Investigation of the effects of ghrelin, obestatin, retinol-binding protein-4, adipsin levels and ghrelin/obestatin ratio on appetite and eating behavior in children with attention deficit hyperactivity disorder (ADHD)

Objective: This study aimed to compare serum levels of ghrelin, obestatin, adipsin, RBP-4, and the ghrelin/obestatin ratio between children and adolescents diagnosed with ADHD and healthy controls, and to investigate the associations of these parameters with eating behaviors. Materials and Methods: The study included 129 children and adolescents diagnosed with ADHD and 105 healthy controls. Psychiatric evaluations were conducted using the K-SADS-PL, ADHD severity was assessed by the T-DSM-IV-S, and eating behaviors were evaluated using the CEBQ and DEBQ scales. Height, weight, and waist circumference were measured to calculate BMI. After 8 hours of fasting, blood samples were collected, and serum levels of adipsin, ghrelin, obestatin, and RBP-4 were measured using ELISA. The ghrelin/obestatin ratio was also calculated. Results: After controlling for age, sex, BMI, and waist circumference, analyses revealed that serum obestatin, RBP-4, and adipsin levels were significantly higher in the ADHD group, while ghrelin levels were similar between groups. Additionally, the ghrelin/obestatin ratio was found to be significantly lower in the ADHD group. Conclusion: Our study demonstrated that children and adolescents with ADHD had significantly higher serum levels of adipsin, obestatin, and RBP-4, along with a lower ghrelin/obestatin ratio. Furthermore, the ADHD group showed higher scores for hedonic hunger and desire to drink compared to controls. These findings suggest that these molecules may play a role in the biological underpinnings of ADHD and contribute to an increased risk of obesity through disrupted eating behaviors. Keywords: Attention Deficit Disorder with Hyperactivity, Ghrelin, Retinol-Binding proteins, Adipokines, Appetite.