Role of Appetite Hormone Dysregulation in Symptomology and Executive Function in Adolescents with Attention Deficit Hyperactivity Disorder

Abstract

Background: Evidence suggests an association of insulin and leptin with attention and executive function. The roles of dysregulated appetite hormones, including insulin and leptin, in the pathomechanisms of attention deficit hyperactivity disorder (ADHD) and associated cognitive function impairment remain unknown. Methods: In total, 50 adolescents with ADHD were enrolled and age and sex matched with 50 typically developing controls. The parent-reported Swanson, Nolan, and Pelham IV scale and self-reported Barratt Impulsiveness Scale were employed for symptom assessment. The fasting serum concentrations of appetite hormones—leptin, ghrelin, insulin, and adiponectin—were measured. The Wisconsin Card Sorting Test was used to examine executive function. Results: Generalized linear models with adjustment for age, sex, body mass index, and medications indicated that the adolescents with ADHD had higher levels of insulin (P= .039) and leptin (P= .006) than did those in the control group. Self-reported attention and self-control symptoms were negatively associated with insulin level (P= .025 and .018, respectively) and positively associated with leptin level (both P< .001). In addition, insulin level was positively associated with executive function (P= .031). Conclusion: Appetite hormone dysregulation was associated with the symptomology and executive function among adolescents with ADHD. Our results may inspire researchers to further examine the role of appetite hormone dysregulation in ADHD pathogenesis.