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This study investigated the associations of these biological factors with the behaviour of primary school children, specifically examining the effects of heavy metals, catecholamines, and microbiome-associated metabolites of dopamine, noradrenaline, adrenaline, and thyroxine precursors. Urine samples from 87 unselected primary school children were analysed to assess heavy metal load (arsenic, cadmium, lead, mercury), noradrenaline\/adrenaline ratio, and microbiome-associated metabolites of phenylalanine, tyrosine and L-dopa (3-phenylpropionic acid, p-OH-phenylacetic acid, 4-hydroxybenzoic acid, 3,4-dihydroxyphenylpropionic acid). Three months later, executive functions, ADHD symptoms (inattention, hyperactivity and impulsivity), and social behaviour were evaluated via parent and teacher questionnaires. In a path model, heavy metal load, microbiome-associated metabolites, and the noradrenaline\/adrenaline ratio measured in urine accounted for 32% of social behaviours. Microbiome-associated metabolites predicted 11% of the variance in executive functions and 17% in ADHD symptoms. Executive functions shared 55% of the variance with ADHD symptoms and 17% with social behaviours. Children with the lowest social behaviours had a sixfold increase in the odds of high heavy metal loads and a 3.4-fold increase in the odds of elevated microbiome-associated metabolites. Similarly, children with the most compromised executive functions had a threefold increase in the odds of such high metabolite levels. Overall, the results indicate that children\u2019s social behaviours are influenced by heavy metal accumulation, catecholamine balance, and the microbiome-associated metabolism of amino acids, that are crucial for producing stress and thyroid hormones.<\/jats:p>","DOI":"10.1038\/s41598-025-00680-5","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T06:27:40Z","timestamp":1748586460000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Heavy metals, noradrenaline\/adrenaline ratio, and microbiome-associated hormone precursor metabolites: biomarkers for social behaviour, ADHD symptoms, and executive function in children"],"prefix":"10.1038","volume":"15","author":[{"given":"Kristin","family":"Krajewski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"680_CR1","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s11894-009-0045-z","volume":"11","author":"F Tsai","year":"2009","unstructured":"Tsai, F. & Coyle, W. 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