Abstract:

Objective To detect the levels and existing forms of vitamin D （VD） in peripheral blood of the children with development language disorder（DLD） comorbid with attention deficit hyperactivity disorder（ADHD），to clarify the role of VD in the occurrence of DLD comorbid with ADHD， and to provide the new method for its treatment. Methods A total of 90 children with DLD comorbid with ADHD were regarded as observation group， and fifty physically and mentally healthy children in the Health Examination Center in our hospital during the same period were selected as control group. The DLD and ADHD were diagnosed according to the relevant chapters of the International Classification of Diseases， 11th Revision （ICD-11） and the American Diagnostic and Statistical Manual of Mental Disorders， Fifth Edition （DSM-5）.Griffiths Mental Development Scales （GMDS） was used to detect the language ability and the Developmental Quotient（DQ） was caculated；ADHD was classified according to the Snoopy Rating Scale Ⅳ （SNAP-4） Parent and Teacher Questionnaire；Conners Parent Symptom Questionnaire （PSQ） was used for ADHD scoring；the levels of serum VD of the subjects in two groups were detected by liquid chromatography-mass spectrometry. The results of GMDS and PSQ of all subjects and SNAP-4 of the subjects in observation group were collected.When DQ was less than （100－1）×standard deviation， the language ability of the subjects was lower than that of the contemporary；the children’s behavioral problems were divided into six factors according to the PSQ，such as learning problem， psychosomatic problem， anxiety， hyperactivity-impulsivity， conduct problem， and hyperactivity index； when the scores of six factors were all greater than 2 points， the related problems could be diagnosed；according to SNAP-4， ADHD was divided into predominantly inattentive ADHD（ADHD-I），predominantly-hyperactivity/impulsivity（ADHD-HI） and combined ADHD（ADHD-C） groups. Results In observation group， 71.1% were male and 28.9% were female. The levels of serum VD3 and VD of the chinldren in observation group were significantly lower than those in control group （P<0.01）.The levels of serum VD and VD3 of all three types（DLD-ADHD-C，DLD-ADHD-HI，and DLD-ADHD-I） of the subjects in observation group were significantly lower than those in control group （P<0.01）.The DQ values of the subjects in control group were positively correlated with the levels of serum VD and VD3（r=0.512，P<0.01；r=0.529，P<0.01）；the DQ values of the subjects in observation group was positively correlated with the levels of serum VD and VD3（r=0.299， P<0.01； r=0.279， P<0.01），and was negatively correlated with the level of VD2（r=－0.122， P<0.01）.There were significantly differences in the scores of learning problem， psychosomatic problem， conduct problem，anxiety， hyperactivity/impulsivity and hyperactivity index among three types （DLD-ADHD-C，DLD-ADHD-HI，and DLD-ADHD-I） of the subjects in observation group（P<0.01）.The level of serum VD3 was negatively correlated with the scores of the above indexes of the chlildren with DLD-ADHD-C type in observation group（r=－0.438，r=－0.357，r=－0.422，r=－0.465，r=－0.583， r=－0.593，P<0.01），and was positively correlated with the conduct problem of the children with DLD-ADHD-HI type in observation group（r=0.522，P<0.01），the level of VD3 was negatively correlated with hyperactivity-impulsivity and hyperactivity index（r=－0.455，P<0.05； r=－0.424，P<0.01），was negatively correlated psychosomatic problems and hyperactivity-impulsivity（r=－0.468，r=－0.496，P<0.05）， and was positively correlated with hyperactivity index（r=0.694，P<0.01）. The level of VD was negatively correlated with the scores of all six factors mentioned above of the children with DLD-ADHD-C type in observation group（r=－0.444，r=－0.498，r=－0.450，r=－0.501，r=－0.594， r=－0.522，P<0.01），and was negatively correlated with psychosomatic problem， conduct problem，hyperactivity/impulsivity and hyperactivity index of the children with DLD-ADHD-HI type in observation group（r=－0.355，r=－0.578，r=－0.509， r=－0.422，P<0.05or P<0.01）；the level of VD was negatively correlated with psychosomatic problem and hyperactivity/impulsivity（r=－0.485，r=－0.497，P<0.05）， and was positively correlated with the hyperactivity index （r=0.682，P<0.01）. Conclusion VD3 deficiency may be one of the causes of DLD comorbid with ADHD.VD3 supplementation may have a positive effect in the prevention and treatment of the children with DLD comorbid with ADHD.

Key words: Speech disorder, Attention deficit hyperactivity disorder, Comorbidity, Vitamin D