الفهرس 
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Abstract
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may increase health problems. Children and adolescents obesity is a big problem in today’s society. Obese children are more likely to have pre-diabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes. Childhood obesity predisposes to insulin resistance, hypertension, hyperlipidemia, liver and renal diseases. This condition also increases the risk of adult-onset obesity and cardiovascular diseases.
Myeloperoxidase (MPO) is an enzyme most abundantly expressed in neutrophils andlesser extent in monocytes. MPO is involved in cellular home ostasis and plays an importantrole in the initiation and progression of acute and chronic inflammatory diseases, fundamentally cardiovascular diseases (CVD).
Our aims were to:
1- Evaluate level of MPO in obese pre-pubertal children and obese pubertal adolescents and its relation with lipid profile and insulin resistance.
2- Seek for the correlation between MPO serum level and the criteria of metabolic syndrome in these patients.
The study was conducted at the National Nutrition Institute. from 2015 to 2016. Fifty Obese (95th BMI percentile) children and adolescents as case group and twenty five non obese as control group were included in the current study.
All cases and controls are subjected to:
• Complete history taking.
• Examination: including anthropometric data (height, weight, BMI, waist circumference, hip circumference and waist hip ratio), arterial blood pressure measurement.
• Laboratory: measurement of serum MPO, lipid profile (total cholesterol, triglycerides, LDL, HDL), fasting insulin, fasting blood glucose and HOMA-IR.
• Metabolic syndrome was diagnosed according to metabolic syndrome criteria.
The study revieled the following results:
1- Serum MPO was significantly higher in obese groups than control group.
2- Obese group had significantly higher weight, BMI z-scores, waist circumference, hip circumference, W/H ratio, systolic and diastolic BP than those of control group.
3- MPO, cholesterol, triglyceride, LDL, fasting insulin, HOMA-IR and CRP of case group were significantly higher versus control and HDL was significantly lower in obese groups than control group.
4- There were no significant differences among case, control groups for age, sex and fasting glucose.
5- Metabolic syndrome was highly prevalent among obese children (58%) and acanthosis nigrican was found in 40% of obese children.
6- Obese pubertal had significantly higher waist circumference, hip circumference and serum MPO than those of obese prepubertal group.
7- No gender difference was found in anthropometric and laboratory findings.
8- Obese group with metabolic syndromewere significantly high in all anthropometric measures, BP, cholesterol, TG, LDL, insulin, HOMA- IR, CRP and MPO versus obese without MS and control groups.
9- There were positive correlation between serum MPO and W/H ratio, fasting insulin and HOMA - IR in obese groups.
10- Roc curve: MPO showed significantly perfect diagnostic performance in obesity. Cutoff points 480.0 and 490.0 can perfectly classify obese from normal in pre-pubertal and pubertal stage.
11- BMI-z, waist / hip ratio, serum HOMA-IR are considered as risk factors of high serum MPO in Linear regression of all obese groups.
from the previous results it could be concluded that:
Serum MPO was elevated in obese children and this enzyme was associated with cardiovascular risk factors especially HOMA- IR.
MPO had significantly perfect diagnostic performance in obesity.
Serum MPO level was significantly higher in cases with metabolic syndrome (≥3 criteria). Thus, MPO could be considered as a good marker for cardiometabolic complications of obesity.