الفهرس 
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Abstract
This is across sectional study conducted in nutrition unit of Children’s hospital of Assuit university during period from 2016 to 2016. The present study included 130 attending to outpatient nutrition clinic or admitted to nutrition unit suffering from under-nutrition and over-nutrition also the study included 65 healthy controls of matched age and sex. The study aims to assess the relationship between basal serum leptin in children (as indicator for later on obesity )and certain risk factors like maternal body mass index, pattern of feeding, age of weaning, environmental factors and occurrence of fatty liver as indicator for abnormal fat metabolism. All participants were subjected to medical history, clinical examination, laboratory investigations and abdominal ultrasound.Medical history included the nutritional, developmental, medical, socioeconomic history.Clinical examination included anthropometric of child and mother, clinical signs of malnutrition including edema, hair and skin changes, mental changes and complete systemic examination.Laboratory investigations included complete lipid profile and serum leptin level.all investigations were measured for all patient and control.Abdominal ultrasound were done for all patient and controls to asses liver state. Our study revealed that 63.1%of the overweight children were females and 36.9%were males.the high risk of undernourishment in rural children more than urban due to lack healthy nutrition and many factors increase malnutrition rates. also high rates of overweight in rural children due to consumption of high caloric food(country cooking)rich in fat and carbohydrates.Occupation of mothers affect the nutritional status that 58.5% of was underweight children were housewife mother to 41.5% were employed mothers. low educational status and higher number of children were high risk for the development of under-nutrition in <3yrs. Anthropometric measurements are non-invasive, easy to apply, and inexpensive techniques which help to evaluate nutritional status of all ages including newborns. While body composition scales, DEXA and platsmygraphy were more accurate in assessing the body composition for our studied groups.genetic factors may play important role in children weight status, but multiple interactions between genes, environmental and behavioral factors. the effect of BMI of mother on anthropometric her child depend on the social factors such as the socio-economic condition and lifestyle of the mother could indirectly influence unhealthy dietary (fatty foods, snacking, sweetened beverages), physical activity or sedentary behaviors (TV and computer addiction)of their children.so no correlation between BMI of mother and BMI of their children. Delay in physical development was detected in 58.5%of our studied undernourished children. So undernutrition is still causing significant health burden inspite of major efforts by ministry of health in providing healthy nutritional support for infant with inadequate breastfeeding. Fatty liver and hepatomegaly, respectively occurred in 10 (15.4%), and 26 (30%) children of overweight group. Serum leptin in the current study had positive significant strong correlation with body mass index of child, mid arm circumference, moderate correlation with triglyceride, weak correlation with age of child and cholesterol and had insignificant correlation with body mass index of mother and low density lipoproteins,. Serum leptin had no correlation with weaning age and high density lipoproteins and head circumference. normal weight one of predictors of normal physical development. Yogurt consumption may enhance the proportion of beneficial gut microbiota that are thought to be involved in weight maintenance via regulation of energy uptake and extraction. Iron-fortified cereals contribute significant amounts of iron and are helpful in preventing deficiency. Promoting motor skills (walking, running, jumping) begin to develop. Normal body weight predictors are in-time weaning age, yogurt, normal leptin level and cereals.