Possible Associations of Disturbed Neurometals and Ammonia with Glycaemic Control in Type 1 Diabetic Children with Atten
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Possible Associations of Disturbed Neurometals and Ammonia with Glycaemic Control in Type 1 Diabetic Children with Attention Deficit Hyperactivity Disorder Hala M. Sakhr 1 & Mohammed H. Hassan 2
&
Tarek Desoky 3
Received: 27 November 2019 / Accepted: 30 January 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The chronicity of type 1 diabetes mellitus (T1DM) is reported to be associated with various psychological disorders. The current study aimed to evaluate the levels of serum ammonia and various neurometals (zinc, copper, and magnesium) in patients with T1DM with and without ADHD and to correlate their levels with glycaemic status. A prospective case-control study was conducted with 60 diabetic children with T1DM (allocated into a group of 20 patients with a diagnosis of ADHD and a group of 40 patients without ADHD) who were comparable to 60 matched controls. Assays of glucose, glycated haemoglobin (HbA1c), ammonia, zinc, copper, and magnesium were performed. Overall, ammonia and copper levels were significantly higher in the diabetic patients especially those with ADHD than in the control group (p ˂ 0.05 for all). The calculated copper/zinc ratio was significantly higher in the diabetic patient group than in the control group and higher in diabetic children with ADHD than in diabetic children without ADHD (p ˂ 0.05 for all). Diabetic children had significantly lower magnesium levels than the controls (p ˂ 0.05), but no significant difference between the diabetic subgroups was detected. A positive correlation between glycaemic control (HbA1c %) and ammonia level was found in the diabetic group and subgroups, and a positive correlation was found between HbA1c % and the Cu/Zn ratio in diabetic children with ADHD (p ˂ 0.05 for all). The current study confirms an association of elevated ammonia and copper/zinc ratio with poor glycaemic control and ADHD development among children with T1DM. Keywords T1DM . Copper/zinc ratio . Magnesium . Ammonia . ADHD
Introduction The chronicity of type 1 diabetes mellitus (T1DM) is reported to be associated with altered brain function and various psychological disorders [1, 2]. Children with diabetes frequently suffer from attention deficit hyperactivity disorder (ADHD), which seriously affects compliance with treatment and, accordingly, the prognosis of the disease [3, 4]. ADHD is a
* Mohammed H. Hassan [email protected]; [email protected] 1
Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
2
Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt
3
Department of Neuropsychiatry, Faculty of Medicine, South Valley University, Qena, Egypt
serious and common neurodevelopmental disorder whose symptoms mostly appear before the age of 12 and are present for more than 6 months. The symptoms of ADHD include inattention, hyperactivity, and impulsivity [5]. Increased levels of blood ammonia in subjects with ADHD may be due to alterations in the
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