| BACKGROUDIron deficiency not only causes anemia,but also affects other organs,especially the brain.Iron is involved in a number of basic biochemical functions in the brain,and is an auxiliary factor in many metabolic processes and material syntheses.It also has an important impact on myelination,transmitter delivery,gene expression and other neural development and function.Iron deficiency can reduce the iron content in the brain,resulting in central nervous system dysfunction,which ultimately leads to neuropsychiatric symptoms.Clinically,it was found that early iron deficiency affected the development of sensation and movement,growth and development,cognition and language,social emotion,learning and memory by changing brain structure,gene expression,neurotransmitter function,neural metabolism.With the social development,the state and the people pay more attention to children's physical health and social communication ability,neuropsychiatric diseases in children have an increasing trend year by year.Iron plays an important role in the development and function of children's central nervous system,but there are many influencing factors,such as different iron demand of growth stages,physical state,social environment,biological living environment and so on.Serum ferritin is generally considered to be a reliable indicator of iron storage in the body and is used in studies related to iron deficiency.This study is to explore the trends and related factors of serum ferritin in children with common neurological and psychiatric diseases,in order to promote the physical and mental health for children.METHODAll outpatients or inpatients in The Children's Hospital Zhejiang University School of Medicine with the first diagnosis as attention deficit hyperactivity disorder(ADHD),or tic disorder,or developmental disorder,or behavioral disorder,or cerebral palsy,or emotional disorder,or sleep disorder,or language disorder,or motor development delay,or mental disorder from 2006 to 2017 were included.They were carried out a project of serum ferritin,which was detected by immunoelectrochemical luminescence.The correlation factors of serum ferritin were determined by binary logistics regression and multiple linear regression.A p-value<0.05 was considered statistically significant.RESULTSFrom 2006 to 2017,a total of 6792 cases(12 inpatients and 6780 outpatients)of 10 common neuropsychiatric diseases in children were included in the analysis.In 2017,the largest number of the cases(1011 cases)was detected,accounting for 14.9%of the total.The average age of the children was 4.23±3.15 years old,and the disease with the largest number of cases was developmental disorder(3364 cases),accounting for 49.5%.1150 cases with low serum ferritin levels(<24 ?g/L)were detected,accounting for 16.9%of the total number of cases;males accounted for 63.0%,but there was no significant difference with women(P>0.05);the number of cases with low serum ferritin levels increased year by year(P<0.01).In the research,the number of cases with low serum ferritin in different diseases were from high to low,followed by developmental disorder(604 cases),sleep disorder(324 cases),motor development delay(60 cases),behavioral disorder(59 cases),and ADHD(58 cases);while the top five of incidence of low-serum-ferritin diseases were cerebral palsy(44.4%),motor development delay(35.1%),sleep disorder(20.1%),developmental disorder(18.0%),and language disorder(17.7%)(P<0.01).The number of cases with low serum ferritin in different age groups were from high to low in order of 1-2 years old(353 cases),0-1 years old(277 cases),and 2-3 years old(127 cases),while the top three of incidence of low-serum-ferritin age group were 0-1 years old(34.8%),1-2 years old(27.4%),and 2-3 years old(16.5%)(P<0.01).The mean serum ferritin level in male patients(48.40±33.58?g/L)was significantly lower than that in females(50.88±35.98?g/L)(P<0.05);the average serum ferritin level decreased year by year(P<0.001);the disease with the highest serum ferritin level was mental disorder(70.32±31.54?g/L),the lowest was language disorder(43.53±26.32?g/L);the age with the lowest serum ferritin level is 1-2 years old(39.28 ±25.90 ?g/L).Binary logistic regression and multiple linear regression analysis found that serum ferritin was associated with year,gender,age,and disease type.Linear regression analysis showed that serum ferritin in ADHD children was closely related to year and age(P<0.05);serum ferritin in children with tic disorder was only closely related to the year(P<0.05);serum ferritin in children with developmental disorders was closely related to age,gender and year(P<0.001);serum ferritin in children with behavioral disorder was closely related to age and gender(P<0.001);serum ferritin in children with sleep disorder was closely related to age and year(P<0.001).CONCLUSION1.The average serum ferritin level of children with common neuropsychiatric diseases decreased year by year,while the incidence of low serum ferritin had a tendency to increase year by year.2.The average serum ferritin level in male children with common neuropsychiatric diseases is significantly lower than that in females,and male children have a higher risk of low serum ferritin than female.3.Low serum ferritin in children with common neuropsychiatric diseases mainly occurs in 0-3 years old.4.Serum ferritin in children with common neuropsychiatric diseases is closely related to year,sex,age,and disease type. |
PDF Full Text Request