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World J Biol Psychiatry. 2018 Jan 11:1-9. doi: 10.1080/15622975.2017.1417636. [Epub ahead of print]

Attention-deficit/hyperactivity disorder is associated with reduced levels of serum low-density lipoprotein cholesterol in adolescents. Data from the population-based German KiGGS study.

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a Department of Experimental Neurodegeneration, Centre for Nanoscale Microscopy and Molecular Physiology of the Brain , University Medical Centre Göttingen , Göttingen , Germany.
b Faculty of Medicine , University of Porto , Porto , Portugal.
c Department of Child and Adolescent Psychiatry and Psychotherapy , University Medical Centre Göttingen , Göttingen , Germany.
d Max Planck Institute for Experimental Medicine , Göttingen , Germany.
e Department of Psychosomatic Medicine and Psychotherapy , University Medical Centre Göttingen, University of Göttingen, and German Centre for Cardiovascular Research (DZHK) , Göttingen , Germany.



Attention-deficit/hyperactivity disorder (ADHD) is a multifactorial, complex and the most common neurodevelopmental disorder in childhood. In this analysis, we tested the hypothesis that altered serum lipid patterns are associated with ADHD.


Using data from the nationwide, population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS), we compared serum levels of total cholesterol, high-density (HDL) and low-density lipoprotein (LDL) cholesterol, and also triglycerides, in participants with physician-diagnosed and/or suspected ADHD, as defined by a value of ≥7 on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire (SDQ), with non-ADHD controls.


Among 6,898 participants aged between 11 and 17 years, 666 (9.7%) had a physician-based diagnosis of ADHD and/or suspected ADHD. We found correlations between the parent-rated SDQ scores on the hyperactivity-inattention subscale and concentrations of triglycerides (r = 0.064, p < .001), total cholesterol (r = -0.026, p = .033), HDL cholesterol (r = -0.059, p < .001) and LDL cholesterol (r = -0.027, p = .031). In multivariate models, low serum levels of LDL cholesterol remained a significant predictor of ADHD (Exp(β) = 0.382, 95% confidence interval = 0.165-0.888, p = .025).


Our findings in a large, nationwide and representative sample of German adolescents demonstrated a small, but significant and inverse link between LDL cholesterol levels and symptoms of ADHD. Further studies are required to decipher the biochemical mechanisms behind this relationship.


Attention-deficit/hyperactivity disorder; cholesterol; lipid profile; low-density lipoprotein; triglycerides

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