Iron Supplementation in Management of Neurodevelopmental Disorders: Systematic Review, Meta-Analysis, and Qualitative Synthesis.

IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY
Stephen D Elliott, Mark L Vickers, Gemma McKeon, Lars Eriksson, Eva Malacova, James G Scott
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Abstract

Objective: The authors sought to explore the role of iron supplementation in the management of neurodevelopmental disorders among children and youths.

Methods: A systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken. A subset of results was suitable for meta-analysis. The quality of the evidence and strength of the clinical recommendations were assessed by using the Grading of Recommendations, Assessment, Development, and Evaluation method, and critical appraisal was conducted with the Joanna Briggs Institute critical appraisal tools.

Results: Nine articles met inclusion criteria. These articles included studies of attention-deficit hyperactivity disorder (ADHD) (N=7), autism spectrum disorder (N=1), and Tourette's syndrome (N=1). Three randomized controlled trials evaluating iron supplementation for ADHD hyperactivity symptom severity (124 participants: placebo, N=56; supplement, N=68) met inclusion criteria for a meta-analysis. Effect sizes for the placebo and supplement groups were moderate (Cohen's d=0.76) and large (Cohen's d=1.70), respectively, although these differences were not significant. The impact of iron supplementation on inattentive ADHD symptom severity was examined in two trials (75 participants: placebo, N=31; supplement, N=44). Large, nonsignificant effect sizes were demonstrated for the placebo (Cohen's d=1.66) and supplementation (Cohen's d=3.19) groups. The quality of the evidence and strength of the clinical recommendations were considered very low.

Conclusions: Further research is needed to examine the role of iron supplementation in the management of ADHD and neurodevelopmental disorders more generally. Additionally, iron supplementation comes with risks, including death in the case of overdose.

神经发育障碍管理中的铁补充剂:系统综述、元分析和定性综合。
目的作者试图探讨补铁在治疗儿童和青少年神经发育障碍中的作用:根据《系统综述和元分析首选报告项目》指南进行了系统综述。其中一部分结果适合进行荟萃分析。采用 "建议、评估、发展和评价分级法 "评估了证据的质量和临床建议的力度,并使用乔安娜-布里格斯研究所的批判性评价工具进行了批判性评价:结果:9 篇文章符合纳入标准。这些文章包括对注意力缺陷多动障碍(ADHD)(7 篇)、自闭症谱系障碍(1 篇)和抽动秽语综合征(1 篇)的研究。三项随机对照试验评估了铁补充剂对多动症多动症状严重程度的影响(124 名参与者:安慰剂组,56 人;补充剂组,68 人),符合荟萃分析的纳入标准。安慰剂组和补充剂组的效应大小分别为中等(Cohen's d=0.76)和较大(Cohen's d=1.70),尽管这些差异并不显著。两项试验(75 名参与者:安慰剂组,31 人;补充剂组,44 人)研究了补铁对注意力不集中多动症症状严重程度的影响。安慰剂组(Cohen's d=1.66)和补充剂组(Cohen's d=3.19)的效应大小较大,但不显著。证据的质量和临床建议的强度被认为很低:需要进一步研究补铁在治疗多动症和一般神经发育障碍中的作用。此外,铁质补充剂也有风险,包括用药过量导致的死亡。
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来源期刊
CiteScore
5.30
自引率
3.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.
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