Zinc status in attention-deficit/hyperactivity disorder: a systematic review and meta-analysis of observational studies

Ghoreishy, Seyed Mojtaba; Mousavi, Sara Ebrahimi; Asoudeh, Farzaneh; Mohammadi, Hamed

doi:10.1038/s41598-021-94124-5

Cited by 8 publications

(6 citation statements)

References 52 publications

(75 reference statements)

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“…In contrast, a review from 2018 concluded that low serum iron levels were associated with ADHD [58]. There was no difference in zinc levels in blood, serum, plasma [59] or hair between children and adolescents with ADHD and healthy controls [60].…”

Section: Resultsmentioning

confidence: 99%

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

Chaulagain,

Lyhmann,

Halmøy

et al. 2023

Eur. Psychiatr.

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Background There are now hundreds of systematic reviews on attention deficit hyperactivity disorder (ADHD) of variable quality. To help navigate this literature, we have reviewed systematic reviews on any topic on ADHD. Methods We searched MEDLINE, PubMed, PsycINFO, Cochrane Library, and Web of Science and performed quality assessment according to the Joanna Briggs Institute Manual for Evidence Synthesis. A total of 231 systematic reviews and meta-analyses met the eligibility criteria. Results The prevalence of ADHD was 7.2% for children and adolescents and 2.5% for adults, though with major uncertainty due to methodological variation in the existing literature. There is evidence for both biological and social risk factors for ADHD, but this evidence is mostly correlational rather than causal due to confounding and reverse causality. There is strong evidence for the efficacy of pharmacological treatment on symptom reduction in the short-term, particularly for stimulants. However, there is limited evidence for the efficacy of pharmacotherapy in mitigating adverse life trajectories such as educational attainment, employment, substance abuse, injuries, suicides, crime, and comorbid mental and somatic conditions. Pharmacotherapy is linked with side effects like disturbed sleep, reduced appetite, and increased blood pressure, but less is known about potential adverse effects after long-term use. Evidence of the efficacy of nonpharmacological treatments is mixed. Conclusions Despite hundreds of systematic reviews on ADHD, key questions are still unanswered. Evidence gaps remain as to a more accurate prevalence of ADHD, whether documented risk factors are causal, the efficacy of nonpharmacological treatments on any outcomes, and pharmacotherapy in mitigating the adverse outcomes associated with ADHD.

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Section: Resultsmentioning

confidence: 99%

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

Chaulagain,

Lyhmann,

Halmøy

et al. 2023

Eur. Psychiatr.

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“…However, zinc may be widely involved in the pathophysiology of other mental disorders due to its role in numerous biological processes 20 . Some meta-analyses have shown that lower zinc levels were also observed in people with depression 39 and neurodevelopmental disorders, including autism spectrum disorder 40 and attention-deficit hyperactivity disorder 41 . Thus, further studies in adolescents will be required to investigate the relationship between lower zinc levels and the risk of these disorders.…”

Section: Discussionmentioning

confidence: 99%

Hair zinc levels and psychosis risk among adolescents

et al. 2022

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Recent meta-analyses have shown lower zinc and higher copper levels in the serum of people with schizophrenia than in healthy controls. However, the relationship between trace elements (TEs) and the pathophysiology of psychosis, including schizophrenia, remains unclear due to the antipsychotic effects on mineral levels. In this study, we aimed to determine the relationship between zinc and copper levels in hair and psychosis risk among drug-naïve adolescents. This study was conducted as a part of a population-based biomarker subsample study of the Tokyo Teen Cohort Study, including 252 community-dwelling 14-year-old drug-naïve adolescents. Zinc and copper levels in hair were measured using inductively coupled plasma mass spectrometry. The thought problems (TP) scale from the Child Behavior Checklist was used to evaluate psychosis risk. Regression analysis showed that hair zinc levels were negatively correlated with the TP scale (T-score) (β = −0.176, P = 0.005). This result remained significant after adjusting for age and sex (β = −0.175, P = 0.005). In contrast, hair copper levels were not associated with the TP scale (T-score) (β = 0.026, P = 0.687). These findings suggest that lower zinc levels could be involved in the pathophysiology of psychosis, independent of antipsychotics. Further longitudinal studies are required to investigate whether hair zinc level is a useful new biomarker for assessing psychosis risk.

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“…Zinc deficiency has been suggested to increase the risk of ADHD, while sufficient zinc supply is thought to improve ADHD symptoms. Since various studies regarding the zinc status in ADHD yielded inconsistent results, a recent systematic review and meta-analysis attempted to estimate the association between ADHD and serum/plasma and hair zinc concentrations [ 29 ]. This meta-analysis including 22 studies (1280 individuals with ADHD and 1200 controls) found no statistically significant difference in hair and serum/plasma zinc levels between people with ADHD and controls.…”

Section: Zincmentioning

confidence: 99%

“…This meta-analysis including 22 studies (1280 individuals with ADHD and 1200 controls) found no statistically significant difference in hair and serum/plasma zinc levels between people with ADHD and controls. Sensitivity analysis in studies examining circulating levels of zinc showed that the exclusion of one study changed the overall effect, with circulating zinc levels being significantly lower in individuals with ADHD in comparison with healthy controls [ 29 ]. Further well-designed studies need to clarify the pathophysiological role of zinc in ADHD.…”

Section: Zincmentioning

confidence: 99%

Nutrition in the Management of ADHD: A Review of Recent Research

Lange,

Nakamura

et al. 2023

Curr Nutr Rep

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Purpose of Review Various nutrients and diet quality have been suggested to be involved in the pathophysiology of ADHD. The purpose of this review was to examine data from recent cohort studies and dietary interventions to determine whether nutrition may play a role in the management of ADHD. Recent Findings Preliminary evidence suggests that minerals might have beneficial effects on ADHD symptomatology. Probiotics might offer novel strategies to prevent or treat ADHD. Inverse associations between adherence to “healthy” diets and ADHD symptoms have been observed. Children with ADHD responding to the few-foods diet (or oligoantigenic diet) with an elimination of individually identified food items show substantially improved behavior and cognitive functioning. Summary Evidence from recent research does not allow any recommendations regarding the use of micronutrients or probiotics in the management of ADHD. The few-foods diet may become an additional therapeutic option for children with ADHD.

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Zinc status in attention-deficit/hyperactivity disorder: a systematic review and meta-analysis of observational studies

Cited by 8 publications

References 52 publications

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

Hair zinc levels and psychosis risk among adolescents

Nutrition in the Management of ADHD: A Review of Recent Research

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