Dikkat Eksikliği ve Hiperaktivite Bozukluğu Tanılı Çocuklarda D Vitamini ve B12 Vitamini Düzeylerinin İncelenmesi

Öz

AMAÇ: Dikkat eksikliği ve hiperaktivite bozukluğu (DEHB), çocukluk çağının en yaygın nörogelişimsel bozukluklarından biridir. Bu bağlamda, 
B12 vitamini ve D vitamininin DEHB patofizyolojisindeki olası rollerinin olabileceğini gösteren çalışmalar dikkat çekmektedir. Bu çalışmada 
DEHB tanısı almış çocuklarda B12 vitamini ve D vitamini düzeylerini araştırmayı amaçladık.
GEREÇ ve YÖNTEM: : Retrospektif olan bu çalışmaya Uşak Üniversitesi Eğitim ve Araştırma Hastanesi Çocuk Ruh Sağlığı ve Hastalıkları Polikliniği'ne başvuran toplamda 96 çocuk dahil edildi. Çalışmada DEHB grubu ve kontrol grubu olmak üzere iki grup oluşturuldu. DEHB grubu ve sağlıklı grubunu oluşturan bireylere ait yaş, cinsiyet gibi demografik veriler ve B12 vitamini, D vitamini düzeyleri hastanenin elektronik sistemi üzerinden retrospektif olarak incelendi. İstatistiksel analizler; Kolmogorov-Smirnov testi, Student t-testi, normal dağılım göstermeyen numerik verilerde Mann Whitney-U testini içeriyordu.
BULGULAR: DEHB grubu ile kontrol grubunun yaş ortalaması arasında istatistiksel anlamlılık yoktu. B12 vitamini ve D vitamini düzeyi kontrol grubunda ortalama olarak daha yüksek olduğu tespit edildi, gruplar arasındaki fark istatistiksel olarak ileri düzeyde anlamlıydı (p<0,0001). SONUÇ: Mevcut literatürde DEHB ile B12 vitamini ve D vitamini düzeyleri arasındaki ilişkiyi inceleyen çalışmalar giderek artmakla birlikte, sonuçlar bazı tutarsızlıklar göstermektedir. Bu çalışmada DEHB grubunda D vitamini ve B12 vitamini düzeylerinin anlamlı derecede düşük olması, bu vitaminlerin eksikliğinin DEHB fizyopatolojisiyle ilişkili olabileceğini düşündürmektedir.

Anahtar Kelimeler

• DEHB
• B12 vitamini
• D vitamini

Etik Beyan

Bu retrospektif çalışma, Uşak Eğitim ve Araştırma Hastanesi'ndeki tıbbi kayıtlar ve Hastane Bilgi Yönetim Sistemi (HBYS) veri tabanları incelenerek gerçekleştirildi. Çalışma protokolü yerel etik kurul tarafından onaylandı (onay numarası: 80-80-13) ve çalışma Helsinki Bildirgesi'ne uygun olarak yürütüldü.

Investigation of Vitamin D and Vitamin B12 Levels in Children Diagnosed with Attention Deficit Hyperactivity Disorder

Öz

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. In this 
context, studies showing the possible roles of vitamin B12 and vitamin D in the pathophysiology of ADHD are noteworthy. In this study, we 
aimed to investigate the levels of vitamin B12 and vitamin D in children diagnosed with ADHD.
MATERIALS and METHODS: A total of 96 children who applied to the Child Mental Health and Diseases Polyclinic of Uşak University Training and Research Hospital were included in this retrospective study. Two groups were formed in the study: an ADHD group and a control group. Demographic data such as age and gender, and vitamin B12 and vitamin D levels of individuals in the ADHD group and the healthy group were retrospectively examined through the hospital's electronic system. Statistical analyses; The Kolmogorov-Smirnov test, Student t-test, and Mann Whitney-U test for numerical data not showing normal distribution were included.
RESULTS: There was no statistically significant difference in the mean age between the ADHD group and the control group. Vitamin B12 and vitamin D levels were found to be higher on average in the control group, and the difference between the groups was statistically highly significant (p<0.0001).
CONCLUSION: Although studies examining the relationship between ADHD and vitamin B12 and vitamin D levels are increasing in the current literature, the results show some inconsistencies. In this study, the significantly lower levels of vitamin D and vitamin B12 in the ADHD group suggest that deficiencies in these vitamins may be related to the pathophysiology of ADHD.

Anahtar Kelimeler

• DEHB
• B12 vitamini
• D vitamini

Etik Beyan

This retrospective study was conducted through a review of medical records and Hospital Information Management System (HBYS) databases at Uşak University Training and Research Hospital. The study protocol was approved by the local ethics committee (approval number: 80-80-13), and the study was conducted in accordance with the Declaration of Helsinki.

Kaynakça

1. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007; 164(6): 942-948. doi: 10.1176/ajp.2007.164.6.942
2. Cormier E. Attention deficit/hyperactivity disorder: a review and update. J Pediatr Nurs. 2008; 23(5): 345-357. doi: 10.1016/j.pedn.2008.01.003
3. Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA, Rohde LA, Sonuga-Barke EJS, Tannock R, Franke B. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers. 2015; 1: 15020. doi: 10.1038/nrdp.2015.20
4. Huskisson E, Maggini S, Ruf M. The influence of micronutrients on cognitive function and performance. J Int Med Res. 2007; 35(1): 1-19. doi: 10.1177/147323000703500101
5. Eyles DW, Burne THJ, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013; 34(1): 47-64. doi: 10.1016/j.yfrne.2012.07.001
6. Cui X, Gooch H, Petty A, McGrath JJ, Eyles D. Vitamin D and the brain: genomic and non-genomic actions. Mol Cell Endocrinol. 2017; 453: 131-143. doi: 10.1016/j. mce.2017.05.035
7. Patrick RP, Ames BN. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J. 2015; 29(6): 2207-2222. doi: 10.1096/fj.14-268342
8. Massoodi A, Javadian Koutanaei S, Faraz Z, Geraili Z, Zavarmousavi SM. Comparison of serum vitamin D levels between healthy and ADHD children. Caspian J Intern Med. 2023; 14(4): 681-686. doi: 10.22088/cjim.14.4.681

9. Bottiglieri T. Homocysteine and folate metabolism in depression. Prog Neuropsychopharmacol Biol Psychiatry. 2005; 29(7): 1103-1112. doi: 10.1016/j.pnpbp.2005.06.021
10. Ho PI, Ashline D, Dhitavat S, Ortiz D, Collins SC, Shea TB, Rogers E. Folate deprivation induces neurodegeneration: roles of oxidative stress and increased homocysteine. Neurobiol Dis. 2003; 14(1): 32-42. doi: 10.1016/S0969-9961(03)00070-6
11. Moore E, Mander A, Ames D, Carne R, Sanders K, Watters D. Cognitive impairment and vitamin B12: a review. Int Psychogeriatr. 2012; 24(4): 541-556. doi: 10.1017/S1041610211002511
12. Razavinia F, Ebrahimiyan A, Faal Siahkal S, Ghazinezhad N, Abedi P. Vitamins B9 and B12 in children with attention deficit hyperactivity disorder (ADHD): a systematic review. Int J Vitam Nutr Res. 2024; 94(5-6): 476-484. doi: 10.1024/0300-9831/a000809
13. Lukovac T, Hil OA, Popović M, Jovanović V, Savić T, Pavlović AM, Pavlović D. Serum biomarker analysis in pediatric ADHD: implications of homocysteine, vitamin B12, vitamin D, ferritin, and iron levels. Children (Basel). 2024; 11(4): 497. doi: 10.3390/children11040497
14. Elshahawi H, Amin G, Khalil S, Kasem R, Mostafa Serum vitamin D level in children with attention deficit hyperactivity disorder (ADHD). QJM. 2024; 117(Supplement_2): hcae175.491. doi: 10.1093/qjmed/hcae175.491
15. Li M, Gu H, Chen Y. Serum levels of fat-soluble vitamins in children with attention deficit hyperactivity disorder and relationship with symptom subtypes. Front Psychiatry. 2025; 16: 1646885. doi: 10.3389/fpsyt.2025.1646885
16. Zhang P, Liu Y, Ma Y, Zhao T, Zhang C, Sun H. Vitamin D insufficiency and sleep disturbances in children with ADHD: a case-control study. Front Psychiatry. 2025; 16: 1546692. doi: 10.3389/fpsyt.2025.1546692
17. Yang J, Yuan H, Qiu R, Fu X. Effect of 25 hydroxyvitamin D on attention deficit and hyperactivity in school-age children with ADHD. Medicine (Baltimore). 2023; 102(43): e35728. doi: 10.1097/MD.0000000000035728
18. Mirhosseini H, Maayeshi N, Hooshmandi H, Moradkhani S, Hosseinzadeh M. The effect of vitamin D supplementation on the brain mapping and behavioral performance of children with ADHD: a double-blinded randomized controlled trials. Nutr Neurosci. 2024; 27(6): 566-576. doi: 10.1080/1028415X.2023.2233752
19. Urbaniak AD, Tomaszek N, Badura A, Modzelewski S, Grywińska W. Vitamin D3 and its therapeutic potential in pediatric ADHD: a narrative review of clinical outcomes. Psychiatria. 2025; 22: 32-39. doi: 10.5603/psych.103158
20. Kitaneh R, Jalilian-Khave L, Ysrayl BB, Borelli A, Funaro MC, Potenza MN, et al. The relationship between vitamin D and the development and treatment of attention-deficit hyperactivity disorder: an overview of systematic reviews. Curr Behav Neurosci Rep. 2024; 11(3): 164-181. doi: 10.1007/s40473-024-00278-7
21. Goksugur SB, Tufan AE, Semiz M, Gunes C, Bekdas M, Tosun M, Demircioglu F. Vitamin D status in children with attention-deficit-hyperactivity disorder. Pediatr Int. 2014; 56(4): 515-519. doi: 10.1111/ped.12286
22. Şahin N, Altun H, Kurutaş EB, Balkan D. Vitamin D and vitamin D receptor levels in children with attentio-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat. 2018; 14: 581-585. doi: 10.2147/NDT.S158228
23. Bala KA, Doğan M, Kaba S, Mutluer T, Aslan O, Doğan SZ. Hormone disorder and vitamin deficiency in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs). J Pediatr Endocrinol Metab. 2016; 29(9): 1077-1082. doi: 10.1515/jpem-2015-0473
24. Afşar Karatepe B, Taşar Yıldırım T, Yıldız S. Investigation of Attention Deficit and Hyperactivity Disorder in Women with Vitamin D Deficiency. Fırat Tıp Dergisi. 2025; 30(3): 165- 171.
25. Adak İ, Halıcı T, Kaya İ, Zoroğlu SS. Serum Vitamin D Status in Children with ADHD: An Outpatient Clinic Study. Psychiatry and Behavioral Sciences. 2025; 15(4): 189-195. doi: 10.5455/PBS.20250916084437
26. Tan Y, Zhou L, Gu K, Xie C, Wang Y, Cha L, Wu Y, Wang J, Song X, Chen X, Hu H, Yang Q. Correlation between Vitamin B12 and Mental Health in Children and Adolescents: A Systematic Review and Meta-analysis. Clin Psychopharmacol Neurosci. 2023; 21(4): 617-633. doi: 10.9758/cpn.22.1040
27. Adıgüzel Akman Ö, Sarıgedik E. Cognitive disengagement syndrome: the same as or different from attention-deficit hyperactivity disorder? An examination based on biochemical parameters. J Psychiatr Res. 2025; 182: 270-276. doi: 10.1016/j.jpsychires.2025.01.029 28. Kabukçu Başay B, Çelik Yıldırım H, Ünal EB, Başay Ö. No Elevated Genomic Damage Despite High Oxidative Stress and Homocysteine Levels Among ADHD Children. Int J Dev Neurosci. 2025; 85(7): e70067. doi: 10.1002/jdn.70067
28. Shea TB, Rogers E. Lifetime requirement of the methionine cycle for neuronal development and maintenance. Curr Opin Psychiatry. 2014; 27(2): 138-142. doi: 10.1097/YCO.0000000000000046
29. Holton KF. Micronutrients May Be a Unique Weapon Against the Neurotoxic Triad of Excitotoxicity, Oxidative Stress and Neuroinflammation: A Perspective. Front Neurosci. 2021; 15: 726457. doi: 10.3389/fnins.2021.726457
30. Coşar A, İpçioğlu OM, Özcan O, Gültepe M. Folate and homocysteine metabolisms and their roles in the biochemical basis of neuropsychiatry. Turk J Med Sci. 2014; 44(1): 1-9. doi: 10.3906/sag-1211-39