Several studies reported abnormal cortisol and inflammatory biomarker levels in youths with attention deficit hyperactivity disorder (ADHD), but the results have not been conclusive. We conducted a systematic review followed by a meta-analysis of case-control studies assessing blood or saliva cortisol levels and blood levels of inflammatory biomarkers in youth with ADHD. The effect sizes (ES) were synthesized by using a random-effects model. In the 19 studies on cortisol levels (totaling n = 916 youth with ADHD and n = 947 typically developing (TD), healthy youth), youth with ADHD have lower basal cortisol levels at any time-points during the day (effect size: .68; p = 0.004) and lower cumulative levels of cortisol (ES: .39, p = .008) throughout the day than TD youth. Moreover, morning cortisol levels were lower in ADHD youth when compared with TD youth (14 studies, n = 1679, ES: .84, p = 0.003), while there is no difference for the afternoon cortisol levels (p = 0.48). The meta-analysis on inflammation biomarker was conducted on 4 studies (totaling n = 404 youth) showed that Tumour Necrosis Factor-alpha (TNF-α) was lower in ADHD when compared with TD (3 studies, n = 257 youth, p = 0.004), while no differences for Interleukin-1β(IL-1β) (p = 0.21), IL-6 (p = 0.09) and IL-10 (p = 0.77). The lower cortisol in the context of low TNF-α levels may indicate a specific pattern of biomarkers in ADHD, and further investigation is warranted.

几项研究报告了患有注意力缺陷多动障碍 (ADHD) 的青少年皮质醇和炎症生物标志物水平异常，但结果尚无定论。我们进行了系统回顾，然后对病例对照研究进行了荟萃分析，这些病例对照研究评估了 ADHD 青年的血液或唾液皮质醇水平以及炎症生物标志物的血液水平。效应大小 (ES) 是通过使用随机效应模型合成的。在 19 项关于皮质醇水平的研究中（总共n  = 916 名患有 ADHD 的青少年和n  = 947 名典型发育 (TD) 的健康青少年），患有 ADHD 的青少年在一天中的任何时间点都有较低的基础皮质醇水平（效应量：. 68；p  = 0.004）和较低的皮质醇累积水平（ES：0.39，p =.008) 全天比 TD 年轻。此外，与 TD 青少年相比，ADHD 青少年的早晨皮质醇水平较低（14 项研究，n  = 1679，ES：0.84，p  = 0.003），而下午皮质醇水平没有差异（p  = 0.48）。对 4 项研究（总计n = 404 名青少年）进行的炎症生物标志物荟萃分析 表明，与 TD 相比，ADHD 患者的肿瘤坏死因子-α (TNF-α) 较低（3 项研究，n  = 257 名青少年，p  = 0.004)，而白细胞介素 1β(IL-1β) ( p  = 0.21)、IL-6 ( p  = 0.09) 和 IL-10 ( p = 0.77）。在低 TNF-α 水平的情况下较低的皮质醇可能表明 ADHD 中生物标志物的特定模式，需要进一步调查。