Correlation analysis of the platelet-to-lymphocyte ratio with attention-deficit hyperactivity disorder in children aged 6-14: based on the National Health and Nutrition Examination Survey database.

Objective: This study aimed to elucidate the association between the platelet-to-lymphocyte ratio (PLR) and the risk of attention deficit hyperactivity disorder (ADHD) in children aged 6-14 based on National Health and Nutrition Examination Survey (NHANES) data.

Method: We utilized data from NHANES 2013-2014 for analysis, with PLR as the independent variable and ADHD as the dependent variable. Weighted logistic regression was used to construct the relationship model. The subgroup analysis with stratification and adjustment for confounding factors was conducted to explore the association between PLR and ADHD risk in children aged 6-14. Finally, the restricted cubic spline (RCS) analysis was carried out to explore the non-linear relationship between PLR and ADHD.

Results: The study included 1455 samples with 91 ADHD cases. A significant positive association (OR > 1, P < 0.05) was observed between PLR and ADHD risk in the multivariate weighted logistic regression model. Race and asthma status remarkably influenced the relationship between PLR and ADHD (P for interaction<0.05). The positive association between PLR and ADHD risk was particularly significant (P < 0.05) in boys, children born to mothers aged 20-29, and children with asthma. The RCS curve indicated a non-linear association between PLR and ADHD risk (P-non-linear = 0.0040), with OR > 1 when PLR ≥ 106.40.

Conclusion: Increased PLR elevated the risk of ADHD, especially in males, children born to mothers aged 20-29, and children with asthma, with 106.40 possibly being an effective threshold for PLR's impact on ADHD risk.