Prevalence of Metabolic Syndrome and Insulin Resistance in a Sample of Adult ADHD Outpatients

Abstract

BackgroundHigh prevalence of Metabolic Syndrome (MS) was found in patients with schizophrenia and bipolar disorders. Insulin Resistance (IR) seems to mediate MS role in developing cardiometabolic consequences.AimsTo investigate the prevalence of MS, and the role of MS components and IR surrogate indexes in determining MS in adult ADHD outpatients.MethodsIn the present cross-sectional study, MS, defined according to the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III), and IR surrogate indexes were assessed on a consecutive sample of adult ADHD outpatients. Logistic regression analysis was performed to evaluate the effect of each ATP III component and IR surrogate index in determining MS.ResultsSeventeen out of 158 patients (10.8%, 95%CI = 0.064/0.167) fulfilled the ATP-III criteria for MS. A comprehensive comparison with prevalence in the reference population was hindered by the lack of patients over 60 in the study sample, however under this age no significant differences were found. Among MS components, blood triglycerides level (OR = 1.02, 95%CI=1.01/1.03, p = 0.001) was the main predictor for MS, followed by diastolic blood pressure (OR = 1.08, 95%CI=1.01/1.16, p = 0.024) and waist circumference (OR = 1.06, 95%CI=1.01/1.13, p = 0.029). Lipid Accumulation Product (LAP, OR = 1.0006, 95%CI=1.0003/1.0009, p < 0.001) outperformed Triglyceride-Waist Circumference (TG-WC, OR=1.03, 95%CI=1.01/1.04, p < 0.001) in predicting MS.ConclusionsMore attention should be paid not only to MS but also to each ATP III component of MS and LAP in ADHD patients both at first assessment and during follow-up process.

Serum levels of glucose, thyroid stimulating hormone, and free thyroxine in boys diagnosed with attention deficit hyperactivity disorder: a cross-sectional pilot study

“…Our study found a positive correlation between serum glucose levels and hyperactivity. Other studies suggest a possible link between ADHD and other factors related to IR [ 36 , 37 ]. This may be due to common risk factors (e.g.…”

“…While there is some evidence suggesting a link between ADHD and IR, direct and consistent evidence is limited. The study by di Girolamo et al [ 37 ] examines the relationship between ADHD and metabolic syndrome (MS) in adults. The study, conducted in Italy, examines the role of MS components and IR indices in this population.…”

From attention-deficit hyperactivity disorder to sporadic Alzheimer’s disease—Wnt/mTOR pathways hypothesis

“…Partially linked with mitochondrial dysfunction, the energy metabolism imbalance in ADHD has been discussed as a possible source of neurodevelopmental delays ( Cannon Homaei et al, 2022 ; Foschiera et al, 2022 ; Radtke et al, 2022 ). Cerebral glucose hypometabolism has been found in childhood-onset adult ADHD patients ( Zametkin et al, 1990 ), however, this may also be a consequence of deficits in impulse control leading to metabolic syndrome ( di Girolamo et al, 2022 ). Indeed, a recent meta-analysis found a bidirectional association between ADHD and T2DM ( Ai et al, 2022 ), pointing to long-lasting BIR effects.…”

Paediatric obesity and metabolic syndrome associations with cognition and the brain in youth: Current evidence and future directions

“…In addition, to promote the applicability of imaging findings and allow the identification of robust predictors of individual variation in responses, these studies must take care to include minority populations with disproportionately high obesity rates, which are often under-represented in imaging studies. The comorbidity of obesity and MetS 149 , 150 with psychiatric and neurodevelopmental disorders 151 , 152 (e.g., depression, attention deficit hyperactivity disorder ADHD) 153 , 154 also deserves further attention. For example, increasing evidence suggests that ADHD and obesity share neural and genetic underpinnings 155 , 156 and thus findings of studies that do not screen out individuals with ADHD symptoms may be driven in part by a subset of individuals with both obesity and ADHD symptomatology who may not be wholly representative of the larger population.…”