الفهرس 
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Abstract
Despite improved neonatal care over the past decades, infections remain common and sometimes life-threatening in neonates admitted to the neonatal intensive care unit (NICU).
Leptin is a 16-kDa polypeptide hormone that is mainly, but not exclusively, produced in adipose tissue and plays an important role in the innate immune defence.
This study was done in The Neonatal Intensive Care Unit of Menoufia University Hospital from June 2014 to March 2015 to clarify the role of leptin in diagnosis of neonatal septicemia compared to other more established measures as CBC, CRP and blood culture.
Our study was carried out on 60 newborns divided into 2 groups:
• Group (1):
Group (1a): Septicemic full term newborns (n = 40).
Group (1b): Septicemic full term newborns after 2 weeks of antimicrobial therapy (n = 40).
• Group (2): Healthy full term newborns as controls (n = 20).
Each of the studied newborns was subjected to history taking, clinical examination and laboratory investigations including CBC, CRP, blood culture, I/T and leptin.
In our study we found that neonates who developed sepsis had their serum leptin levels significantly higher than those of the control group and leptin levels were highly significantly higher in patients before Antimicrobial therapy than after antimicrobial therapy.
Summary
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In our study, there was positive correlation between leptin, CRP, immature neutrophils, I/T,clinical and haematological score at start but after 2 weeks of antimicrobial therapy there was positive correlation between leptin, immature neutrophils and I/T only.
The elevation in the leptin level was independent of age, gestational age, weight, sex and mode of delivery.
Serum leptin level increased in cases of early onset sepsis more than cases of late onset sepsis.
In our study, it has proven that leptin has a significant role in differentiation between early-onset and late-onset sepsis which remains challenging problem.
The cutoff value of leptin recorded in this study was 7.4 ng/ml , with sensitivity 90%, specificity 80%, and positive predictive value 90% in the studied septic group.
Our data provide evidence that leptin not only an adipostatic hormone, but also stress related hormone, sharing other proinflammatory mediators in playing major role in inflammatory response.
We suggested that serum level of leptin is elevated during infection and can be used as diagnostic marker for neonatal septicemia.