Plasma Serotonin as a Biomarker of the Severity of Attention Deficit Hyperactivity Disorder, in Children and Overweight/Obesity.

BACKGROUND AND AIMS: Recently, the potential use of plasma serotonin concentration as a biomarker for various diseases has been reported. However, whether plasma serotonin levels are useful for diagnosing attention deficit hyperactivity disorder (ADHD) remains controversial. To evaluate 5-hydroxytryptamine (5-HT, serotonin) as a biomarker for ADHD diagnosis, its severity, and overweight/obesity in school-aged children.

METHODS

Eighty-nine school-aged children (20 controls and 69 with ADHD: 17 hyperactive, 26 inattentive, and 26 mixed) were analyzed. Free 5-HT (5-HTF) and platelet 5-HT (5-HTP) levels were compared for ADHD presence, severity, and obesity, respectively, using the Kruskal-Wallis test. Multiple regression models assessed the predictive value of 5-HTF and 5-HTP for the presence and severity of ADHD, adjusting for age and obesity. The diagnostic utility of 5-HTF was evaluated using odds ratios (OR) and area under the curve (AUC) from logistic regression.

RESULTS

Patients with ADHD exhibited significantly elevated 5-HTF levels. No significant subgroup differences were found, but 5-HTF levels increased with ADHD severity. Higher 5-HTF levels were also observed in patients with overweight/obesity. Inverse trends were noted for 5-HTP, though less pronounced. Logistic regression showed a 71% increase in ADHD odds for each 0.1 µmol/L rise in 5-HTF. ORs for ADHD severity were 8.77 (severe), 2.31 (moderate), and 0.45 (mild). The AUC for 5-HTF was 0.76 for ADHD diagnosis and 0.93 for moderate/severe ADHD.

CONCLUSIONS

Plasma 5-HTF concentration can be a useful biomarker for the ADHD diagnosis, its severity, and comorbidity with overweight/obesity in these patients.