注意缺陷多动障碍儿童的体格生长和膳食特征：一项横断面研究

Physical growth and dietary characteristics of children with attention deficit hyperactivity disorder: a cross-sectional study

摘要:

目的 调查注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）儿童的体格生长及膳食特征，并分析其与ADHD核心症状的关系。 方法 纳入2020年6—12月在南京医科大学附属儿童医院初诊为ADHD的患儿268例（ADHD组），另选取同期健康体检的非ADHD儿童102例作为对照组。对两组儿童进行体格测评、膳食调查，并依据美国精神障碍诊断与统计手册第5版进行ADHD诊断及评分，采用因子分析、Spearman秩相关分析及中介效应分析评估ADHD核心症状、膳食模式及体格生长之间的关系。 结果 ADHD组超重/肥胖检出比例显著高于对照组（35.8% vs 21.6%，P<0.05）。依据食物频率问卷共提取3种膳食模式：素食膳食模式、传统膳食模式及零食快餐模式。其中ADHD组儿童零食快餐模式因子得分高于对照组（P<0.05）。ADHD症状评分、零食快餐模式因子得分及体脂百分比两两之间呈显著正相关（P<0.05）。中介效应分析显示，零食快餐模式因子得分在ADHD症状评分与体脂百分比的关系中起到了部分中介作用，中介占比为26.66%。 结论 ADHD儿童超重/肥胖率高于非ADHD儿童；ADHD儿童核心症状与膳食模式、体格生长状况相关，其中零食快餐模式在ADHD核心症状与体格生长状况之间发挥了部分中介作用。

Abstract:

Abstract：Objective To investigate the physical growth and dietary characteristics of children with attention deficit hyperactivity disorder (ADHD), and to analyze their relationship with core symptoms of ADHD. Methods A total of 268 children who were newly diagnosed with ADHD in Children's Hospital of Nanjing Medical University from June to December 2020 were included in the ADHD group, and 102 healthy children who underwent physical examination during the same period were selected as the control group. Physical evaluations and dietary surveys were conducted for both groups. ADHD diagnosis and scoring were performed according to the Diagnostic and Statistical Manual of Mental Disorders (5th edition). Factor analysis, Spearman correlation analysis, and mediation analysis were used to study the relationship between core symptoms of ADHD, dietary patterns, and physical growth. Results The rate of overweight/obesity in the ADHD group was significantly higher than that in the control group (35.8% vs 21.6%, P<0.05). Three dietary patterns were extracted from the food frequency questionnaire: vegetarian dietary pattern, traditional dietary pattern, and snack/fast food pattern. The factor score for the snack/fast food pattern in the ADHD group was higher than that in the control group (P<0.05). There was a significant positive correlation between ADHD symptom scores, snack/fast food pattern factor scores, and body fat percentage (P<0.05). The mediation analysis showed that the snack/fast food pattern played a partial mediating role in the relationship between ADHD symptom scores and body fat percentage, with a mediation proportion of 26.66%. Conclusions The rate of overweight/obesity in children with ADHD is higher than that in non-ADHD children. Core symptoms of ADHD are related to dietary patterns and physical growth, with the snack/fast food pattern playing a partial mediating role in the relationship between core symptoms of ADHD and physical growth.