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Hair Zinc and Severity of Symptoms Are Increased in Children with Attention Deficit and Hyperactivity Disorder: a Hair Multi-Element Profile Study

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Abstract

Determination of bioelement levels in hair is an emerging non-invasive approach for screening bioelement deposition. However, the role of essential bioelement levels in hair and attention deficit/hyperactivity disorder (ADHD) risk or severity is largely unknown. In this study, we have compared multi-element hair profiles between healthy and ADHD Thai children. In addition, the correlations between bioelements and ADHD symptoms according to Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnostic criteria were identified. A case-control study was conducted in 111 Thai children (45 newly diagnosed ADHD and 66 matched healthy), aged 3–7 years, living in Bangkok and suburban areas. Levels of 39 bioelements in hair were measured by ICP-MS. Among the analyzed bioelements, Cu/Zn and P/Zn ratios in ADHD children were significantly lower than those in healthy children. Indeed, increased hair Zn level was correlated with more symptoms of inattention, hyperactivity, and total ADHD symptoms. Higher Zn content was also associated with being female and older age. Furthermore, Zn in hair was positively correlated with levels of Ca, Mg, and P; however, it showed a negative correlation with Al, As, Fe, and Mo. These findings warrant further confirmation in a large-scale study. Thai Clinical Trials Registry (TCTR) study ID: 20151113001

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Acknowledgments

The study was funded by the National Research Council of Thailand (FY2016; Thesis Grant for Master’s Degree Student). Data collection was supported by the executives, nursing, and supporting staff of BBH Hospital, with special gratitude to Ms. Aunchisa Suksawang and Dr. Augchara Yaovapak. We were grateful for the effort of Dr. Mehraj Ahmad in the professional editing of the manuscript.

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Authors and Affiliations

  1. BBH Hospital, Bangkok, Thailand

    Torsak Tippairote

  2. Institute of Nutrition, Mahidol University, Phutthamonthon, Salaya, Nakhon Pathom, 73170, Thailand

    Piya Temviriyanukul, Wenika Benjapong & Dunyaporn Trachootham

Authors
  1. Torsak Tippairote
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  2. Piya Temviriyanukul
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  3. Wenika Benjapong
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  4. Dunyaporn Trachootham
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Corresponding author

Correspondence to Dunyaporn Trachootham.

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Funding

This study was funded by the National Research Council of Thailand (FY2016; Thesis Grant for Master’s Degree Student).

Conflict of Interest

TT has received a research grant from the National Research Council of Thailand. TT is an executive member of BBH Hospital. Other authors declare that they have no conflict of interest.

Ethical Approval for Research Involving Human Participants

The study had been performed in accordance with the Declaration of Helsinki. The protocol was approved by the institutional review board of Mahidol University with certificate of approval (COA) No. MU-CIRB 2015/125.2010 and registered in the Thai Clinical Trials Registry (TCTR) with study ID of 20151113001.

Human and Animal Rights and Informed Consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Online resource 1

Checklist for ADHD symptoms according to DSM (V) diagnostic criteria (DOCX 25 kb)

Online resource 2

Exposure history questionnaire (DOCX 49 kb)

Online resource 3

Comparison in hair levels of other bioelements between ADHD and healthy Thai children (DOCX 30 kb)

Online resource 4

The correlation of zinc log10 level in hair samples to body weight and height of boys and girls in both study groups (DOCX 99 kb)

Online resource 5

The correlation of zinc level in hair samples to height of boys and girls in both study groups (DOCX 95 kb)

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Tippairote, T., Temviriyanukul, P., Benjapong, W. et al. Hair Zinc and Severity of Symptoms Are Increased in Children with Attention Deficit and Hyperactivity Disorder: a Hair Multi-Element Profile Study. Biol Trace Elem Res 179, 185–194 (2017). https://doi.org/10.1007/s12011-017-0978-2

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  • DOI: https://doi.org/10.1007/s12011-017-0978-2

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