The relationship of betatrophin wi̇th nutritional and metabolic status in prepubertal children

Purpose: Nutritional disorders in childhood cause many comorbidities. They also predispose to the emergence of many systemic diseases in the adult age group. The frequency of nutritional disorders has increased all over the world and has become an important public health problem. Our aim in this study; is to find the level of β-Trofin, one of the adipokines thought to play an important role in the consumption and storage of energy in adipose tissue in children with primary protein-energy malnutrition and obesity, to compare it with the , β-Trofin level in normal children and to examine the relationship between the patients' clinical status. By obtaining information about , β-Trofin, which we think plays a role in the obesity, malnutrition and normal group of children without a specific diagnosis, we aimed to help this peptide to be used in the treatment of malnutrition and obesity in the future. Methods and Materials: Anthropometric measurements of 142 children between the ages of 2 and 12, who were admitted to our pediatric outpatient clinic between June 2019 and December 2020, who were obese, malnutrition and normal, according to their relative weights, and who had not started their adolescence (prepubertal) were performed. Routine blood tests of the children were taken. The leftover blood from routine blood samples was divided into 2 ml serum gel tube to be studied with Human β-Trofin ELISA kit. It was stored under suitable conditions until the day of work. Children with a diagnosis of neurological, gastrointestinal, metabolic, endocrine, infectious disease or any chronic disease were excluded from the study. Findings: Our study includes a total of 142 children whose ages are between 2 years and 12 years, with an average age of 7.69 ± 3.04 years. 71 of the children (50%) were male; 71 of them (50%) were girls. Children were divided into three groups according to relative weight in the study, 31.7% (n = 45) were malnourished, 33.1% (n = 47) were normal and 35.2% (n = 50) were examined as obese. No statistically significant difference was found between the age distributions of the malnutrition, obese and normal groups according to the groups. β-Trofin values did not show a significant difference according to the groups (p >0.05). In the malnourished group, there was positive correlation between Ferritin and Betatrophin (Betatrophin increases as Ferritin increases) (r=0.307; p<0.05). In the group consisting of children with normal relative weight, was found a negative correlation between MCHC and Betatrophin (Betatrophin decreases as MCHC increases) (r=-0.385; p<0.01). In the group consisting of children with normal relative weight, there was also a negative correlation between Betatrophin and T4 (Betatrophin decreases as T4 increases) (r=-0.550; p<0.01). In the obese group, a negative correlation between Betatrophin and insulin measurements was defined (Betatrophin decreases as insulin increases) (r=-0.328; p<0.05). In addition, a statistically significant negative correlation was found between Betatrophin and HOMA-IR measurements in the obese group (Betatrophin decreases as HOMA-IR increases) (r=-0.340; p<0.05). No statistically significant correlation was found between any of the other biochemical variables and Betatrophin values of normal, obese and malnourished children (p>0.05) IX No statistically significant difference was found between total cholesterol, HDL and glucose levels in obese, malnutrition and normal children (p> 0.05). However triglyceride measurements showed a significant difference in obese, malnutrition and normal children (p <0.01); especially triglyceride measurements of the obese group were found to be statistically significantly higher than the malnutrition and normal groups (p = 0.031). No significant difference was found between the triglyceride measurements of normal and malnourished patients (p = 1,000). Insulin values differed significantly according to the groups (p <0.01); especially insulin measurements of the obese group were found to be statistically significantly higher than malnutrition and normal cases (p = 0.001; p = 0.001). No statistically significant difference was found between insulin measurements of normal and malnourished patients (p = 0.733). HOMA-IR measurements differed significantly according to the groups (p <0.01); HOMA-IR measurements of the obese group were found to be statistically significantly higher than malnutrition and normal cases (p = 0.001; p = 0.001). There was no significant difference between the HOMA-IR measurements of normal and malnourished patients (p = 0.511). While ferritin values differed significantly according to the groups (p <0.05); the ferritin measurements of the obese group were found to be statistically significantly higher than malnutrition and normal cases (p = 0.020; p = 0.039). No statistically significant difference was found between ferritin measurements of normal and malnourished patients (p = 1,000). Conclusions: There was not any significant difference between the β-Trofin levels of the groups. Keywords: Obesity, malnutrition,β-Trofin, Nutritional disorders in childhood, adipokines.