A large prospective study published in Brain Sciences has found that suboptimal maternal cholesterol levels, in particular low high-density lipoprotein (HDL) cholesterol, may increase the risk for attention-deficit/hyperactivity disorder (ADHD) in offspring.
Yuelong Ji, MS, MSPH, of the Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health in Baltimore, Maryland, and colleagues also found that the male fetus appears to be more vulnerable to maternal cholesterol levels.
The investigators analyzed data from the Boston Birth Cohort, in which participants were enrolled at birth and followed up to age 15 years. The final analysis included 1479 mother-infant pairs — 303 children with ADHD and 1176 neurotypical children. The median age at ADHD diagnosis was 7 years. The study population was predominantly urban, low income, and minority.
Results from multiple logistic regression analysis indicated that a low maternal HDL level (<60 mg/dL) was associated with an increased risk for ADHD compared with higher maternal HDL levels. A “J” curve was observed between triglyceride level and ADHD risk. The correlation between ADHD and maternal HDL and triglyceride levels was stronger for boys than for girls.
The study has a number of limitations. One of these is that only a single measurement of maternal cholesterol level was made 24 to 72 hours after delivery. The investigators noted that, ideally, lipid levels should be recorded throughout pregnancy. An additional limitation is that the study used nonfasting blood samples, which may have biased the results toward the null. Finally, another limitation is that the study was conducted in an urban, low-income, primarily minority population, who may have had a higher risk for exposure to additional risk factors for ADHD.
The authors suggest that their findings provide new hypotheses for understanding the origins of ADHD, gender differences, and future targets for the prevention of ADHD, and thus warrant further investigation.
Ji Y, Riley AW, Lee L-C, et al. A prospective birth cohort study on maternal cholesterol levels and offspring attention deficit hyperactivity disorder: new insight on sex differences. Brain Sci. 2018;8(1):3.