الفهرس 
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Abstract
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UMMARY
he current cross sectional study was conducted on hundred and twenty children with T1DM aged between 10-18 years. The T1DM group was further divided into 2 groups, according to the presence or absence of insulin resistance. All cases were recruited from the Pediatric and Adolescent Diabetes Units, Ain Shams University, over a 1-year period (October 2020 to October 2021). This study aimed primarily to investigate the relationship between total, regional obesity and insulin resistance in T1DM patients.
The mean age of the studied children and adolescents with T1DM was 14.29 ± 2.43 years. They were 70.8% females and 29.2% males. The mean ± SD of BMI was (21.79 ± 4.01), the mean ± SD of waist circumference (70.29 ± 6.49), and the mean ± SD of waist/hip ratio was (0.67 ± 0.07) among the studied cases.
Using BIA, the mean ± SD of total fat (%) of the studied children and adolescents with T1DM was (22.81 ± 7.82) while the mean ± SD of total fat (Kg) was (12.45 ± 6.61).
The current study found that insulin resistant cases have a higher insulin dose (1.23 ± 0.39 Unit/kg/day) compared to non-insulin resistant cases (1.03 ± 0.32 Unit/kg/day) with highly statistical significance.
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The present study showed that insulin resistant cases had significantly higher mean values of weight, weight Z score, BMI, BMI Z score, waist circumference (WC), and waist/hip ratio compared to non-insulin resistant cases.
The current study found that insulin resistant cases had significantly higher mean values of total fat (%), total fat (Kg), visceral fat, and visceral fat/ subcutaneous fat ratio compared to non-insulin resistant cases.
This study showed that the insulin resistant cases group had higher serum levels of HbA1C (%), HbA1C (mmol/mol), fasting glucose (mg/dL), and LDL (mg/dL) compared to non-insulin resistant cases group, all with a highly statistical significance.
The current study showed that the insulin resistant cases group had a significantly lower mean value of eGDR (7.76 ± 0.59 mg/kg/min) compared to non-insulin resistant cases group (10.51 ± 0.95 mg/kg/min).
The present study showed significant positive correlations between both total fat (%) and total fat (Kg) with visceral fat and visceral / subcutaneous fat.
The current study found significant positive correlations between total fat (Kg) and total fat (%) with all anthropometric measurements among the studied cases with. A significant
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negative correlations between eGDR with both total fat (%) and total fat (Kg) was found n the studied T1DM cases.
The current study found significant positive correlations between visceral fat with age, BMI, BMI percentile, BMI Z score, waist circumference (cm), and waist/hip ratio. Also, a significant positive correlations between visceral fat with serum insulin was reported, whereas a significant negative correlations between visceral fat and visceral fat/ subcutaneous fat ratio with eGDR n the studied patients.
The current study found that waist circumference (cm), eGDR, and LDL were significant and independent factor of visceral fat in the multiple stepwise linear regression analysis. Also, visceral fat, waist / hip ratio, eGDR, and LDL were considered significant independent factors of visceral fat/ subcutaneous fat ratio in the multiple stepwise linear regression analysis.