Analysis of risk factors for attention deficit hyperactivity disorder among children in Hubei region based on liquid chromatography-tandem mass spectrometry

Abstract

Objective To quantitatively assess nutritional elements using LC-MS/MS, this study examines the correlations between nutritional elements and vitamins and ADHD in children residing in Hubei Province. Additionally, it explores the associations among various monitoring indicators, thereby providing a reference for the clinical diagnosis and treatment of ADHD. Methods The study cohort comprised 354 children diagnosed with ADHD and 350 healthy controls, all of whom attended the Child Health Care Department of Hubei Provincial Maternal and Child Health Hospital between January 2023 and December 2025. Nutritional elements were quantified using ICP-MS, while serum levels of vitamins A and D were measured via LC-MS/MS. Comparative analyses were conducted to identify differences between the groups. Univariate and multivariate logistic regression analyses were employed to evaluate the correlations between these nutritional indicators and ADHD, as well as to identify independent associated factors. Results The serum concentrations of vitamins A and D were found to be notably lower in the ADHD group compared to the control group (P < 0.05). A logistic regression analysis identified vitamin A and vitamin D were independently inversely associated with ADHD, with statistical significance (P < 0.05). An age-stratified subgroup analysis revealed that within the ADHD cohort, children aged 6–8 years exhibited significantly lower levels of both vitamin A and vitamin D compared to the control group. Children aged 9–11 years demonstrated reduced levels of vitamin A, vitamin D, and manganese (Mn), but elevated copper (Cu) levels relative to controls. Furthermore, children aged 12–16 years had significantly lower vitamin D levels than their control counterparts (P < 0.05). Among the ADHD subgroups, significant differences were observed in the concentrations of iron (Fe), magnesium (Mg), calcium (Ca), Cu, zinc (Zn), vitamin A, and vitamin D (P < 0.05). Spearman correlation analysis revealed a strong association between vitamin A and vitamin D levels in children with ADHD, alongside a significant positive correlation between vitamin A and both Fe and Zn (P < 0.05). Conclusion Vitamin A and vitamin D deficiencies are prevalent among children with ADHD in Hubei Province, and low levels of these vitamins are independently associated with an increased likelihood of ADHD.