Serum adiponectin in newborns and in one and two years old infants: relationship with body weight, leptin and insulin

Adiponectin is the only adipose-specific hormone that, despite its exclusive production by adipose tissue, is reduced in obesity and is inversely correlated with leptin levels in adults. It plays a critical role in the control of energy balance in adult life. However, its functions and relations to other hormones are not yet fully understood in infants. The aim of this study is to assess adiponectin levels in newborns at birth, one and two years of life and to define its association with weight, serum leptin and insulin. Serum adiponectin, leptin and insulin levels were investigated in 48 newborns [24 small for gestational age [SGA] and 24 appropriate for gestational age [A GA]]. Infants aged one year [n=20] and two years [n=20] were also included in this study. The levels of serum adiponectin were significantly decreasing while serum leptin and insulin were significantly increasing at one and two years. Serum adiponectin was correlated positively with weight [r=0.509, p<0.001] and leptin [r=0.355, p<0.05] but not correlated with serum insulin in all newborns. At one and two years adiponectin was correlated positively with insulin [r=0.444, p<0.05 and r0.448, p<0.05 respectively]. The correlation between adiponectin and weight at one year [r=-0.056, p=0.816] and between it and leptin at two years [r=-0.171, p=0.471] changed into negative but did not reach a statistically significant level. Serum leptin was correlated positively with weight in all newborns [r=0.935, p<0.001]. At two years it was positively correlated with weight [r=0. 721, p<0.001] and insulin [r=0.641, p<0.01]. Serum adiponectin and leptin levels were significantly lower in SGA than AGA infants [30.08 +/- 9.54 micro/ml and 4.33 +/- 3.20 microg/L, p<0.001 respectively] but there was no difference in serum insulin. In conclusion, adiponectin is higher in newborns than at one and two years. The change in correlation of adiponectin with weight and leptin from positive in newborns to negative in adults might occur at the first 2 years of life

Coagulation defects and platelets function in splenectomized and non-splenectomized beta-thalassemic children

The aim of this work is to evaluate the coagulation defects and platelet function in beta-thalassemic children before and after splenectomy. Also to evaluate the effect of L-carnitine therapy on the coagulation events and platelet function in these patients. The study included 56 beta-thalassemic children who were admitted at the Hematology Unit in the Pediatric University Hospital - Assiut with 20 sex and age matched children as controls. They were subjected to clinical examination and laboratory investigations in the form of: screening tests for coagulation: PT, APTT TT, PC and fibrinogen, natural anticoagulants studies like protein S, protein C and antithrombin III activity and platelet response to adinosindiphosphate [ADP], ristocetin [Rist], collagen and arachidonic acid [AA]. Nineteen children did splenectomy and these studies were done after 2 months of this manover. L-Carnitine therapy in a dose of 3 gm orally daily for 2 months was given to 20 non-splenectomized beta-thalassernic children and the previous follow up laboratorial studies were done. It was found that platelet response to ADP, Rist, collagen and AA was significantly decreased in non-splenoctomized patients and significantly increased in the splenectomized ones in comparison to controls. The coagulation screen tests showed significant defect in the form of prolonged PT, APTT, TT and low PC with decrease fibrinogen levels in both splenectomized and nonsplenecloinized beta-thalassemic children in comparison to controls with no significant difference between before and after splenectomy. Natural anticoagulants except protein S were significantly lower in both non-splenectomized and splenectomized beta-thalassemic children than those of the controls with no difference between before and after splenectomy. L-Carnitine therapy improved the platelet aggregation in the non splenectomized beta-thalasseinic children with no affection on the coagulation tests and natural anticoagulants. In conclusion, thalassemia major can be complicated by defective platelet aggregation and bleeding tendency. Splenectomy causes increased platelet aggregation which with the decreased levels of natural anticoagulants lead to the liability to thromboembolic complications. L-Carnitine might affect and improve platelet aggregation in non-splenectomized children but it could aggravate the thromboembolic complications in the non-splenectomized ones. Iron overload prevention with iron celation and antioxidants is recommended to prevent platelet aggregation and coagulation defects. Salicylates therapy to cases with thromboembolic complications might decrease thrombus formation and dangerous events