الفهرس 
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Abstract
The aim of this study is to assess the presence of vascular dysfunction in the children with JIA, and to determine whether there is any correlation between sVCAM-1 and either FMD of brachial artery or carotid IMT. This study was conducted on fifty-five JIA patients6 -16yeas old and 30 apparently healthy controls of matching age and gender. All the patients were subjected to Thorough history taking, Full clinical examination; General, Systemic, Locomotor system spine examination including alignment and curve, Assessment of disease activity by JADAS-27, physical activity assessment by PAQ, Disability Index CHAQ for functional assessment, fatigue assessment by 18-item PedsQL Multidimensional Fatigue Scale. Investigations were radiological ;Ultrasound to assess FMD of brachial artery, IMT of CCA, Laboratory tests to exclude other pathology CBC,ESR,CRP,FBS, lipid profile, ELISA assessment of sVCAM-1.The results revealed There was a statistically significant higher HAQ disability index in patients with JIA compared with controls and significant lower fatigue scale scorres and PAQ scores. There were significant increment of total cholesterol, LDL-c, CRP, ESR with significant lower HDL-c . Significantly increased sVCAM-1, and increased IMT levels, while FMD was significantly decreased compared to control subjects . No significant difference in age , gender ,weight, height, BMI, sVCAM-1, IMT, FMD between JIA subtypes. While sJIA had increased CRP levels, increased fatigue levels. Increased disability index in polyarticular JIA. But no significant correlation between sVCAM-1, IMT, and FMD, while each correlated with lipid profile , fatigue , and physical activity to conclude, that JIA patients had impaired endothelial function, increased cIMT with increased sVCAM-1 and dyslipoproteinemia which strongly confirms the presence of cardiovascular changes predispose to atherosclerosis at early age, independently to JIA subtype. This endothelial dysfunction was correlated with FMD, IMT. So we Recommend: Reestablishment of healthy life style, including avoidance of adiposity and physical inactivity, for gaining the full benefit of effective anti-inflammatory treatment and securing a healthy life in adulthood. Further studies on greater number of patients to confirm results and in different JIA subtypes.