[Potential interaction effect on attention-deficit/hyperactivity disorder between mother's educational level and preschoolers' dietary pattern].

Objective: To explore the interaction effect between mother's educational level and preschoolers' dietary pattern on attention-deficit/hyperactivity disorder (ADHD). Methods: In 2014, there were 16 439 children aged 3-6 years old from 91 kindergartens in Ma'anshan municipality of China. A semi-quantitative food frequency questionnaire and the 10-item Chinese version of the Conners' Abbreviated Symptom Questionnaire (C-ASQ) were administered to assess the usual dietary intake and symptoms on ADHD. Social-demographic information was collected through questionnaires. Unconditional logistic regression was used to analyze the multiplication interaction effect between mother's educational level and preschoolers' dietary pattern on ADHD. Excel software was used to analyze the additive interaction effect of mother's educational level and preschoolers'dietary pattern on ADHD. Results: Results showed that factors as: mother's low educational level[aOR=1.31 (1.13-1.52)], scores related to preschoolers in the top quintile of "food processing" [aOR=1.31 (1.16-1.48)] and "snack" [aOR=1.45 (1.29-1.63)]patterns showed greater odds while preschoolers in the top quintile of "vegetarian" [aOR=0.80 (0.71-0.90)]showed less odds for having ADHD symptoms. Both multiplication and additive interactions were observed between mothers with less education. The processed dietary patterns (OR=1.17, 95%CI: 1.11-1.25), relative excess risk of interaction (RERI), attributable proportion (AP) and the interaction index (SI) appeared as 0.21, 0.13 and 1.47, respectively. Multiplication interaction was observed between levels of mother's low education and the snack dietary pattern (OR=1.21, 95%CI: 1.14-1.29), with RERI, AP and SI as 0.49, 0.26 and 2.36, respectively. However, neither multiplication interaction or additive interaction was noticed between levels of mother's low education and the vegetarian dietary pattern (OR=0.97, 95%CI: 0.92-1.03), with RERI, AP and SI as 0.09, 0.05 and 1.15, respectively. Conclusions: Levels of mother's low education presented a risk factor for ADHD symptoms in preschool children. Both multiplication interaction and additive interaction were observed between mother's low education levels and the processed dietary pattern. Multiplication interaction was noticed between mother's education levels and the snack dietary pattern but not with the vegetarian dietary pattern.目的： 探讨母亲文化程度与学龄前儿童饮食模式对注意缺陷多动障碍（ADHD）症状的交互作用。 方法： 2014年选择马鞍山市区91所幼儿园16 439名3~6岁学龄前儿童作为研究对象，通过问卷调查食物频率和社会人口学特征，采用Conners父母症状问卷进行ADHD症状评估。采用非条件logistic回归分析母亲文化程度与学龄前儿童饮食模式对ADHD症状的相乘交互作用，采用Excel软件分析其相加交互作用。 结果： 母亲文化程度偏低[aOR=1.31（1.13~1.52）]、学龄前儿童加工型饮食模式得分偏高[aOR=1.31（1.16~1.48）]、零食型饮食模式得分偏高[aOR=1.45（1.29~1.63）]均增加学龄前儿童ADHD症状的发生风险，素食型饮食模式得分偏高[aOR=0.80（0.71~0.90）]降低学龄前儿童ADHD症状的发生风险。母亲文化程度低与学龄前儿童加工型饮食模式对ADHD症状交互作用的超额相对危险度（RERI）为0.21、交互作用归因比（AP）为0.13和交互作用指数（SI）为1.47，存在相加交互作用和相乘交互作用（OR=1.17，95%CI：1.11~1.25）；母亲文化程度低与零食型饮食模式（RERI=0.49，AP=0.26，SI=2.36）未发现相加交互作用，但存在相乘交互作用（OR=1.21，95%CI：1.14~1.29）；与素食型饮食模式（RERI=0.09，AP=0.05，SI=1.15）未发现相加交互作用和相乘交互作用（OR=0.97，95%CI：0.92~1.03）。 结论： 母亲文化程度低是学龄前儿童ADHD症状发生的危险因素，与学龄前儿童的加工型饮食模式存在相加和相乘交互作用，与零食型饮食模式存在相乘交互作用，与素食型饮食模式无相加和相乘交互作用。.