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Contents : Journal of American Science 2010 6(12) http://www.americanscience.org Adiponectin level in Protein Energy Malnutrition and its Role in Predicting the Disease Severity Nassar M.F.*1 Badawy N.B.1 Soha Ezz El-Arab2 El-Batrawy S.R.3 and Kamal M.A.1 Departments of 1Pediatrics and 2Clinical Pathology Faculty of Medicine Ain Shams University Cairo Egypt 3 Department of Anthropology National Institute of Research Cairo Egypt. * maie nassar@yahoo.co.uk Abstract: Background and aims: Since adiponectin plays an important role in the pathogenesis of both obesity and anorexia nervosa its level might be altered in protein energy malnutrition (PEM) patients which would highlight the pathogenesis of the morbidities that those patients suffer from. This work was thus designed to assess the adiponectin level in PEM and its relation to the severity of the condition. Methods: The present study was conducted on 20 PEM infants in comparison to ten clinically healthy infants. Dietetic history and anthropometric measurements were taken. Routine laboratory investigations were done as well as serum adiponectin level by ELISA. Patients were re-evaluated after nutritional rehabilitation. Results: Initial serum adiponectin levels were significantly higher in PEM patients in comparison to the controls and decreased after nutritional rehabilitation. Distinct negative correlation was found between initial adiponectin levels and both the z score and serum albumin in all studied patients. Conclusions: Adiponectin level is increased in PEM patients and decreases upon nutritional rehabilitation which further proves the inverse relationship between adiponectin level and both weight and body fat. This up regulated adiponectin level in PEM may have an anti-inflammatory role which awaits further studies. Nassar M.F. Badawy N.B. Soha Ezz El-Arab El-Batrawy S.R. and Kamal M.A. Adiponectin level in Protein Energy Malnutrition and its Role in Predicting the Disease Severity. Journal of American Science 2010 6(12):1413-1422 . (ISSN: 1545-1003). http://www.americanscience.org. Key words: Adiponectin Protein energy malnutrition Nutritional rehabilitation.. We hypothesize that since adiponectin plays an important role in the pathogenesis of both obesity and anorexia nervosa its level might be altered in PEM patients which would highlight the pathogenesis of the morbidities that those patients suffer from. This work was thus designed to assess the adiponectin level in PEM and its relation to the severity of the condition. The effect of nutritional rehabilitation on these levels was studied as well. 1. Introduction: Adiponectin the most abundant adiposespecific protein is suggested to possess antihyperglycemic anti-atherogenic and antiinflammatory properties 1 . Low levels have been associated with obesity insulin resistance Type II diabetes and cardiovascular disease 2 . In anorexia nervosa an inverse linear relationship was reported between adiponectin level and fat mass 3 . Protein energy malnutrition (PEM) is by far the most lethal form of malnutrition. Children are its most visible victims. Malnutrition the silent emergency is an accomplice in at least half of the 10.9 million child deaths each year 4 . PEM is manifested primarily by inadequate dietary intake of protein and energy. However PEM is almost always accompanied by deficiencies of other nutrients. For this reason the term severe childhood undernutrition (SCU) which more accurately describes the condition is preferred 5 . The pathogenesis of the affection of various body systems in PEM is still the center of attention of many researchers. There is definite change in body weight and fat content as well as many inflammatory changes. http://www.americanscience.org 2. Patients and methods: The present study was conducted on 20 infants having protein energy malnutrition (PEM) based on the criteria of 6 . Their ages ranged between 6-24 months with mean age of 11.15 4.85 months. They were 8 males and 12 females. The PEM patients were recruited from the Outpatient Clinic Nutrition Clinic and Inpatient Department Children's Hospital Faculty of Medicine Ain-Shams University in the period from June 2005 till April 2006. They were free from any chronic renal or liver diseases any neurological deficits chromosomal or congenital malformations and were born full term. 1413 editor@americanscience.org Journal of American Science 2010 6(12) http://www.americanscience.org automated analyzer and the rest of the sample was stored at -40 degree centigrade until used later to determine serum adiponectin level by ELISA using the kit purchased from A&D Company. Patients entered a nutritional rehabilitation program according to the WHO 9 for a period of 2 4 months then they were re-evaluated using the previously mentioned clinical and laboratory parameters. Regarding the statistical methods the standard computer program SPSS for Windows release

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