Associations Between Attention-Deficit/Hyperactivity Disorder (ADHD), ADHD Medication, and Shorter Height: A Quasi-Experimental and Family-Based Study - 28/11/23
, Miguel Garcia-Argibay, PhD a, b, Ebba Du Rietz, PhD b, Agnieszka Butwicka, MD, PhD b, c, Samuele Cortese, MD, PhD f, g, h, i, j, Brian M. D’Onofrio, PhD b, d, Jonas F. Ludvigsson, MD, PhD a, b, e, Henrik Larsson, PhD bAbstract |
Objective |
The association between attention-deficit/hyperactivity disorder (ADHD) and shorter height is unclear. This study examined the risk of shorter height in individuals with ADHD, and the influence of prenatal factors, ADHD medication, psychiatric comorbidity, socioeconomic factors, and familial liability.
Method |
We drew on Swedish National Registers for 2 different study designs. First, height data for 14,268 individuals with ADHD and 71,339 controls were stratified into 2 groups: (1) before stimulant treatment was introduced in Sweden, and (2) after stimulant treatment was introduced in Sweden. Second, we used a family-based design including 833,172 relatives without ADHD with different levels of relatedness to the individuals with ADHD and matched controls.
Results |
ADHD was associated with shorter height both before (below-average height: OR = 1.31, 95% CI = 1.22-1.41) and after (below-average height: OR = 1.21, 95% CI = 1.13-1.31) stimulants for ADHD were introduced in Sweden, and was of similar magnitude in both cohorts. The association between ADHD and shorter height attenuated after adjustment for prenatal factors, psychiatric disorders, and socioeconomic status. Relatives of individuals with ADHD had an increased risk of shorter height (below-average height in full siblings: OR = 1.14, 95% CI = 1.09-1.19; maternal half siblings: OR = 1.10, 95% CI = 1.01-1.20; paternal half siblings: OR = 1.15, 95% CI = 1.07-1.24, first full cousins: OR = 1.10, 95% CI = 1.08-1.12).
Conclusion |
Our findings suggest that ADHD is associated with shorter height. On a population level, this association was present both before and after ADHD medications were available in Sweden. The association between ADHD and height was partly explained by prenatal factors, psychiatric comorbidity, low socioeconomic status, and a shared familial liability for ADHD.
Le texte complet de cet article est disponible en PDF.Key words : ADHD, adult height, ADHD medication
Plan
| This article was reviewed under and accepted by Deputy Editor Melissa P. DelBello, MD. |
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| Henrik Larsson acknowledges financial support from the Swedish Research Council (2018-02599) and the Swedish Brain Foundation (FO2021-0115). Angieszka Butwika is supported by Stiftelsen Söderström Königska Sjukhemmet (SLS-969059), the Swedish Research Council (2017-00788), and Stockholm Region (FoUU clinical research appointment 2018-0718). Ebba Du Rietz received financial support from the Swedish Research Council for Health, Working Life, and Welfare (FORTE) (2019-01172), the Swedish Society for Medical Research (SSMF) (PD20-0036), Fredrik & Ingrid Thurings Stiftelse (2021-00638), and The Strategic Research Area in Epidemiology and Biostatistics (SFOepi). |
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| The research was performed with permission from the Regional Ethical Review Board in Stockholm. |
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| Dr. Garcia-Argibay served as the statistical expert for this research. |
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| Author Contributions Conceptualization: Ahlberg, Garcia-Argibay Data curation: Garcia-Argibay Formal analysis: Ahlberg, Garcia-Argibay Funding acquisition: Larsson Methodology: Ahlberg, Garcia-Argibay, Larsson Software: Garcia-Argibay Supervision: Du Rietz, Larsson Validation: Garcia-Argibay Writing – original draft: Ahlberg, Du Rietz, Larsson Writing – review and editing: Ahlberg, Garcia-Argibay, Du Rietz, Butwicka, Cortese, D’Onofrio, Ludvigsson |
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| Disclosure: Dr. Du Rietz has served as a speaker for Shire Sweden AB, a Takeda Pharmaceutical Company outside of this work. Dr. Cortese has declared honoraria and reimbursement for travel and accommodation expenses for lectures from the following non-profit associations: Association for Child and Adolescent Central Health (ACAMH), Canadian ADHD Alliance Resource (CADDRA), British Association of Pharmacology (BAP), and from Healthcare Convention for educational activity on ADHD. Prof. Ludvigsson has coordinated a study on behalf of the Swedish IBD quality register (SWIBREG). That study received funding from Janssen corporation. He has also received financial support from MSD developing a paper reviewing national healthcare registers in China and is currently discussing potential research collaboration with Takeda. Prof. Larsson has reported receiving grants from Shire Pharmaceuticals; personal fees from and serving as a speaker for Medice, Shire/Takeda Pharmaceuticals and Evolan Pharma AB; and sponsorship for a conference on attention-deficit/hyperactivity disorder from Shire/Takeda Pharmaceuticals and Evolan Pharma AB, all outside the submitted work. Drs. Garcia-Argibay and Butwicka, Prof. D’Onofrio, and Mr. Ahlberg have reported no biomedical financial interests or potential conflicts of interest. |
Vol 62 - N° 12
P. 1316-1325 - décembre 2023 Retour au numéro
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