Cardiovascular disease risk in children and adolescents with attention deficit/hyperactivity disorder
Necati Uzun 1*, Mehmet Akif Akıncı 2, Hayrullah Alp 3
1Necmettin Erbakan University Meram School of Medicine Department of Child and Adolescent Psychiatry, 2Dr.Ali Kemal Belviranlı Maternity and Children Hospital Department of Child and Adolescent Psychiatry, 3Dr.Ali Kemal Belviranlı Maternity and Children Hospital Department of Pediatric Cardiology
Received: July 8, 2021; Revised: August 23, 2021; Accepted: August 23, 2021; Published online: August 23, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Objective: The possible relationship of attention-deficit/hyperactivity disorder (ADHD) with cardiovascular disease risk by subclinical atherosclerosis in children rarely investigated in the literature. The aim of this case-controlled study is to evaluate chronic inflammation, subclinical atherosclerosis and cardiovascular disease risk in children and adolescents with ADHD.
Methods: A total of 51 medication-free children and adolescents with ADHD and 51 healthy controls were included in this study. In order to evaluate subclinical atherosclerosis, common carotid intima media thickness (IMT), epicardial adipose tissue thickness (EAT), and periaortic adipose tissue thickness (PAT) were assessed as well as clinical parameters.
Results: The IMT (0.037±0.005 vs. 0.026±0.003), EAT (0.472±0.076 vs. 0.355±0.051), and PAT (0.135±0.016 vs. 0.118±0.009) measurements were significantly higher in the ADHD group than in the control group. Additionally, partial correlation analyses revealed that a positive correlation was observed between IMT and EAT, and PAT measurements separately. Multivariate linear regression analysis revealed that, body mass index (BMI) positively predicted IMT. Also, age and BMI positively predicted the EAT levels of the subjects with ADHD.
Conclusions: Subclinical atherosclerosis is an important early marker for cardiovascular diseases especially at advancing age. Also, chronic inflammation may be the underlying mechanism. Our results suggest that children and adolescents with ADHD have a risk for cardiovascular disease. For this reason, subclinical atherosclerosis should be taken into consideration in the follow-up and treatment of ADHD for cardiovascular disease risk.
Keywords: attention-deficit/hyperactivity disorder, intima-media thickness, epicardial adipose tissue thickness, periaortic adipose tissue thickness, chronic inflammation, cardiovascular disease