注意欠陥多動性障害およびチック障害を有する小児における血清フェリチン値

Serum ferritin levels in children with attention deficit hyperactivity disorder and tic disorder.

抄録

背景:

鉄は脳の神経発達機能に重要な役割を担っている。注意欠陥多動性障害とチック症の子供の血清フェリチンレベルは健康な子供と異なっている。

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.

目的:

神経発達障害児の鉄欠乏の現状とその性・年齢的影響を探ること。

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

方法:

2020年1月1日から2021年12月31日の間に、北京小児病院で注意欠陥多動性障害（ADHD）児1565人、チック障害（TD）児1694人、ASD児93人、健常対照児1997人を対象とした。疾患群ごとの年齢レベルやフェリチンレベルの違い、その性差について述べる。各疾患の性差はt検定で解析した。血清フェリチン低値の発生率を用いて、各疾患と各年齢層の違いを記述した。疾患群と対照群との血清フェリチン低値発生率の差はカイ二乗検定を用いて解析した。サブグループ間の比較には分散分析を用い、交絡因子の制御には回帰分析を用いた。

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.

結果:

5～12歳のADHD患者計1565人が本研究に参加し、男性および女性の平均血清フェリチン値はそれぞれ36.82±20.64μg/Lおよび35.64±18.56μg/Lであった。5～12歳のTD患者計1694人を対象とし、男女児の平均血清フェリチン値はそれぞれ35.72 ± 20.15 μg/Lおよび34.54 ± 22.12 μg/Lであった。年齢が上がるにつれて，ADHDとTDの血清フェリチン低値の発生率はまず低下し，次に上昇し，10歳が上昇の分岐点であった。ADHDの血清フェリチン低下率は8.37％，TDの血清フェリチン低下率は11.04％，健常対照群の血清フェリチン低下率は8.61％で，そのうちTDの男性児童は9.25％，TDの女性児童は11.62％を占めていた．3群間で有意差があった（< 0.05）。また、ASD児は93名で、平均血清フェリチン値は30.99±18.11μg/L、血清フェリチン発生率は15.05％であった。

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 ( < 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%.

結論:

結論として、低血清フェリチンはADHDやTDのリスクファクターではない。5歳から12歳のADHDとTDの子供における血清フェリチン低値の発生率は、まず減少し、その後年齢とともに増加する。

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.