Prevalence of eveningness and its association with cardiometabolic risk factors, risky sexual behavior, and alcohol use in adolescents and young adult males with ADHD

Background: Individuals with eveningness chronotype may be at a higher risk for developing unhealthy lifestyle and cardiovascular risk factors. Screening with traditional biomarkers may not help in detecting children and young adults with such a risk. There is paucity of literature studying novel biomarkers such as Apo B/ApoA1 ratio and highly sensitive C reactive protein (hs CRP) in predicting cardiometabolic risk in this population. Objectives: To study the prevalence of eveningness chronotype in attention-deficit/hyperactivity disorder (ADHD) and to know its association with metabolic risk factors that predict cardiometabolic consequences. Materials and Methods: This cross-sectional study consisted of thirty consenting adolescents and young adults who were on treatment for ADHD. Sociodemographic details were collected and the Morningness-eveningness questionnaire, alcohol use disorders identification test, HIV risk-taking behavior scale-sexual behavior subsection were used to determine eveningness, alcohol use, and risky sexual behavior, respectively. Body mass index (BMI) was measured. Blood investigations high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides, Apo B/A1 ratio, lipoprotein A, and hsCRP were sent. Results: The prevalence of eveningness in our study participants was 30% (n = 9). Risky sexual behavior was more among those with eveningness (P = 0.03). Those with eveningness had significantly earlier sexual experience (P = 0.05). Alcohol use was also significantly more in those with eveningness (P = 0.02). There was no significant difference in traditional markers such as BMI, lipid profile for cardiometabolic risk among study participants with or without eveningness. However, Apo B/A1 ratio was significantly more in those with eveningness (P = 0.01). Conclusion: Eveningness chronotype is common in ADHD which could indicate risk for future cardiometabolic consequences in addition to behavioral issues. There is a need for large-scale cohort studies studying cardiometabolic risk and the clinical utility of novel biomarkers such as ApoB/ApoA1 in this population.