Data_Sheet_1_Identification and Characterization of Influential Factors in Susceptibility to Attention Deficit Hyperactivity Disorder Among Preschool-Aged Children.docx

Attention deficit hyperactivity disorder (ADHD) is the most common childhood-onset neurodevelopmental disorder. Currently, increasing amounts of attention have been focused on the epidemiologic profiling of ADHD in children, viewed as a continuously distributed risk dimension throughout the whole lifespan. This study aimed to identify and characterize potential influential factors susceptible to ADHD-related symptoms among preschool-aged children. A comprehensive questionnaire was self-designed for both children and their parents or guardians and was distributed to 30 kindergartens from Beijing and Hebei, collecting potential influential factors in susceptibility to ADHD. ADHD was assessed by the Conner’s Abbreviated Symptom Questionnaire (C-ASQ), and 7,938 children were analyzed. Least absolute shrinkage and selection operator (LASSO) regression and hierarchical degree of adjustment were used to control possible covariates. Five factors, namely, children’s secondhand smoking exposure, breastfeeding duration, sleep mode, maternal pregnancy smoking exposure, and parental self-rating for patience, were identified to be independently and significantly associated with ADHD susceptibility. Meanwhile, dose–response relationships were observed between breastfeeding duration, parental self-rating for patience, and ADHD-related symptoms. Finally, a nomogram model was created for predicting ADHD susceptibility based on significant and conventional attributes under each criterion.

注意缺陷多动障碍（Attention deficit hyperactivity disorder, ADHD）是最常见的儿童起病型神经发育障碍。目前，学界对儿童ADHD的流行病学特征分析关注度与日俱增，该病症被视为贯穿全生命周期的连续分布风险维度。本研究旨在识别并表征学龄前儿童中易受ADHD相关症状影响的潜在影响因素。本研究自行编制了针对儿童及其家长或监护人的综合调查问卷，向北京与河北的30所幼儿园发放，收集与ADHD易感性相关的潜在影响因素数据。采用康纳氏简化症状问卷（Conner’s Abbreviated Symptom Questionnaire, C-ASQ）对ADHD进行评估，最终纳入7938名儿童进行数据分析。本研究采用最小绝对收缩和选择算子（Least absolute shrinkage and selection operator, LASSO）回归以及分层调整法来控制潜在混杂变量。最终识别出5个与ADHD易感性独立且显著相关的因素，分别为儿童二手烟暴露情况、母乳喂养时长、睡眠模式、母亲孕期吸烟暴露情况以及家长自我评定的耐心程度。同时，研究发现母乳喂养时长、家长自我评定的耐心程度与ADHD相关症状之间存在剂量-反应关系。本研究最终构建了列线图模型，基于各标准下的显著因素与常规属性，用于预测ADHD易感性。