الفهرس 
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Abstract
Summary
Childhood obesity have become a major health problem spread to involve developing countries.
The prevalence of childhood obesity has increased significantly with an alarming rise of incidence of metabolic syndrome and accompanying co-morbidities.
Obese children are more likely to suffer co-morbidities of dyslipidemia with high cholesterol, triglycerides, and low HDL, as well as hypertension, uncontrolled glycemic state with hyperglycemia, insulin resistance with or without acanthosis negricans, prediabetes, diabetes, etc.
An important new finding was discovered to be present in the serum of obese children was Irisin.
Irisin is a novel myokine and adipokine found circulating in a higher levels in plasma of obese children rather than others of normal weight.
Irisin is useful in maintaining integrity of different tissues, organs, and body systems. It also helps converting white adipose tissue to brown adipose tissue facilitating energy expenditure and protecting against insulin resistance and obesity.
Irisin alone or together with HOMA-IR is useful in prediction of presence of metabolic syndrome in obese and overweight children.
The present study was a cross sectional study that included 69 normal weight, overweight, and obese children, recruited from Endocrinology Pediatric clinic in Beni-Suef University. They were 39 males (56.52 %) [10 normal weight (25.6 %), 8 overweight (20.5%), 21 obese (53.8%)] and 30 females (43.47 %) [10 normal weight (33.3%), 5 overweight (16.7 %), 15 obese (50 %)], with an average age of 12.1 ± 3.83 years for normal weight males, 11.25 ± 1.48 years for overweight males, 10.48 ± 2.16 years for obese males, 9.8 ± 2.52 years for normal weight females, 10.8 ± 1.64 years for overweight females, 10.17 ± 2.62 years for obese females.
The aim of this study was to evaluate the association of circulating level of plasma Irisin with the anthropometric and metabolic parameters in normal weight, overweight and obese children. And to assess the ability of using Irisin and HOMA-IR score in Prediction of presence of metabolic syndrome in obese and overweight children.
All children included in the study were subjected to a detailed history, complete general examination, anthropometric assessment (height, weight, pubertal assessment, waist circumference and hip circumference) and laboratory tests (serum cholesterol, high density lipoprotein, serum triglycerides, serum fasting insulin, serum fasting glucose, oral glucose tolerance test and serum Irisin). Assess insulin resistance and sensitivity by calculating HOMA-IR (Homeostasis model assessment method- Insulin Resistance) from fasting insulin and fasting glucose.
The study showed that the obese group had a higher level of Irisin than the normal weight and the overweight groups (P-value<0.001). Furthermore, the obese group had a significant higher prevalence of metabolic syndrome regarding the MSC Cook’s and the MSC deFerranti criteria. Obese children had the highest prevalence of acanthosis negricans (33.3%) (P-value<0.05). In addition, most of the overweight and the obese groups were hypertensive. obese group had the highest waist circumference significantly (P-value<0.001). obese group had a highest level of cholesterol and triglycerides and the lowest level of HDL significantly than the normal and the overweight groups (P-value<0.001).
The study showed that in the obese group there was a significant linear positive correlation between the Irisin level and BP, BMI, cholesterol level, fasting insulin, fasting glucose, the number of criteria of metabolic syndrome of Metabolic Syndrome Components as regards International Diabetic Federation and the HOMA IR score.
In the overweight group, there was a significant linear positive correlation between the Irisin level and age, BP, BMI, fasting insulin and the number of criteria of metabolic syndrome of Metabolic Syndrome Components as regards International Diabetic Federation.
Our study revealed that Irisin as well as HOMA-IR can predict presence of metabolic syndrome with high sensitivity and specificity at different levels.
In conclusion obese children exhibit a higher risk of getting involved in cardiovascular, cardiometabolic disorders and metabolic syndrome as well.
High level of Irisin in serum of obese children proves its role as a protective hormone against harmful outcome of obesity, through enhancing process of metabolism , fat burning, energy expenditure, and keeping integrity of various body systems and organs.