BACKGROUND:The rapidly increasing prevalence of childhood obesity became a major burden on health worldwide, giving an alarm to clinicians and researchers. Adipocytes act as an active endocrine organ by releasing plenty of bioactive mediators (adipokines) that play a major role in regulating metabolic processes. Apelin is a recently identified adipokine that is expressed in adipocytes.AIM:The current work aimed to uncover the relation between serum apelin and childhood obesity and its related complications as hypertension and hyperglycemiaMETHOD:A group of 50 obese and 31 non-obese; sex- and age-matched children were enrolled in our study with a mean age of (9.5 ± 2.1) and (8.7 ± 1.3) respectively. Anthropometric measurements, blood pressure, were assessed in all studied participants, we also determined the lipid profile, serum insulin, fasting blood glucose (FBG) level, HOMA-IR and serum apelin.RESULTS:Obese children had higher levels of HbA1c, FBG, serum insulin, HOMA-IR, total cholesterol, triglycerides, low-density lipoprotein (LDL) and diastolic blood pressure (DBP Z-score); compared to controls (all P < 0.05). Apelin was significantly higher in obese children versus controls and correlated positively with BMI Z-Score (P = 0.008), DBP Z-Score (P = 0.02), cholesterol, TG (both P = 0.02), serum insulin (P = 0.003), FBG and HOMA-IR (both P = 0.001). Linear regression analysis showed that FBG was the most effective factor in predicting the level of serum apelin (P = 0.04).CONCLUSION:This work supports the hypothesis that apelin may have a crucial role in the pathogenesis of health hazards related to obesity in children including insulin resistance, hypertension and a higher risk of occurrence of metabolic syndrome.

AIM: The study aimed to evaluate serum vitamin D concentrations among neonates with pneumonia. METHODS: This case-control study enrolled 33 neonates with pneumonia in addition to 30 healthy controls. CBC, CRP, Serum vitamin D and Pentraxin 3 levels were measured for all participants. RESULTS: There was significant difference between patients and controls regarding Hemoglobin levels, TLC and CRP (p value < 0.01, = 0.002, < 0.01 respectively). Patients with pneumonia showed significant lower levels of Vit. D (9 ± 2.1) compared to controls (14.1 ± 2.8), P value < 0.01. However, patient group had significant higher levels of Pentraxin 3 (29.1 ± 4.8) compared with controls (12.6 ± 3), P value < 0.01. Moreover, mechanically ventilated patients revealed significant lower vit D (7.7 ± 1.8) and higher pentraxin 3 (32.2 ± 2.6) compared to patients on free oxygen (9.1 ± 2.1, 26.4 ± 3.7 respectively), P value = 0.05, 0.02 respectively. Regarding hospital stay, it had significant positive correlation with serum pentraxin 3 (r = 0.6, P value < 0.01) and significant negative correlation with serum vit D (r = -0.4, P value = 0.04). Finally a significant negative correlation between serum levels of vitamin D and Pentraxin 3 was found (r = -0.4, P value = 0.01). CONCLUSION: Lower concentration of serum vitamin D may be significantly associated with neonatal pneumonia. It also can predict the need for mechanical ventilation and duration of hospital stay in neonatal pneumonia. Similarly, higher levels of Pentraxin 3 may be used as an indicator for mechanical ventilation need and a longer hospital stay in neonates with pneumonia.

BACKGROUND: Breast milk (BM) is the main nutritional source for newborns before they are capable to eat and consume other foods. BM has carbohydrates, lipids, complex proteins, and other biologically active components which have a direct effect on infant growth. AIM: The aim of the study was to correlate anthropometric data of the infant to macronutrients in BM (fat, protein, and carbohydrates) and to find some modifiable issues affecting macronutrient contents of BM for the benefits of upcoming infants. METHODS: One hundred breastfeeding mothers participated in the study, they were recruited from the outpatient clinic, El Demerdash Hospital, Ain Shams University, from September 2019, to December 2019. BM was expressed by an electric pump, macronutrient content was assessed. Anthropometric data of the babies and mothers were obtained, gestational age, parity, age of the women, and the route of birth were recorded. RESULTS: For the macronutrients content of milk, a positive significant correlation was observed between BM fat, protein, and lactose. Infants’ body mass index (BMI) was negatively related to the fat content of BM, while no relation was found between BMI and protein or lactose content of the milk. BM fat content was negatively correlated with gestational age and maternal age. Positive correlations were found between BMI and protein, lactose and infant age. Protein content was negatively correlated with parity. No impact of infant’s sex on BM composition and as regards maternal diet, high protein consumption leading to increase BM protein content. CONCLUSIONS: The current study confirms that BM macronutrient composition has a wide variability; this variability is associated with each macronutrient, respectively. To improve BM composition, one could aim for improving the nutritional balance in lactating women, especially for protein intake. More well-designed longitudinal studies about factors that influence human milk compositions are warranted.

BACKGROUND: Obesity is an expanded health problem worldwide and it is blamed for a startling rise in type 1 diabetes (T1DM), the interaction between obesity, autoimmune processes, and glucose homeostasis is a growing field of study. AIM: This study was undertaken to predict the role of the inflammatory cytokines (interleukin [IL]-17 and IL-10) as biomarkers in early screening for obesity and T1DM and to determine the relation of inflammatory cytokines with diabetic complications especially nephropathy. SUBJECTS AND METHODS: The target group consisted of 92 children with type 1 diabetes children who were diagnosed according to the criteria provided by American Diabetes Association Diabetic; cases were divided into two groups, Group 1 (overweight and obese diabetics) and Group 2 (normal weight diabetic children). The levels of serum IL-17 and IL-10 were assayed in these children by an enzyme-linked immunosorbent assay. Serum triglycerides (TG) and cholesterol levels were measured as well as urinary microalbumin level was estimated for detection of nephropathy. RESULTS: Diabetic overweight and obese children exhibited significantly 3.8 folds more at risk to be bad glycemic control than diabetic children with normal body mass index (BMI). Furthermore, overweight and obese diabetic children displayed significantly 15 times more at risk of having nephropathy than diabetic children with normal BMI. Low serum level of IL 10 and high level of IL 17 showed a significant association with high BMI in diabetic children. High HBA1c, low IL 10, and long disease duration were significantly considered as predominant risk factors for diabetic nephropathy in diabetic children. CONCLUSION: The obtained data from these investigations proved that overweight and obese children have a low serum level of IL-10 and high serum IL-17 levels. The relationship between IL-10/IL-17 can be applied as a good marker for the inflammatory state and these inflammatory interleukins can be employed as biomarkers in early screening for obesity and T1DM. Furthermore, these interleukins can be utilized as a predictor for early diabetic complications, particularly nephropathy.

Ghrelin is a pleiotropic hormone that governs eating and energy equilibrium as well as promotes the release of growth hormone release. Although cord blood ghrelin has been correlated to the weight at birth and other anthropometric measures, the implication of des-acyl ghrelin in fetal and postnatal growth still not well understood. The goal of this research was to investigate the concentration of des-acyl ghrelin (DAG) in cord blood of appropriate for gestational age (AGA), small for gestational age (SGA) and large for gestational age (LGA) infants in order to elucidate their correlation with birth weight, anthropometric measures as well as apgar score of the newborn and relating them to maternal DAG levels. Cord blood specimens were procured from 25 SGA, 24 AGA infants and 25 LGA infants. Desacyl ghrelin, was quantified by ELIZA. A significant negative correlation has been found between cord ghrelin and neonatal anrthropometric measures( neonatal weight, height, head circumference, mean arm circumference) As well, a significant negative correlation has been detected between cord ghrelin and apgar score at 1 and 5 min. The current results shed the light on the critical role of DAG in the growth during the intrauterine period. Further studies are necessary to identify the exact mechanisms underlying the contribution of DAG in the growth of the fetus.