| Objective:To investigate the change of levels of serum Leptin and Tumor necrosis factor alpha(TNF-α), plasma Ghrelin and immunity function in children with anorexia,then to find out the influence of anorexia on growth and development in children, and to provide evidence for clarifying the mechanism of appetite regulation disorder in children with anorexia.Methods:Forty patients with anorexia were enrolled in our study from May 2009 to October 2009 at the department of pediatrics in The Second Xiangya Hospital of Central South University, ranging from 2 to 13 years old, and they were divided into two groups by age:2-6 years old and 7-13 years old.Thirty healthy children at the age of 2 to 13 with matched age and sex proportion were chosen for control group, and they were also divided into two groups by age:2-6 years old and 7-13 year old.For all study subjects, the height, weight, body mass index(BMI), blood routine(BR), levels of immunoglobulin(lgA,lgG,lgM,lgE), complement component 3 and 4, CD4+ lymphocytes percentage, CD8+ lymphocytes percentage, Th/Ts, liver function including aspirate aminotransferase (AST) and alanine aminotrsferase (ALT), albumin (ALB), globulin(GLB), prealbumin (PAB) were tested, and the levels of plasma ghrelin and serum leptin, TNF-αwere tested with Enzyme-linked-immunosorbent assay (ELISA) in our study.Results:1.The levels of height,weight and BMI in the two anorexia groups were significantly lower than that of control groups(P<0.01). Compared with the mean of children with the same gender and same age, there were 36 cases(90%) in anorexia groups with lower weight level and 34 cases(85%)with lower height level, while there were 7 cases(23%) and 8 cases(27%) respectively in control groups. In anorexia groups, the lowest BMI was 11.40. In the control groups, the lowest BMI was 13.34.2. The two anorexia groups had significantly lower PAB, lgG, lgA, CD8+ lymphocytes percentage levels than that of control groups(P<0.01 or P<0.05) and had significantly higher Th/Ts level than that of control groups(P<0.05). Anorexia subjects aged 2-6 years had significantly lower haemoglobin (Hb), ALB, complement component 3 levels than that of control group (P<0.01), while there was no significant differences in anorexia group aged 7-13 years (P>0.05). There were no significant differences concerning levels of GLB, lgM, lgE, complement component 4, CD4+ lymphocytes percentage between anorexia and control groups (P>0 .05).3. The two anorexia groups had significantly lower Leptin and TNF-αlevels and had significantly higher Ghrelin level than that of control groups(P<0.01). 4. Serum Leptin,TNF-a and plasma Ghrelin had no significant correlations with each other in both 2-6 age and 7-13 age groups (P>0.05), Plasma ghrelin had negtive correlations with serum IgG,IgA(P<0.01) with age,gender and BMI as the controlling by partial correlation analysis, while it had no significant correlations with IgE,IgM, CD4+lymphocytes percentage, CD8+lymphocytes percentage, Th/Ts(P>0.05). Serum leptin and TNF-αhad no significant correlations with immunity function indexes in the two anorexia groups(P>0.05). With age, gender as the controlling by partial correlation analysis, serum leptin had a significant positive correlation with BMI in both 2-6 age and 7-13 age groups(P<0.01 or P<0.05),plasma ghrelin had a negtive correlation with BMI in 2-6 age groups(P<0.01), while there were no significant correlations of that in 7-13 age groups.Conclusions:(1)Children with anorexia have behind growth and development and poor nutrition compared with the same age healthy children,and had impaired immunity and Th/Ts ratio imbalance.(2)The change of levels serum Leptin,TNF-αand plasma Ghrelin in children with anorexia is possibly a protective mechanism.(3)The pathogenesis of anorexia at the age of 7-13 may differ from that of preschoolers. (4)Ghrelin possibly paly an important role in the regulation of anorexia children with impaired immunity,while Leptin may have no this effects.
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