الفهرس 
obesityOnly 14 pages are availabe for public view
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Abstract
ver the last two decades, the rise in the prevalence rates of overweight and obesity may explain the emergence of Nonalcoholic fatty liver disease (NAFLD) as the leading cause of liver disease in pediatric populations worldwide.
NAFLD comprises a disease spectrum ranging from simple steatosis to Nonalcoholic steatohepatitis (NASH), with varying degrees of inflammation and fibrosis progressing to end-stage liver disease with cirrhosis and hepatocellular carcinoma.
Although liver biopsy is still the criterion standard for diagnosis of NAFLD, however given its invasive nature, costs and complications, there is a considerable interest in trying to make the diagnosis using noninvasive and reliable methods.
The aim of our work was to validate the clinical value of determination of chemerin levels in the blood for diagnosis and assessment of disease severity in children with suspected nonalcoholic fatty liver disease (NAFLD) and the effectiveness of l-carnitine in treatment of nonalcoholic fatty liver disease (NAFLD). This study included 60 children, 30 with obesity recruited from the obesity clinic (14 boys and 16 girls) their ages ranged from 5.8 years up to 14 years, with mean of 9.9±2.44 and 30 normal children (17 boys and 13 girls) their age ranged from 5 years to 15 years with mean of 9.22±3.05, they were recruited from the outpatient clinic. They were matched as regards age, sex, and pubertal stage, All were subjected to thorough medical history taking, full clinical examination including; blood pressure measurements, anthropometric measurements, abdominal ultrasonography, and investigations for liver enzymes, lipid profile and chemerin level using ELISA kit.
Chemerin levels were significantly higher in obese children with fatty liver than in normal weight controls.
Receiver operating characteristics (ROC) curve was used to define the best cut off value of chemerin which was >350 ng/dl, with sensitivity of 93.3% specificity of 93.3% positive predictive value of 93.3%, negative predictive value of 93.1% with diagnostic accuracy of 93.3%.
Patients had significantly higher fasting glucose, fasting insulin, glucose/insulin ratio,VLDL,ALT and MPV, while HDL and glucose/insulin ratio were significantly lower in cases than in control WC and its SDS,waist/hip ratio and its SDS among patients after l-carnitine therapy.
There was a significant reduction in fasting insulin, ALT and MPV and a significant increase in G/I ratio in patient after L-carnitine therapy.
There was a significant reduction of serum chemerin among patients after l-carnitine therapy.
There was a significant decrease in severity of NAFLD grade after l-carnitine therapy.
There was statistically significant positive correlations between Chemerin and each of Ht. (SDS), BMI and its SDS, BP systolic and diastolic centiles and HGB.
There were statistically significant positive correlations between BMI and each of (wt, wc, HC & W/H).
There was statistically significant association between U.S and each of (wt, BMI, WC(abdominal obesity) and HC).