Association between Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms and obesity and hypertension in early adulthood: A population-based study

Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
International journal of obesity (2005) (Impact Factor: 5). 10/2010; 35(6):852-62. DOI: 10.1038/ijo.2010.214
Source: PubMed


To examine the associations between attention-deficit/hyperactivity disorder (ADHD) symptoms, obesity and hypertension in young adults in a large population-based cohort.
The study population consisted of 15,197 respondents from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents followed from 1995 to 2009 in the United States. Multinomial logistic and logistic models examined the odds of overweight, obesity and hypertension in adulthood in relation to retrospectively reported ADHD symptoms. Latent curve modeling was used to assess the association between symptoms and naturally occurring changes in body mass index (BMI) from adolescence to adulthood.
Linear association was identified between the number of inattentive (IN) and hyperactive/impulsive (HI) symptoms and waist circumference, BMI, diastolic blood pressure and systolic blood pressure (all P-values for trend <0.05). Controlling for demographic variables, physical activity, alcohol use, smoking and depressive symptoms, those with three or more HI or IN symptoms had the highest odds of obesity (HI 3+, odds ratio (OR)=1.50, 95% confidence interval (CI) = 1.22-2.83; IN 3+, OR = 1.21, 95% CI = 1.02-1.44) compared with those with no HI or IN symptoms. HI symptoms at the 3+ level were significantly associated with a higher OR of hypertension (HI 3+, OR = 1.24, 95% CI = 1.01-1.51; HI continuous, OR = 1.04, 95% CI = 1.00-1.09), but associations were nonsignificant when models were adjusted for BMI. Latent growth modeling results indicated that compared with those reporting no HI or IN symptoms, those reporting 3 or more symptoms had higher initial levels of BMI during adolescence. Only HI symptoms were associated with change in BMI.
Self-reported ADHD symptoms were associated with adult BMI and change in BMI from adolescence to adulthood, providing further evidence of a link between ADHD symptoms and obesity.

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Available from: Bernard Fuemmeler
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    • "Higher body weight or body mass index (BMI) occurs in both children and adolescents with ADHD (Anderson, Cohen, Naumova, & Must, 2006; Byrd, Curtin, & Anderson, 2013; Chen, Kim, Houtrow, & Newacheck, 2010; Curtin, Bandini, Perrin, Tybor, & Must, 2005; Erhart et al., 2012; Faraone, Biederman, Monuteaux, & Spencer, 2005; Güngör, Celiloğlu, Raif, Özcan, & Selimoğlu, 2013; Hanć & Cieślik, 2008; Hanć et al., 2012; Holtkamp et al., 2004; Hubel, Jass, Marcus, & Laessle, 2006; Lam & Yang, 2007; Ptacek, Kuzelova, Paclt, Zukov, & Fischer, 2009; Schwartz et al., 2014; Spencer et al., 1996; Spencer et al., 2006; Swanson et al., 2006; Waring & Lapane, 2008; Yang, Mao, Zhang, Li, & Zhao, 2013) and adults with this diagnosis (Biederman et al., 2003; Cortese et al., 2013; Fuemmeler, Østbye, Yang, McClernon, & Kollins, 2011; Pagoto et al., 2009). This has been confirmed by epidemiological studies (Anderson et al., 2006; Byrd et al., 2013; Chen et al., 2010; Erhart et al., 2012; Fuemmeler et al., 2011; Güngör et al., 2013; Lam & Yang, 2007; Waring & Lapane, 2008) as well as studies performed in clinical groups (Biederman et al., 2003; Curtin et al., 2005; Faraone et al., 2005; Hanć & Cieślik, 2008; Holtkamp et al., 2004; Spencer et al., 1996; Spencer et al., 2006; Swanson et al., 2006; Ptacek et al., 2009). Studies also indicate increased incidence of ADHD symptoms in people with obesity (Agranat-Meged et al., 2005; Altfas, 2002; Erermis et al., 2004; Fleming, Levy, & Levitan, 2005). "
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    ABSTRACT: Assessment of the prevalence of overweight and obesity in children and adolescents with ADHD with emphasis on pharmacological treatment and comorbid disorders. We analyzed 408 medical records of patients with ADHD aged 7 to 18. The prevalence of overweight (14.71% vs. 12.83%, χ(2) = 3,586.43, p < .001) and obesity (6.37% vs. 3.45%, χ(2) = 3,588.19, p < .001) was significantly higher in children with ADHD compared with the population. There was significantly higher incidence of obesity in patients with comorbid diagnosis of adjustment disorder (22.22% vs. 4.42%, χ(2) = 5.66, p = .02) and mental retardation (19.05% vs. 4.42%, χ(2) = 7.63, p = .005). Pharmacological treatment was associated with a higher incidence of obesity (8.37% vs. 2.76%, χ(2) = 4.92, p = .03). Standardized body mass index (BMI), prevalence of overweight, and obesity was higher in patients with ADHD compared with the population. Higher incidence of obesity was shown in patients with analyzed comorbidities. © 2015 SAGE Publications.
    Full-text · Article · Apr 2015 · Journal of Attention Disorders
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    • "The effect of psychostimulants on blood pressure and heart rate, a small increase in both, is well documented in the literature and generally considered to be clinically insignificant [4, 6]. Risk for severe cardiovascular events such as sudden death has long been suspected to be influenced by treatment with psychostimulants; however, recently published data from a large population based study was reassuring and did not support this suspicion [12]. "
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    ABSTRACT: Childhood hypertension's increasing prevalence has generally been linked to the obesity epidemic. We observed that a significant proportion of children referred to our pediatric center with documented office hypertension are nonobese and have a history of attention deficit hyperactivity disorder (ADHD). To define the extent of this anecdotal observation, we performed a retrospective analysis of ambulatory blood pressure monitoring (ABPM) tests which in our center are routinely performed in newly referred children suspected of hypertension. Twenty-one percent (48 of 227 new referrals) had a history of ADHD, and 81% of them were treated with psychostimulant medications at the time of their ABPM test. Children in this group had a significantly lower average BMI z-score compared with the rest of the children (0.18 versus 0.75) and were significantly more likely to have abnormally elevated wake systolic loads on ABPM (38% versus 4%). The overall proportion of children with any abnormality on ABPM was comparable in both groups (46% versus 40%). Conclusion. A significant proportion of children suspected of hypertension have ADHD which may be related to higher wake systolic BP values. The prevalence of hypertension among children with ADHD will have to be determined in prospective studies.
    Full-text · Article · Jul 2013 · International Journal of Hypertension
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    • "ADHD was found to be significantly more prevalent in clinically ascertained obese children [Agranat-Meged et al., 2005], adolescents [Erermis et al., 2004] and adults [Altfas, 2002; Fleming et al., 2005]. Similarly, obesity is more prevalent in pediatric clinically [Spencer et al., 1996; Biederman et al., 2003; Holtkamp et al., 2004; Curtin et al., 2005; Faraone et al., 2005; Hubel et al., 2006; Spencer et al., 2006; Swanson et al., 2006; Ptacek et al., 2009] and epidemiologically [Anderson et al., 2006; Lam and Yang, 2007; Waring and Lapane, 2008; Chen et al., 2010; Fuemmeler et al., 2011; Erhart et al., 2012] ascertained subjects with ADHD, as well as in epidemiologically ascertained adult probands with ADHD [Pagoto et al., 2009; de Zwaan et al., 2011]. However, the evidence for the association of ADHD and obesity is not completely consistent [Mustillo et al., 2003; Braet et al., 2007; Dubnov-Raz et al., 2011]. "
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    ABSTRACT: Children with attention-deficit/hyperactivity disorder (ADHD) have a higher rate of obesity than children without ADHD. Obesity risk alleles may overlap with those relevant for ADHD. We examined whether risk alleles for an increased body mass index (BMI) are associated with ADHD and related quantitative traits (inattention and hyperactivity/impulsivity). We screened 32 obesity risk alleles of single nucleotide polymorphisms (SNPs) in a genome-wide association study (GWAS) for ADHD based on 495 patients and 1,300 population-based controls and performed in silico analyses of the SNPs in an ADHD meta-analysis comprising 2,064 trios, 896 independent cases, and 2,455 controls. In the German sample rs206936 in the NUDT3 gene (nudix; nucleoside diphosphate linked moiety X-type motif 3) was associated with ADHD risk (OR: 1.39; P = 3.4 × 10(-4) ; Pcorr = 0.01). In the meta-analysis data we found rs6497416 in the intronic region of the GPRC5B gene (G protein-coupled receptor, family C, group 5, member B; P = 7.2 × 10(-4) ; Pcorr = 0.02) as a risk allele for ADHD. GPRC5B belongs to the metabotropic glutamate receptor family, which has been implicated in the etiology of ADHD. In the German sample rs206936 (NUDT3) and rs10938397 in the glucosamine-6-phosphate deaminase 2 gene (GNPDA2) were associated with inattention, whereas markers in the mitogen-activated protein kinase 5 gene (MAP2K5) and in the cell adhesion molecule 2 gene (CADM2) were associated with hyperactivity. In the meta-analysis data, MAP2K5 was associated with inattention, GPRC5B with hyperactivity/impulsivity and inattention and CADM2 with hyperactivity/impulsivity. Our results justify further research on the elucidation of the common genetic background of ADHD and obesity. © 2013 Wiley Periodicals, Inc.
    Full-text · Article · Jun 2013 · American Journal of Medical Genetics Part B Neuropsychiatric Genetics
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