Assessment of Serum Ferritin and Magnesium Levels in Children with Attention-De cit Hyperactivity Disorder

Abstract

Background & objective: Attention-deficit/hyperactivity disorder (ADHD) is a multifactorial neurodevelopmental disorder. While genetics play a major role, environmental factors such as mineral deficiencies (Iron and Magnesium) are increasingly implicated in its pathogenesis due to their roles in neurotransmitter synthesis and brain metabolism. This study was designed to measure and compare the levels of serum ferritin and magnesium in children with ADHD against an apparently healthy control group in Bangladesh. Methods: This cross-sectional study was conducted in the Department of Physiology, Dhaka Medical College, from January 2024 to December 2024. A total of 60 children aged 4–12 years were enrolled: 30 newly diagnosed ADHD cases (per DSM-5 criteria) and 30 age-matched healthy controls. Data collection included demographic and clinical factors such as age, gender, body mass index (BMI), family history of ADHD, maternal infection while pregnant, and birth weight etc. Serum ferritin was measured via sandwich chemiluminescence immunoassay, and serum magnesium (Mg) was measured using a photometric color test. Statistical analysis was performed using independent student’s t-tests and chi-square tests via SPSS version 26.0. Results: Statistical analysis showed that the groups were well-matched for age and body mass index. However, gender distribution and family history differed significantly; the ADHD cohort demonstrated a notably higher proportion of male participants (p = 0.021) and a more frequent family history of the condition (p = 0.011) compared to the control group. A Significantly lower mean serum ferritin levels were observed in the ADHD group compared to the control group (31.44 ± 20.87 ng/ml vs. 45.14 ± 20.60 ng/ml; p = 0.013). Similarly, mean serum magnesium levels were significantly lower in children with ADHD (1.80 ± 0.26 mg/dl vs. 2.13 ± 0.31 mg/dl; p < 0.001). Within the ADHD group, pre-school children (aged < 6 years) exhibited significantly lower Mg levels than primary school-aged children (1.71 ± 0.22 mg/dl vs. 1.90 ± 0.22 mg/dl; p = 0.011). Ferritin and Mg levels were also significantly lower in male ADHD subjects compared to male controls. Conclusion: Children with ADHD exhibit significantly lower levels of serum ferritin and magnesium compared to healthy children. These findings suggest that micronutrient deficiencies are common comorbidities in ADHD, particularly in younger children and males, highlighting the potential for nutritional screening and intervention in clinical management.

Ibrahim Card Med J 2025; 15 (2): 22-28