, ghrelin, adiponectin, and BDNF levels were similar in the ADHD and control groups. The most common adverse events occurring in the ADHD group after a 2-month treatment period included loss of appetite (70%) and weight loss (66.7%). A significant difference was found in body weight, BMI, and CGI scores of the ADHD patients after the treatment. While post-treatment ghrelin and adiponectin levels were significantly higher in the ADHD group, BDNF level was significantly lower. Post-treatment decrease in leptin levels was not significant.. Leptin and BDNF were not associated with poor appetite and/or weight loss due to methylphenidate treatment. However, ghrelin and adiponectin might be biomolecules that play a role in underlying neurobiological mechanisms of methylphenidate-related appetite or weight loss.

Topics: Adiponectin; Adolescent; Appetite; Attention Deficit Disorder with Hyperactivity; Brain-Derived Neurotrophic Factor; Central Nervous System Stimulants; Child; Delayed-Action Preparations; Female; Ghrelin; Humans; Leptin; Male; Methylphenidate

Evidence suggests an association of insulin and leptin with attention and executive function. The roles of dysregulated appetite hormones, including insulin and leptin, in the pathomechanisms of attention deficit hyperactivity disorder (ADHD) and associated cognitive function impairment remain unknown.. In total, 50 adolescents with ADHD were enrolled and age and sex matched with 50 typically developing controls. The parent-reported Swanson, Nolan, and Pelham IV scale and self-reported Barratt Impulsiveness Scale were employed for symptom assessment. The fasting serum concentrations of appetite hormones-leptin, ghrelin, insulin, and adiponectin-were measured. The Wisconsin Card Sorting Test was used to examine executive function.. Generalized linear models with adjustment for age, sex, body mass index, and medications indicated that the adolescents with ADHD had higher levels of insulin (P = .039) and leptin (P = .006) than did those in the control group. Self-reported attention and self-control symptoms were negatively associated with insulin level (P = .025 and .018, respectively) and positively associated with leptin level (both P < .001). In addition, insulin level was positively associated with executive function (P = .031).. Appetite hormone dysregulation was associated with the symptomology and executive function among adolescents with ADHD. Our results may inspire researchers to further examine the role of appetite hormone dysregulation in ADHD pathogenesis.

Topics: Adolescent; Appetite; Attention Deficit Disorder with Hyperactivity; Executive Function; Humans; Insulin; Leptin

ADHD is one of the most common childhood psychiatric disorders. Research indicates that there is some link between obesity/overweight and ADHD, though the mechanism of this association remains uncertain. It is the aim of the present study to explore the association between ADHD, obesity, and plasma leptin, neuropeptide Y (NPY), and adiponectin levels.. Thirty-six patients diagnosed with ADHD were included in the study. The control group consisted of 40 healthy children and adolescents who had similar age and gender features with the patient group. Plasma leptin, adiponectin, NPY levels were measured, and body mass index (BMI), weight for height, and standard deviation scores (SDS) of height, weight, and BMI were calculated.. No significant difference was found between patients and healthy children in terms of BMI and BMI percentile. Participants were classified into three groups according to their weight to height values. There was no significant difference between the two groups, but 10% of the control group and 30.6% of the ADHD group were classified as overweight, which was 3 times higher than the control group. The adiponectin plasma level was significantly lower and leptin/adiponectin (L/A) ratio was significantly higher in the ADHD group. There was no significant difference between serum NPY levels. In the ADHD group, the mean leptin plasma level was high, but was not statistically significant.. We think that a low adiponectin level and high L/A ratio may be the underlying mechanism of the obesity in ADHD patients.

Topics: Adiponectin; Adolescent; Attention Deficit Disorder with Hyperactivity; Case-Control Studies; Child; Female; Humans; Leptin; Male; Neuropeptide Y; Pediatric Obesity

The purpose of this study was to determine the levels of leptin, ghrelin, and nesfatin-1 to elucidate the causes of poor appetite and growth retardation in patients receiving methylphenidate therapy for attention deficit hyperactivity disorder. The study was performed on 89 male subjects; 48 patients and 41 healthy controls, aged 7-14 years. Following treatment, patients' leptin levels increased and ghrelin levels decreased while no significant change was found in nesfatin-1 levels. Of the 48 patients, 34 developed lack of appetite. In patients who developed lack of appetite, body weight SDS, body mass index (BMI), and BMI SDS were statistically significantly reduced; moreover, height SDS was reduced, though not to a statistically significant extent. This study attempted to elucidate the mechanisms that mediate the association between methylphenidate and appetite and growth, for which no studies have yet to be published.

Topics: Adolescent; Appetite; Attention Deficit Disorder with Hyperactivity; Biomarkers; Body Height; Body Weight; Case-Control Studies; Central Nervous System Stimulants; Child; Developmental Disabilities; Ghrelin; Humans; Leptin; Male; Methylphenidate; Prospective Studies

Stimulant medication is known to cause transient weight loss and slowing down of growth, but whether it delays physical maturation is unclear. We studied growth and bone age over the first 3 years of treatment in children with attention-deficit/hyperactivity disorder (patients) compared with healthy siblings (controls). Bone age was estimated blindly by two independent radiologists using Tanner and Whitehouse version 3. Dexamphetamine or methylphenidate was titrated and continued when clinically indicated. Forty out of 73 patients, together with 22 controls, completed the study. There were no significant growth differences between the two groups at baseline. Despite slower growth on treatment [5.1 cm/year, 95% confidence interval (CI): 4.7-5.5, vs. 6.3 cm/year, 95% CI: 5.7-6.8, P=0.002; and 2.7 kg/year, 95% CI: 2.1-3.3, vs. 4.4 kg/year, 95% CI: 3.5-5.3, P=0.005], the patients showed no significant maturational delay (RUS score: 49 U/year, 95% CI: 44-55, vs. 55 U/year, 95% CI: 47-63, P=0.27). A subgroup of patients underwent serial biochemistry and dual-energy X-ray absorptiometry, recording a significant reduction in fat (5.61±3.56-4.22±3.09 kg, P<0.001) and leptin (3.88±2.87-2.57±1.94 ng/ml, P=0.017). The pattern of change in height z-score over time was modified by the dose of medication (P for interaction=0.024). We found no medication effect on the rate of maturation, which was instead predicted by baseline leptin (P=0.035 controlling for age and sex).

Topics: Absorptiometry, Photon; Adiposity; Age Factors; Anthropometry; Attention Deficit Disorder with Hyperactivity; Biomarkers; Body Height; Body Weight; Bone Development; Case-Control Studies; Central Nervous System Stimulants; Child; Child Development; Dextroamphetamine; Female; Growth Disorders; Humans; Leptin; Male; Methylphenidate; Prospective Studies; Time Factors; Treatment Outcome

There is an increasing awareness of the strong associations between obesity and adult attention- deficit/hyperactivity disorder (ADHD), with high rates of ADHD (26-61%) in patients seeking weight loss.. To determine the frequency of ADHD in a bariatric surgery (BS) sample and investigate whether there were any differences among clinical, analytical and psychological parameters in individuals with criteria for ADHD.. Sixty patients (78.3% female, age 46.3±9.8, months since BS 46.28±18.1) who underwent BS, with a minimum follow-up of 18 months, were evaluated cross-sectionally. Initial and current BMI, eating patterns, comorbidity, socio-demographic and biochemical parameters were recorded. For the screening of ADHD, ADHD self rating scale-v1.1 was administered.. Nineteen individuals (31.6%) had a positive screening for ADHD. This group had higher levels of HDL-cholesterol (62.8±17.3 mg/dl vs 53.5±9.9 mg/dl; p=0.011) and Apo-A (177.7±28.4 mg/dl vs 154.9±34.7 mg/ dl; p=0.015), and an increased consumption of lipids (42.2±7.1% vs 36.7±8.3%; p=0.019). Subjects with ADHD symptoms had more difficulties in following visits after BS (52.6% vs 24.3%; p= 0.011).We could not find any differences in achieved BMI, depressive symptoms or quality of life.. Patients who met criteria for ADHD face significant difficulties with compliance in follow-up, but we could not find differences in major clinical outcomes. Surprisingly, these patients could have a protective lipid profile.. Introducción: Hay una creciente concienciación de la fuerte asociación entre la obesidad y el trastorno por déficit de atención/hiperactividad del adulto (TDAH), con elevadas tasas de TDAH (26-61%) en los pacientes que consultan por pérdida ponderal. Objetivos: conocer la frecuencia del TDAH en una muestra de sujetos sometidos a cirugía bariátrica (CB) e investigar si existen diferencias clínicas, analíticas y psicológicas en estos sujetos. Métodos: Sesenta pacientes (78.3% mujeres, edad 46.3±9.8, meses desde la CB 46.28±18.1) sometidos a CB, con un seguimiento mínimo desde ésta de 18 meses, fueron evaluados transversalmente. Se recogieron y analizaron el IMC inicial y en el momento de la evaluación, patrones alimentarios, comorbilidades, y parámetros sociodemográficos y bioquímicos. Para el screening del TDAH se administró la versión española del “ADHD self-rating scale v 1.1”. Resultados: Diecinueve individuos (31.6%) tenían un screening positivo para TDAH. Estos sujetos tenían niveles superiores de HDL colesterol (62.8±17.3mg/dl vs 53.5±9.9mg/dl; p=0.011) y Apo-A (177.7±28.4mg/dl vs 154.9±34.7mg/dl; p=0.015), y un consumo mayor de lípidos en la dieta (42.2±7.1% vs 36.7±8.3%; p=0.019). Estos sujetos tenían más dificultades en seguir las visitas protocolizadas tras la CB (52.6% vs 24.3%; p= 0.011). No se evidenciaron diferencias en el IMC alcanzado, síntomas depresivos o calidad de vida. Conclusiones: Los pacientes sometidos a CB con criterios para TDAH presentan más dificultades en la adherencia al seguimiento, pero no se evidenciaron diferencias en resultados clínicos relevantes. Curiosamente, estos sujetos podrían presentar un perfil lipídico protector.

Topics: Adult; Attention Deficit Disorder with Hyperactivity; Bariatric Surgery; Blood Glucose; Body Mass Index; Case-Control Studies; Feeding Behavior; Female; Follow-Up Studies; Homocysteine; Humans; Hydrocortisone; Insulin; Leptin; Lipids; Male; Middle Aged; Obesity, Morbid; Patient Compliance; Postoperative Period; Symptom Assessment; Vitamins