Height, Weight, IGF-I, IGFBP-3 and Thyroid Functions in Prepubertal Children with Attention Deficit Hyperactivity Disorder: Effect of Methylphenidate Treatment

Bereket, Abdullah; Turan, Serap; Karaman, Mehmet Gökşin; Haklar, Goncagül; Ozbay, Fatih; Yazgan, M. Yanki

doi:10.1159/000084683

Cited by 42 publications

(44 citation statements)

References 45 publications

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“…14 In contrast, among stimulantnaive patients with ADHD, baseline height may be slightly greater than population norms, 9 and children referred for ADHD treatment are reportedly taller at baseline than those not referred. 9,15,16 The Multimodal Treatment Study of Children With ADHD Cooperative Group reported that untreated prepubertal children with ADHD had average height Z scores that increased over time, suggesting faster growth than population norms. 17 More research is needed to assess associations between ADHD and dysregulated growth.…”

Section: Discussionmentioning

confidence: 99%

ADHD, Stimulant Treatment, and Growth: A Longitudinal Study

Harstad

Weaver²,

Katusic³

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: There is ongoing concern that stimulant medications may adversely affect growth. In a sample of attention-deficit/hyperactivity disorder (ADHD) cases and controls from a population-based birth cohort, we assessed growth and the association between stimulant treatment and growth. METHODS: Subjects included childhood ADHD cases (N = 340) and controls (N = 680) from a 1976 to 1982 birth cohort (N = 5718). Height and stimulant treatment information were abstracted from medical records and obtained during a prospective, adult follow-up study. For each subject, a parametric penalized spline smoothing method modeled height over time, and the corresponding height velocity was calculated as the first derivative. Peak height velocity (PHV) age and magnitude were estimated from the velocity curves. Among stimulant-treated ADHD cases, we analyzed height Z scores at the beginning, at the end, and 24 months after the end of treatment. RESULTS: Neither ADHD itself nor treatment with stimulants was associated with differences in magnitude of PHV or final adult height. Among boys treated with stimulants, there was a positive correlation between duration of stimulant usage before PHV and age at PHV (r = 0.21, P = .01). There was no significant correlation between duration of treatment and change in height Z scores (r = −0.08 for beginning vs end change, r = 0.01 for end vs 24 months later change). Among the 59 ADHD cases treated for ≥3 years, there was a clinically insignificant decrease in mean Z score from beginning (0.48) to end (0.33) of treatment (P = .06). CONCLUSIONS: Our findings suggest that ADHD treatment with stimulant medication is not associated with differences in adult height or significant changes in growth.

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Section: Discussionmentioning

confidence: 99%

ADHD, Stimulant Treatment, and Growth: A Longitudinal Study

Harstad

Weaver²,

Katusic³

et al. 2014

Pediatrics

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“…retardation, possible tolerance to growth inhibition over time, and then rebound growth. 2,4,[24][25][26][27][28] Temporary growth retardation related to stimulant therapy may partly explain altered growth trajectories among children with ADHD, but alternate hypotheses may also implicate the pathophysiology of ADHD. 25 Although direct evidence is generally lacking, 4 several hypotheses have been considered.…”

Section: Discussionmentioning

confidence: 99%

Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

2014

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Childhood attention-deficit/ hyperactivity disorder has been associated with both childhood and adult obesity, whereas treatment with stimulants has been associated with delayed child growth. No longitudinal studies with details about dates of diagnosis, treatment, and duration of stimulant use have been published. WHAT THIS STUDY ADDS:Using electronic health record data, this was the first study to evaluate the independent associations of attention-deficit/hyperactivity disorder diagnosis, stimulant treatment, age at first stimulant use, and duration of stimulant use on longitudinal BMI trajectories throughout childhood and adolescence.abstract BACKGROUND: Childhood attention-deficit/hyperactivity disorder (ADHD) has been associated with childhood and adult obesity, and stimulant use with delayed childhood growth, but the independent influences are unclear. No longitudinal studies have examined associations of ADHD diagnosis and stimulant use on BMI trajectories throughout childhood and adolescence. METHODS:We used longitudinal electronic health record data from the Geisinger Health System on 163 820 children ages 3 to 18 years in Pennsylvania. Random effects linear regression models were used to model BMI trajectories with increasing age in relation to ADHD diagnosis, age at first stimulant use, and stimulant use duration, while controlling for confounding variables.RESULTS: Mean (SD) age at first BMI was 8.9 (5.0) years, and children provided a mean (SD) of 3.2 (2.4) annual BMI measurements. On average, BMI trajectories showed a curvilinear relation with age. There were consistent associations of unmedicated ADHD with higher BMIs during childhood compared with those without ADHD or stimulants. Younger age at first stimulant use and longer duration of stimulant use were each associated with slower BMI growth earlier in childhood but a more rapid rebound to higher BMIs in late adolescence. CONCLUSIONS:The study provides the first longitudinal evidence that ADHD during childhood not treated with stimulants was associated with higher childhood BMIs. In contrast, ADHD treated with stimulants was associated with slower early BMI growth but a rebound later in adolescence to levels above children without a history of ADHD or stimulant use. The findings have important clinical and neurobiological implications. Pediatrics 2014;133:668-676

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“…Furthermore, older results on the effect of stimulant medication on GH secretion appear to be somewhat contradictory. Indications from a number of laboratories are that stimulant usage can cause a decrease in GH secretory activity [37][38][39][40], as well as a decrease in IGF levels [2,41]. A case study by Barter and Krammer [38] showed that methylphenidate is associated with suppression of sleep-induced GH release, while a case study by Holtkamp et al [37] found a decrease in GH secretion in a child experiencing almost complete growth arrest following methylphenidate intake.…”

Section: Stimulants and Growth Hormonementioning

confidence: 99%

“…In order to determine whether a relationship exists between stimulant intake and growth in children with ADHD, the first question to be asked is how un-medicated children with ADHD compare in size to control subjects. Although some studies found un-medicated children with ADHD to be of normal height [1][2][3], weight [1,2] and body mass index (BMI) [2,4]; several, in fact the majority, of studies indicated that un-medicated children with ADHD are actually taller [5][6][7][8][9] and heavier than normal [3,[5][6][7][8]10]. These findings, therefore, contradict the initial suggestion [11] that height deficits in ADHD may be mediated by the disease itself.…”

Section: Introductionmentioning

confidence: 99%

“…can the use of stimulant medication be associated with growth inhibition in children with ADHD? Although this topic is highly controversial, with some studies indicating that stimulant treatment has no effect on the growth of children with ADHD [2,3,12,13]; the overriding evidence in the scientific literature is that stimulant treatment can indeed cause an attenuation of growth. However, this problem seems to be manageable [5].…”

Section: Introductionmentioning

confidence: 99%

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Stimulants and growth in children with attention-deficit/hyperactivity disorder

Negrao

Viljoen

2011

Medical Hypotheses

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a b s t r a c tInitial suggestions that suppression of growth may be an intrinsic characteristic of attention-deficit/ hyperactivity disorder (ADHD) have now largely been disproven. Although controversy persists regarding the possible negative effect of adrenergic stimulants on growth in children with ADHD, the consensus that appears to be reached in the scientific literature is that stimulant usage may cause a manageable attenuation of growth in these children. Since it is known that stimulants increase the amount of dopamine and noradrenaline in the synapse, this writing suggests that these increases in dopamine and noradrenaline are responsible for the growth attenuation in these children. It appears that increased amounts of dopamine and noradrenaline have the ability to inhibit the secretion of growth hormone and growth-related hormones such as prolactin, thyroid hormones, sex hormones and insulin. Therefore, it would be reasonable to suggest that the increases in dopamine and noradrenaline caused by stimulant usage can disrupt the homeostasis of both growth hormone and growth-related hormones, generating the potential for the suppression of growth.

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Height, Weight, IGF-I, IGFBP-3 and Thyroid Functions in Prepubertal Children with Attention Deficit Hyperactivity Disorder: Effect of Methylphenidate Treatment

Cited by 42 publications

References 45 publications

ADHD, Stimulant Treatment, and Growth: A Longitudinal Study

ADHD, Stimulant Treatment, and Growth: A Longitudinal Study

Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

Stimulants and growth in children with attention-deficit/hyperactivity disorder

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