Attention Deficit/Hyperactivity Disorder and Urinary Nonylphenol Levels: A Case-Control Study in Taiwanese Children

PLoS One. 2016 Feb 18;11(2):e0149558. doi: 10.1371/journal.pone.0149558. eCollection 2016.

Abstract

Objective: Nonylphenol (NP) belongs to the family of endocrine disruptors, and it is widely used in industrial applications and is ubiquitous in daily foods. Animal studies have suggested that NP exposure might promote motor hyperactivity, likely by causing deficits in dopaminergic neurons. However, research assessing NP exposure and epidemiology studies on human populations are limited. The aim of this study was to explore the association between child NP exposure and ADHD while considering particular covariants, such as lead levels and dopamine-related gene variations.

Methods: A case-control study was conducted on patients with clinically diagnosed ADHD; the Swanson, Nolan and Pelham, Fourth Revision (SNAP-IV) questionnaire was used to identify normal controls aged 4-15 years. Participants were examined for urinary NP concentrations, blood lead levels, and select single-nucleotide polymorphisms of two dopamine-related genes (D4 dopamine receptor, DRD4, and dopamine transporter, DAT1). Socio-demographic variables, maternal lifestyle factors during pregnancy and family medical history were obtained using a questionnaire.

Results: A total of 97 children with doctor-diagnosed ADHD and 110 normal controls were enrolled. The blood lead levels in both groups were similar (1.57±0.73 vs. 1.73±0.77 μg/dL, p = 0.15). No significant difference in urinary NP concentration was found between the children with ADHD and the control subjects (4.52±3.22 μg/g cr. vs. 4.64±2.95 μg/g cr., p = 0.43). ADHD was significantly more prevalent among males in this study (male to female ratio: 5:1 for the ADHD group and 1.3:1 for the control group, p<0.01). The analysis was repeated after excluding the females, but this had no effect on the association between NP and ADHD. The regression model, including or excluding females, indicated no increased odds of having ADHD in the context of NP exposure after adjusting for covariants.

Conclusion: This study indicated that NP exposure might not promote ADHD in children, even though children in Taiwan had relatively high levels of NP compared to those reported previously and those in developed nations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / genetics
  • Attention Deficit Disorder with Hyperactivity / urine*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Creatinine / metabolism
  • Demography
  • Dopamine / metabolism
  • Environmental Exposure / analysis
  • Female
  • Genetic Variation
  • Humans
  • Lead / adverse effects
  • Male
  • Odds Ratio
  • Phenols / urine*
  • Polymorphism, Single Nucleotide / genetics
  • Taiwan

Substances

  • Phenols
  • Lead
  • nonylphenol
  • Creatinine
  • Dopamine

Grants and funding

This study was financially supported by Department of Health, Taipei City Government, and Aiming for the Top University Plan from the Ministry of Education of the Republic of China, Taiwan. The work was also supported by the National Science Council of Taiwan, grant number NSC 96-2314-B-010-020-MY3, and by MOST 103-2319-B-010-001 from the National Core Facility Program for Biotechnology of Taiwan. The funding sources had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.