الفهرس 
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Abstract
In diabetic children, the presence of subclinical atherosclerotic disease as a precursor of macrovascular complications. Also, impaired carotid artery wall thickness preceding atherosclerotic changes has been observed . As the measurement of the intima-media thickness of the carotid arteries is considered a surrogate marker of subclinical atherosclerosis, this method has been used widely in these patients to asses vascular health .
The present study aimed to assess the relationship between visceral fat and subclinical atherosclerosis in adolescents with type 1 diabetes for prediction and early prevention of cardiovascular disease for those group.
The study was a case control study performed in Pediatric and Radiology Department in Suez Canal University Hospital . The target population were divided to two groups which consisted of 57 adolescents with Type 1 diabetes mellitus and 57 healthy adolescents matched in age, sex, height and weight. All the studied population was subjected to history taking (name, age, gender. history of the diabetes including , age at Onset, duration, Insulin regimen, dose of insulin) clinical examination (blood pressure, anthropometric measurements including height, weight, body mass index, waist circumference) laboratory Investigations (Hemoglobin A1C and Total lipid profile including Triglycerides, Cholesterol, HDL-C and LDL-C) and radiological examination (Carotid Intimal-Medial Thickness and visceral fat volume).
The data was collected, both clinical as well as the laboratory results then tabulated and analyzed using computer facilities.
Our data clearly showed that the determinant factors for subclinical carotid vascular atherosclerosis in the diabetic subjects were different, which was a distinctive feature for diabetic subjects compared with nondiabetic subjects.
Our data also showed that visceral fat-associated might be mediating the development and progression of atherosclerosis in type 1 diabetic subjects. Thus, the improvement of visceral fat volume in type 1 diabetic individuals could be essential to prevent atherosclerosis.
In our study, there was no difference between diabetic patients and control subjects in terms of Body Mass Index, Total Cholesterol, whereas cIMT , triglyceride levels were increased significantly in the diabetic group.
Fat accumulates everywhere as body weight increases; the largest ectopic depots are visceral fat in the abdominal area and extra-pericardial fat in the intrathoracic area. Our results reconsider the role of visceral fat as an important marker of cardiometabolic risk. Visceral fat was the best marker of altered cardiovascular disease risk profile and increased visceral fat was associated with carotid artery atherosclerosis risk.
Owing to the continuing increase in the incidence of diabetes, diabetes related CVD already represents a significant emerging health and economic burden worldwide. Such considerations emphasize the need for medical management of T1D to extend beyond glycaemic control to include a specific focus on reducing the cardiovascular risk that accompanies T1D. Optimal care for the patient with diabetes should focus on aggressive management of traditional cardiovascular risk factors to optimize not only those well recognized (e.g. blood glucose and lipids) but also new and potentially more sensitive and specific risk factors which are increasingly being evaluated.