ABSTRACT
Adiponectin [ADPN], a protein hormone, is exclusively expressed on and secreted from adipocyte. ADPN is a particularly interesting compound because it may have a protective influence on the cardiovascular system. This study was a prospective hospital based study aiming to evaluate ADPN serum level among children with nephrotic syndrome [NS], right ventricular functions by Echocardiography and finding any correlation between ADPN as a protective hormone and right ventricular function. The study included 47 patients [28 boys and 19 girls] with steroid responsive nephrotic syndrome [SRNS]. Cases included two groups: Group A: Included 25 patients with SRNS in relapse. Group B: Included 22 patients with SRNS in remission for periods ranging from 3-9 months and with no steroid therapy. In addition to control group which included 28 children with matched age and sex. A thorough history and full clinical examinations and echocardiography measuring right and left ventricular wall functions and other abnormalities if present were done. Blood samples were collected for measuring serum levels of total cholesterol, triglycerides, high density lipoprotein [HDL], low density lipoprotein [LDL], very low density lipoprotein [VLDL] by Enzymatic Colorimetric kits, in addition to ADPN by ELISA method. Serum ADPN level was significantly higher in patients with SRNS in relapse [33.4 +/- 15.60 micro g/ml] in comparison with patients with SRNS in remission [12.54 +/- 8.76 micro g/ml] and with control group [10.54 +/- 6.43 micro g/ml] with P value<0.001 for both. Right ventricular end diastolic diameter [RVEDD], right ventricular peak pressure[RVPP] and pulmonary artery pressure [PAP] were significantly higher while right ventricular ejection fraction [RVEF%] was significantly lower among cases in relapse [group A] than in cases in remission [group B] or children in control group. During relapse of SRNS, ADPN serum level is higher than its level in SRNS in remission and also, right ventricular dysfunction occurs in relapsed SRNS reflected by decrease of RVEF% and increase in RVEDD, RVPP and PAP