患有多动症儿童的下丘脑-垂体-上腺轴功能障碍:系统性审查和元分析
Li Fulun1, Li Yanan2, Gu Bing1
1Department of Child Development and Behavioral Medicine, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, Gansu 730030, China.
患有ADHD的儿童表现出较低的皮质醇水平,表明下丘脑-垂体-上腺 (HPA) 轴的低活性. 这种模式在多动冲动亚型中最明显,当皮质醇在血液中测量时.
科学领域:
- 神经内分泌学神经内分泌学
- 儿童心理学 儿童心理学
- 发育神经科学的发展神经科学.
背景情况:
- 注意缺陷/多动障碍 (ADHD) 是儿童中普遍存在的神经发育障碍.
- HPA轴调节失调是一种在ADHD中提出的,但不一致的报告的神经生物学机制.
研究的目的:
- 系统地评估和量化 ADHD 儿童与典型发育 (TD) 对照之间的 HPA 轴功能差异.
- 为了研究HPA轴活动的多种生物标志物.
主要方法:
- 1999年至2025年间发表的研究的系统综述和随机效应元分析.
- 搜索包括主要的数据库 (PubMed,Embase等). 对于测量ACTH,皮质醇 (基础,CAR,应激反应,头发) 的研究,遵循PRISMA指南.
- 计算了聚合效应大小 (SMD) 和置信区间;评估了异质性和出版偏差.
主要成果:
- 分析了包括4635名儿童在内的34项研究.
- 与TD对照组相比,患有ADHD的儿童表现出明显较低的早晨觉醒皮质醇,30分钟觉醒后皮质醇,下午皮质醇和测试后皮质醇.
- 对于ACTH,CAR,测试前皮质醇或头发皮质醇度 (HCC) 没有发现显著的群体差异.
结论:
- ADHD与HPA轴低活性的一致模式有关,影响基底分泌和应激反应.
- 这种低活性特征在多动冲动 (ADHD-HI) 亚型中最明显,并且在血液中测量皮质醇时最明显.
- 研究结果表明HPA轴失调是ADHD的潜在生物学相关物,具有亚型特定的神经内分泌特征.
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