الفهرس 
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Abstract
Wasting is a systemic manifestation of tuberculosis and is often thought to affect the severity and outcome of the disease. When tuberculosis infection occurs, a variety of chemokines and cytokines are secreted from infected cells and tissue macrophages.
Leptin and several cytokines are thought to play a role in the relationship between TB, nutritional status and host immune response.
This work aimed to assess the level of serum leptin in patients with active pulmonary tuberculosis.
This Study was carried out in El-Mahala Chest Hospital and in Chest and Medical Biochemistry Departments, Faculty of Medicine, Menoufia University, including 40 adult patients newly diagnosed as having active pulmonary TB and 20 apparently healthy age and sex matched volunteers as a control group from April 2015 to September 2016. An informed consent was taken from all participants.
The exclusion criteria were:
Any disease that may result in change level of leptin hormone as follows:
- Cardiovascular co-morbidities like hypertension, ischemic heart diseases and cerebral vascular diseases.
- Diabetes mellitus - Arthritis - Hepatic cirrhosis - Renal diseases.
- Patients with COPD, malignancy or connective tissue disorders, Patients receiving or received previous anti TB therapy within 6 months. - Oral steroids in the past 8weeks prior to admission.
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All subjects underwent:
1. history taking
2. physical examination included :-(general and local examinations)
a. BMI
b. CXR
c. Sputum smears examination and culture
d. Complete blood picture, erythrocyte sedimentation rate (ESR)
e. Fasting serum glucose level &2h post prandial
f. Kidney functions (Urea and Creatinine) ,liver functions (ALT, AST and Serum Albumin)
g. Serum leptin measurement
Results of this study revealed that :-( group I: 40 adult patients newly diagnosed as having active pulmonary TB and group II 20 apparently healthy individuals.
• There wasn’t statistical significant difference between the two groups (group I, group II) as regard age and sex.
• There was statistical significant difference between the two groups as regards BMI lower in group I and higher in group II.
• The level of serum leptin, it was significant lower in patients of active pulmonary tuberculosis when compared with control.
• There was a highly statistical significant difference between TB patients according to positivity of sputum Z.N stain.
• The BMI of TB patients, it was a highly statistical significant difference between them.
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• The CXR findings of TB patients, it was a highly statistical significant difference between them.
• the cut-off points of leptin were found to be 0.54 ng/ml ,with sensitivity 80%, specificity 89% is suggesting that the evaluation of serum leptin as a potential method for differential diagnosis between healthy group and TB group, positive predictive value 73%,negative predictive value 93%,diagnostic accuracy 87%& area under the curve 0.788.
• There was a highly significant positive correlation between leptin level and BMI.
• There was a significant negative correlation between leptin level and Z.N stain.
• There was a significant negative correlation between leptin level and CXR.