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ARTICLE
Year : 2013  |  Volume : 5  |  Issue : 1  |  Page : 31-38

Serum adiponectin level in children with nephrotic syndrome in relation to right ventricular functions and metabolic profiles


1 Department of Medical Physiology, Faculty of Medicine, Assuit University, Assuit, Egypt
2 Department of Pediatrics, Faculty of Medicine, Assuit University, Assuit, Egypt

Correspondence Address:
Asmaa F Hassan
Department of Medical Physiology, Faculty of Medicine, Assuit University, Assuit
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-489X.210521

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Background: Adiponectin (ADPN), a protein hormone (cytokine), is exclusively expressed on and secreted from adipocytes. It is a particularly interesting compound because it may have a protective influence on the cardiovascular system. Objective: This study was designed to evaluate serum ADPN level, right ventricular functions and metabolic profiles among children with nephrotic syndrome (NS) and asses the correlations between ADPN as a protective hormone and each of right ventricular functions and metabolic profiles. Patients and Methods: A total of 47 children (28 boys; 19 girls) with steroid-responsive nephrotic syndrome (SRNS) were studied. They included two groups: Group A: included 25 children with SRNS in relapse. Group B: included 22 children with SRNS in remission for periods ranging from 3-9 months. A control group included 28 children with matched age and sex. Methods: Serum level of ADPN was estimated by ELISA and nitric oxide (NO) by chemical detection. In addition to total cholesterol, triglycerides, high-density lipoprotein (HDL), low density lipoprotein (LDL), total protein, and albumin by Enzymatic Colorimetric kits. Also, 24-hour urine samples were collected for detection of proteinuria. Electrocardiogram (ECG) and echocardiography measuring right ventricular wall functions were done. Results: Serum levels of ADPN and NO were significantly higher in children with SRNS in relapse in comparison with children with SRNS in remission or control group. Children with SRNS in relapse showed significantly higher levels of total cholesterol, triglycerides, LDL and proteinuria while significantly lower levels of total protein, albumin and HDL as compared with SRNS in remission or control group. Echocardiographic findings revealed that a significant decrease in right ventricular ejection fraction (RVEF %) and significant increase in right ventricular end diastolic diameter (RVEDD), right ventricular peak pressure (RVPP) and pulmonary artery pressure (PAP) were found in cases with SRNS in relapse in comparison to cases with SRNS in remission and control hypertrophy in relapsed cases. Finally, in children with SRNS in relapse it was found that serum ADPN level was significantly positively correlated with each of serum NO, total cholesterol, triglycerides, LDL, proteinuria, RVEDD, RVPP and PAP, while significantly negatively correlated with serum total protein, albumin and RVEF%. Conclusion: During relapse of SRNS, serum ADPN level is higher than its level in SRNS in remission. This higher level may represent a physiologic response to the altered metabolic profiles and right ventricular strain so as to minimize cardiovascular complications.


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