PDF(Pubmed)
Abstract：
Current evidence suggests that iron deficiency (ID) plays a key role in the pathogenesis of conditions presenting with restlessness such as attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS). In clinical practice, ID and iron supplementation are not routinely considered in the diagnostic work-up and/or as a treatment option in such conditions. Therefore, we conducted a scoping literature review of ID guidelines. Of the 58 guidelines included, only 9 included RLS, and 3 included ADHD. Ferritin was the most frequently cited biomarker, though cutoff values varied between guidelines and depending on additional factors such as age, sex, and comorbidities. Recommendations surrounding measurable iron biomarkers and cutoff values varied between guidelines; moreover, despite capturing the role of inflammation as a concept, most guidelines often did not include recommendations for how to assess this. This lack of harmonization on the interpretation of iron and inflammation biomarkers raises questions about the applicability of current guidelines in clinical practice. Further, the majority of ID guidelines in this review did not include the ID-associated disorders, ADHD and RLS. As ID can be associated with altered movement patterns, a novel consensus is needed for investigating and interpreting iron status in the context of different clinical phenotypes.
摘要：
目前的证据表明，缺铁（ID）在表现为不安的疾病的发病机理中起着关键作用，例如注意力缺陷多动障碍（ADHD）和不宁腿综合征（RLS）。在临床实践中,在这种情况下，诊断检查和/或作为治疗选择不常规考虑ID和铁补充剂。因此,我们对ID指南进行了范围研究文献综述.在包括的58条准则中，只有9个包括RLS，3包括ADHD。铁蛋白是最常被引用的生物标志物，虽然截止值在指南和年龄等其他因素之间有所不同，性别,和合并症。围绕可测量的铁生物标志物和截止值的建议在指南之间有所不同；此外，尽管抓住了炎症作为一个概念的作用，大多数指南通常不包括如何评估这一点的建议.铁和炎症生物标志物的解释缺乏协调，这引发了人们对当前指南在临床实践中的适用性的质疑。Further,本综述中的大多数ID指南不包括ID相关疾病，ADHD和RLS由于ID可以与改变的运动模式相关联，在不同临床表型的背景下,研究和解释铁的状态需要一个新的共识.
