Vol. 6, Issue 1, Part A (2024)

85-90% patients of children with Idiopathic Nephrotic syndrome (NS) are steroid sensitive (SSNS) whereas 10-15% children have initial or late steroid resistance (SRNS). Almost 50% of children with SSNS are frequently relapsing (FR) or steroid dependent (SD). Children with FRNS or SDNS course & those with steroid resistance are exhibited high doses of corticosteroids to achieve and maintain remission which remain the first line of therapy which is one of the main risk factor for obesity in children with NS. 
These children are at risk for various metabolic complications including hypertension, dyslipidemia, and metabolic syndrome which may pose a serious risk for long term cardiovascular complications. Previous studies in obese children have reported some biomarkers which indicate predisposition towards metabolic syndrome and possible long-term cardiovascular morbidity including hyperinsulinemia and high leptin levels with low adiponectin levels. Only few small studies have previously looked at these biomarkers in children with nephrotic syndrome with obesity and none from India. We therefore planned this study with an aim to determine the serum levels of Insulin, Leptin and Adiponectin in obese children with SRNS and SDNS and compare the same with disease naive obese children and healthy age matched controls to assess whether they are at risk for cardivascular morbidity. In our study, we found that serum Leptin levels were significantly higher in children with NS with obesity as compared to the obese disease naive children as well as healthy children with normal weight for age. We however found that serum Adiponectin levels to be comparable in obese children with NS and obese children without NS and also in the healthy children. The obese children with or without NS also had higher mean insulin levels than the age matched non-obese controls.