Zinc in attention-deficit/hyperactivity disorder
Zinc in attention-deficit/hyperactivity disorder
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DOI：
10.1089/cap.2005.15.619
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发表时间：
2005-08-01
影响因子：
1.9
通讯作者：
DiSilvestro, RA
中科院分区：
文献类型：
--
作者：
Arnold, LE;DiSilvestro, RA
目的：本研究的目的是审查已发表的证据锌营养在注意力缺陷/多动障碍（ADHD）的作用：方法：计算机文献检索补充了作者的knowledge.Results：许多对照研究报告的横向证据表明，低锌组织水平（血清，红细胞，头发，尿液，指甲）在儿童多动症，与正常对照组和人口norm相比。一些研究表明锌水平与临床严重程度或其对刺激物或化学激发的反应变化相关。两个安慰剂对照试验，一个是锌单药治疗，另一个是哌甲酯补锌，报告了显著的益处。然而，诊断程序和样本的代表性往往不明确，大多数此类报告来自饮食和/或社会经济现实与美国不同的国家和文化（9份已发表的报告中只有一份美国样本）。特别是，这两项积极的补锌临床试验都来自中东（土耳其和伊朗），这是一个疑似地方性缺锌的地区。这些试验中最大的锌剂量高于推荐的耐受上限，并有2在3 dropout rate.Conclusion：目前还不清楚如何积累的证据，锌在ADHD中可能发挥的作用适用于中产阶级的美国儿童。然而，证据似乎足够强大，值得进一步的控制研究，在诊断良好的样本代表的社会经济谱。需要对这种潜在的治疗方法进行假设检验的临床试验，如果发现有效，可能会成为某些患者目前治疗方法的相对安全，廉价的替代品或辅助品。目前，它仍然是一种研究性治疗。
Objective: The aim of this study was to review the published evidence for a role of zinc nutrition in attention-deficit/hyperactivity disorder (ADHD).Method: A computer literature search was supplemented by the authors' knowledge.Results: Numerous controlled studies report cross-sectional evidence of lower zinc tissue levels (serum, red cells, hair, urine, nails) in children who have ADHD, compared to normal controls and population norms. A few studies show correlations of zinc level with either clinical severity or a change thereof in response to stimulant or chemical challenge. Two placebo-controlled trials-one of zinc monotherapy, the other of zinc supplementation of methylphenidate-reported significant benefit. However, diagnostic procedures and sample representativeness were often not clear, and most such reports have come from countries and cultures with different diets and/or socioeconomic realities than are found in the United States (only one American sample in nine published reports). In particular, both positive clinical trials of zinc supplementation came from the Mid-East (Turkey and Iran), an area with suspected endemic zinc deficiency. The largest of these trials used zinc doses above the recommended upper tolerable limit and had a 2 in 3 dropout rate.Conclusion: It is not clear how well the accumulating evidence for a possible role of zinc in ADHD applies to middle-class American children. However, the evidence appears strong enough to warrant further controlled study in well-diagnosed samples representative of the socioeconomic spectrum. Hypothesis-testing clinical trials are needed of this potential treatment that, if found effective, might become a relatively safe, cheap substitute for, or adjunct to, current treatments in some patients. At present, it should remain an investigational treatment.