Does excessive daytime sleepiness contribute to explaining the association between obesity and ADHD symptoms?
Does excessive daytime sleepiness contribute to explaining the association between obesity and ADHD symptoms?
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DOI：
10.1016/j.mehy.2007.04.036
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发表时间：
2008-01-01
影响因子：
4.7
通讯作者：
Lecendreux, Michel
中科院分区：
文献类型：
--
作者：
Cortese, Samuele;Konofal, Eric;Lecendreux, Michel
最近的研究表明，肥胖和注意力缺陷多动障碍（ADHD）之间存在显着关联。这种新描述的合并症的潜在因素仍不清楚，也未探索。在这篇文章中，我们提出，过度的白天嗜睡（EDS）有助于解释和肥胖之间的关联。这一假设的背景来自于对AND和EDS之间关联的研究，以及对肥胖个体EDS的调查。现有的研究表明，与行为显着相关的EDS。此外，越来越多的证据表明，肥胖与EDS显著相关，独立于陡峭呼吸障碍（SDB）或任何其他陡峭疾病。考虑到EDS和AND行为之间的关系，我们假设肥胖个体中高于预期的EDS率有助于解释肥胖和AND行为之间的关联。我们进一步推测脑源性神经营养因子（BDNF）和其他分子，如促炎细胞因子IL-6和TNF-α的作用。我们的假设产生了潜在的相关临床和治疗意义。从临床的角度来看，它可能建议系统地采取与症状（包括多动和冲动）的肥胖患者描述为嗜睡。关于治疗意义，我们建议具有促醒作用的促醒剂，如马吲哚，可能特别适用于治疗肥胖患者的AND症状，因为它们可能同时解决AND症状和体重减轻。总之，考虑到ADHD增加了肥胖的负担，我们认为有必要进一步研究肥胖和AND之间的共病关系。对EDS作用的研究可能会使这一领域取得进展，表明更有效的管理，并最终提高肥胖和AND患者的生活质量。(C)2007 Elsevier Ltd. All. rights reserved.
Recent studies suggest a significant association between obesity and attention-deficit/hyperactivity disorder (ADHD). The factors underlying this newly described comorbidity are still unclear and unexplored. In the present article, we propose that excessive daytime sleepiness (EDS) contributes to explaining the association between AND and obesity. The background for this hypothesis comes from studies on the association between AND and EDS, as well as from investigations on EDS in obese individuals. Available studies suggest that AND behaviours are significantly associated with EDS. Moreover, increasing evidence indicates that obesity is significantly associated with EDS independently of steep-disordered breathing (SDB) or any other steep disorders. Given the relationship between EDS and AND behaviors, we hypothesize that the higher than expected rates of EDS in obese individuals contribute to explaining the association between obesity and AND behaviors. We further speculate on the role of the brain derived neurotrophic factor (BDNF) and other molecules such as the proinflammatory cytokines IL-6 and TNF-alpha. Our hypothesis generates potentially relevant clinical and therapeutic implications. From a clinical standpoint, it may suggest to systematically took for AND symptoms (including hyperactivity and impulsivity) in obese patients described as sleepy. With regard to the therapeutic implications, we suggest that wake-promoting agents with anorexigenic effect, such as mazindol, might be particularly indicated for the treatment of AND symptoms in obese patients, since they might address both AND symptoms and weight reduction. In conclusion, considering the burden that ADHD adds to obesity, we believe that further studies on the comorbidity between obesity and AND are necessary. Research on the role of EDS might allow advancements in this field, suggesting a more effective management and, ultimately, a better quality of life of patients with both obesity and AND. (C) 2007 Elsevier Ltd. All. rights reserved.