Elevated Serum Immunoglobulin E Levels and Risk of Attention-Deficit/Hyperactivity Disorder in Children: A Cross-Sectional Study

To investigate the association between serum immunoglobulin E (IgE) levels and attention-deficit/hyperactivity disorder (ADHD) in children, quantitatively evaluate the independent influence of elevated IgE levels on ADHD risk and related behavioral/cognitive impairments via clinical data analysis, and explore the epidemiological link between IgE-mediated allergic conditions and ADHD onset.

A retrospective cross-sectional study was conducted. Total serum IgE, inhalant- and food-specific IgE (sIgE) levels, Conners scale scores, and demographic data were retrospectively collected from the clinical electronic medical record (EMR) system. The Conners Parent Rating Scale (CPRS) was used to assess childhood hyperactive behaviors. Correlation analysis and logistic regression analysis were applied to compare the prevalence of ADHD across different IgE level groups, explore the association between ADHD prevalence and IgE levels, and analyze the correlation between IgE levels and subscales of the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). In addition, logistic regression models were used to evaluate the effect of IgE levels on ADHD risk.

A total of 513 children were included in this study, among whom 201 (39.18%) were IgE-positive, and 128 (24.95%) met the diagnostic criteria for ADHD. The prevalence of ADHD was significantly associated with both total IgE (P = .023) and inhalant-specific IgE (sIgE) levels (P = .006). Logistic regression analysis identified 2 independent risk factors for ADHD: elevated total IgE (odds ratio [OR] = 1.593, 95% confidence interval [CI]: 1.06-2.39, P = .024) and elevated inhalant sIgE (OR = 1.821, 95% CI: 1.11-2.69, P = .016). Children with elevated total IgE levels had 1.593-fold higher odds of receiving an ADHD diagnosis than those with normal IgE levels, while those with elevated inhalant sIgE had 1.821-fold higher odds of such a diagnosis.

Immunoglobulin E-mediated allergic status constitutes a risk factor for ADHD, with inhalant allergen sensitization demonstrating a particularly strong association.