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Interrelationships among growth hormone, thyroid function, and endocrine-disrupting chemicals on the susceptibility to attention-deficit/hyperactivity disorder

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Abstract

Abnormal growth hormones and thyroid function may be linked to pathophysiology of attention-deficit/hyperactivity disorder (ADHD). Phthalates and bisphenol-A (BPA), two endocrine-disrupting chemicals (EDCs), may affect the human endocrine system. In this study, we aimed to perform a comprehensive investigation of whether growth hormone, thyroid function, and EDCs exhibited differential levels between ADHD patients and healthy controls. In total, 144 children with ADHD and 70 healthy control subjects were enrolled. Their endocrine systems were evaluated using the serum levels of insulin-like growth factor-1 (IGF-1), IGF-binding protein-3 (IGFBP-3), thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and Free T4. The urinary levels of EDCs, including monoethyl phthalate (MEP), mono-methyl phthalate (MMP), monoethylhexyl phthalate (MEHP), mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), and BPA, were also examined. Patients with ADHD had lower IGF-1 levels than healthy controls (p = 0.003), but we observed no significant difference in IGFBP-3, TSH, T3, T4, or Free T4. Compared to the control group, patients with ADHD demonstrated higher MEHP levels (p = 0.043), MnBP (p = 0.033), and MBzP (p = 0.040). Furthermore, MEHP levels (p < 0.001) and BPA levels (p = 0.041) were negatively correlated with IGF-1 levels, while IGF-1 levels were negatively correlated with principal components consisting of ADHD clinical symptoms and neuropsychological performance variables. We suggest that MEHP exposure may be associated with decreased serum levels of IGF-1 and increased risk of ADHD. The mechanism underlying this association may be important for protecting children from environmental chemicals that adversely affect neurodevelopment.

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Acknowledgements

The authors would like to thank Professor Wei-Tsun Soong for granting us the use of the Chinese version of the K-SADS and Professor Shur-Fen Gau for granting our use of the Chinese version of the SNAP-IV.

Funding

This work was supported by the Chang Gung Memorial Hospital Research Projects (phthalates and BPA screening was funded by CMRPG8K1281; growth hormones and thyroid function assessments were supported by CMRPG8J0361).

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Liang-Jen Wang & Wen-Jiun Chou

  2. Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Ying-Hua Huang, Hsin-Yu Chang & Chih-Cheng Chen

  3. Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Sheng-Yu Lee

  4. Department of Psychiatry, College of Medicine, Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Sheng-Yu Lee

  5. Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung County, 912, Taiwan

    How-Ran Chao

  6. Institute of Food Safety Management, College of Agriculture, National Pingtung University of Science and Technology, Pingtung County, 912, Taiwan

    How-Ran Chao

  7. Emerging Compounds Research Center, General Research Service Center, National Pingtung University of Science and Technology, Pingtung County, 912, Taiwan

    How-Ran Chao

  8. School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, 80708, Taiwan

    How-Ran Chao

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  1. Liang-Jen Wang
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Contributions

WLJ participated in interpreting data, reviewing references, and drafting the manuscript. YHH, WJC, SYL, and HYC participated in data collection and patient recruitment. CCC and HRC contribute equally to this study, and they participated in protocol development and revised the manuscript. All authors read and approved the final manuscript and contributed to the drafting and revising of the paper.

Corresponding author

Correspondence to Liang-Jen Wang.

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All authors declare no conflicts of interest.

Ethics approval

This study was approved by the Chang Gung Memorial Hospital review board (IRB No. 201900376A3).

Consent to participate

We obtained a copy of written informed consent from each of all the participants, including 144 patients with ADHD and 70 healthy control subjects.

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All authors consented for publication.

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Wang, LJ., Huang, YH., Chou, WJ. et al. Interrelationships among growth hormone, thyroid function, and endocrine-disrupting chemicals on the susceptibility to attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 32, 1391–1401 (2023). https://doi.org/10.1007/s00787-021-01886-4

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