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Background/Aims: Energy homeostasis is a balance between energy intake and energy expenditure. Leptin and ghrelin are two orexitropic hormones with opposite effect on energy homeostasis. We investigated fasting ghrelin and leptin levels in children with different nutritional conditions. Methods: In 30 obese children of both sexes, aged from 6 to 17.67 years (mean 13.04 ?2.95), fasting ghrelin and leptin levels were measured, along with auxological assessment and pubertal staging. These results were analyzed and compared with the same parameters of 33 lean and 25 undernourished (UN) children. Results: Mean ghrelin/BM (body mass) level was the lowest in obese children, (21,75?12,60 pg/ml/kg) with high significance in comparison with lean and UN subjets. Mean leptin/kg level of 56.12?96.94 in obese, was significantly higher than in lean and UN children (p<0.01 and p<0.001 respectively). Ghrelin and leptin levels showed different profiles in obese, lean and UN children. An inverse relationship was discovered between study groups in ghrelin/leptin and leptin/ghrelin ratios. Conclusion: Obese children, compared to other children, demonstrate significantly higher values of leptin, and UN children demonstrate significantly higher values of ghrelin per kilogram of body weight. The results also illustrate the inverse ratio of ghrelin and leptin, which has been demonstrated as a clinically reliable indicant of the status of obesity or undernutrition in children, with significant implications concerning rather large variations in the concentration of these hormones not only with body mass, but also with age of the children. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 31060]

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