Objective To investigate the value of serum angiotensin-converting enzyme 2(ACE2),tumor necrosis factor-like weak inducer of apoptosis(TWEAK)and CC motif chemokine ligand 5(CCL5)levels in the diagnosis and severity assessment of attention deficit hyperactivity disorder(ADHD)in children.Methods From October 2022 to October 2023,125 children with ADHD in Hebei Children's Hospital were selected as ADHD group,and 105 healthy children in Hebei Maternal and Child Health Center were selected as control group.According to the Clinical Global Impressions-Severity(CGI-S),the children were separated into a mild to moderate group(n=83)and a severe group(n=42).ELISA was applied to detect levels of ACE2,TWEAK,CCL5,luteinizing hormone(LH),and prolactin(PRL).The combined raven test(CRT)and conners parental symptom questionnaire(PSQ)were applied to score the cognitive and behavioral status of children with disabilities.Spearman correlation was used to analyze the correlation among serum ACE2,TWEAK,and CCL5 with CGI-S,CRT,and PSQ scores in the severe group.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of ACE2,TWEAK,and CCL5 for ADHD and severity.Results The serum ACE2(284.35±92.34 pg/ml)and TWEAK(2.56±0.76 pg/ml)levels in children with ADHD were lower than those in the control group(379.23±106.28 pg/ml,3.52±1.12 pg/ml),while CCL5(7.36±2.37 ng/ml)level was higher than that in the control group(5.24±1.63 ng/ml),and the differences were statistically significant(t=7.244,7.703,7.753,all P＜0.05).The levels of CRT,serum ACE2 and TWEAK in the severe group were lower than those in the mild to moderate group(t=5.318,6.686,6.490),while the levels of PSQ and CCL5 were higher than those in the mild to moderate group(t=5.220,6.134),and the differences were statistically significant(all P＜0.05).Spearman correlation analysis results showed that the serum ACE2 and TWEAK levels in the severe group were negatively correlated with CGI-S and PSQ scores(r=-0.432,-0.453;-0.421,-0.426,all P＜0.001),but positively correlated with CRT scores(r=0.427,0.418,all P＜0.000 1).CCL5 was positively correlated with CGI-S and PSQ scores(r=0.421,0.433,all P＜0.001),but negatively correlated with CRT scores(r=-0.446,P＜0.001).The AUCs for diagnosing ADHD by serum ACE2,TWEAK and CCL5 were 0.814,0.803 and 0.807,respectively,and the AUC of the combined diagnosis of the three was 0.945,which was better than individual diagnosis(Z=5.439,4.258,5.576,all P＜0.001).The AUCs for diagnosing severe ADHD by serum ACE2,TWEAK and CCL5 were 0.853,0.796 and 0.805,respectively,and the AUC of the combined diagnosis of the three was 0.930,which was better than the individual diagnosis(Z=2.604,3.851,3.567,all P＜0.001).Conclusion Serum ACE2 and TWEAK are low expressed in the serum of children with ADHD,while CCL5 is highly expressed.The expression levels of the three are correlated and have high diagnostic value for the occurrence and severity of ADHD.
维普
万方数据
