الفهرس 
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Abstract
Chronic liver diseases in children are relatively common disorders with minimal symptoms but long-term risk of significant morbidity and mortality particularly in developing countries. They are defined by continuity of clinical or biochemical evidence of hepatic dysfunction for longer than 6 months (Suchy et al., 2007).
Retinol–binding protein 4 (RBP4) is a 21 kDa (Kilo Dalton) plasma protein, which is mainly secreted from the liver and adipose tissue and is known to transport retinol (ROH) in the blood. The binding of ROH to RBP4 guarantees the homeostatic regulation of plasma ROH levels, which is an essential aspect for a variety of physiological processes (Gropper et al., 2009).
Recently, RBP4 levels have been reported to be elevated in insulin resistant subjects as well as in subjects with obesity and type 2 diabetes (T2DM) (Yang et al., 2005).
The aim of our work was to measure the serum level of retinol binding protein 4 (RBP4) in children with chronic liver diseases (CLDs) and to study the correlation between serum RBP4 and the severity of liver dysfunction.
This study was conducted on 30 children with chronic liver diseases of different etiologies recruited from the Hepatology Clinic, Children’s Hospital, Ain Shams
University during the period from October 2010 to January 2011. They were 18 males and 12 females. Their ages ranged from 0.7 months (21 days) to 192 months (16 years) with mean 104.0 ± 76.7. 20 children served as the control group. The age and sex distribution of the control group were matched to those of the case group.
The results of our study can be summarized in the following :
1. Chronic liver diseases affect the nutritional status of the patient as shown in significant decrease in body mass index in cases compared to controls.
2. Serum levels of RBP4 decrease in children with chronic liver diseases of various etiologies due to decreased hepatic RBP4 production and it is correlated with worsening of the clinical stage of CLD and cirrhosis from Child A to Child B and C classes.
3. Serum RBP4 is dependent on liver protein synthesis capacity. This is supported by the finding that plasma RBP4 levels correlate significantly with plasma levels of proteins indicative of hepatic synthesis capacity such as albumin and coagulation factors (detected by prothrombine time).
4. There is no significant correlation between serum RBP4 with weight and BMI in cases denoting that serum RBP4 decrease in CLDs independently of body composition