الفهرس 
Childhood ObesityOnly 14 pages are availabe for public view
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Abstract
Childhood obesity is one of the most irritating public health problems being a major risk factor for several future chronic diseases, such as, hypertension, dyslipidemia, DM-II, coronary heart diseases, many psychosocial and social problems.
Hormones of the gut–brain axis are found to have an important role in regulating the body‘s energy balance and appetite. Data of literature show parallel changes in Ghrelin and Obestatin secretion in pathological conditions characterized by energy imbalance like obesity. Very few studies addressed the assessment of Ghrelin/Obestatin ratio among Egyptian obese children; therefore, current study represents an important evaluation of the balance between these two hormones among them.
Current study was a cross sectional case-control one, that included 60 obese children of both sexes (27 males & 33 females) aged (6- <12) years old with body mass index ≥ 95th percentile, in addition to 31 healthy children (16 males & 15 females) with (BMI=15 - < 85 percentile).
1) Comparison of the 2 groups under study revealed:
a) Insignificant age and sex differences.
b) Family history of obesity, cardiovascular diseases (CVS) and diabetes mellitus (DM) was more prominent among the obese children.Obese children had higher significant values than the control group regarding Systolic and diastolic BP, all anthropometric measurements, Peripheral subcutaneous fat and Central subcutaneous fat distribution.
d) The obese group in our study showed significantly higher mean values of Waist/height ratio and Waist/Hip ratio than the control group.
e) Obese children in our study had significantly lower serum levels of Ghrelin, Obestatin, Ghrelin /Obestatin ratio and HDL than the control group.
f) The mean fasting insulin levels, fasting blood glucose, HOMA-IR, Cholesterol, Triglycerides and LDL were significantly higher in obese children than the control ones.
g) The mean intake of energy, Fat, Protein, Carbohydrate, Dietary fiber, vitamin B1, Niacin, vitamin B6, Folic acid, vitamin C, Sodium, Magnesium, Phosphorus, Iron and Zinc was significantly higher in the obese children than control ones.
h) Vitamin D intake was significantly higher in the obese children than control one but the intake of both Vitamin D and Calcium was lower than the RDA in the two groups. Calcium intake showed insignificant difference between the two groups.i) Saturated fatty acid, Monounsaturated fatty acids, PUFA and Cholesterol intake was significantly higher in the obese children than in controls.
j) Consumption of sweets, pastries and sugar sweetened beverages was higher among obese children while Consumption of proteins, vegetables and fruits was lower among obese children than in the control group.
2) Correlation between Ghrelin, Obestatin, Ghrelin/Obestatin ratio and all the studied variables in the obese and control groups showed that:
a) Ghrelin had positive significant partial correlation with height (cm) and height (Z-score) in the control group.
b) In the obese group in our study, Ghrelin showed significant positive correlation with serum level of Glucose and in the control group, Ghrelin showed significant positive correlation with serum Glucose and HDL.
c) Obestatin showed significant negative correlation with subscapular SF thickness and with serum LDL in the obese group.
d) Ghrelin/Obestatin ratio had significant positive Partial correlation with Subscapular skin fold thickness in the obese group. Also Ghrelin/Obestatin ratio has significant positive correlation with serum Cholesterol in the obese group.e) Ghrelin showed significant positive correlations with total Energy, protein, Fat, Saturated and Monounsaturated Fatty acids intake in the obese group.
f) In the control group, Obestatin had significant positive correlations with total Energy, total Fat and Saturated Fatty acids intake.
g) Ghrelin/Obestatin ratio had significant negative correlation with total Energy intake in the control group.
3) Correlation between total Energy, Proteins, Fat, Carbohydrates calories and anthropometric parameters in the studied groups showed that:
a) In the obese group, total Energy showed significant positive correlation with suprailiac SF. Protein energy showed significant positive correlation with BMI. Carbohydrate energy shows significant positive correlation with Abdominal SF, Supariliac SF and central subcutaneous fat deposition. Carbohydrates energy showed significant positive correlation with serum LDL.
b) In the control group, Protein Energy showed significant positive correlation with serum Cholesterol, Fat Energy shows significant negative correlation with serum Triglycerides and Carbohydrate Energy showed significant positive correlations with serum Triglycerides and HDL.c) In the obese group Ghrelin showed significant positive correlations with total Energy, protein, Fat, Saturated and Monounsaturated Fatty acids intake.
d) In the control group, Obestatin had significant positive correlations with total Energy, total Fat and Saturated Fatty acids intake.
e) Ghrelin/Obestatin ratio had significant negative correlation with total Energy intake in the control group.
f) Step wise linear regression analysis for Ghrelin, Obestatin, and Ghrelin/Obestatin ratio with total Energy intake showed that, total energy intake is a highly significant predictor for 19% of the changes occurring in Ghrelin. Also, Fat energy intake is a highly significant predictor for 14% of the changes occurring in Ghrelin. The test shows no results with protein energy intake being not responsible for any changes in Ghrelin.
g) Linear regression analysis test also showed that total energy intake is responsible for 4% of the changes occurring in Ghrelin/Obestatin ratio with statistical significance and is responsible for only 1% of the changes occurring in Obestatin with statistical insignificance. The test showed no effect of energy derived from Fat or Protein on Obestatin and Ghrelin/Obestatin ratio.