الفهرس 
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Abstract
Background: With increasing prevelance of childhood obesity worldwide, Nonalcoholic fatty liver disease (NAFLD) become the most common cause of chronic liver disease in obese children. Insulin resistance is the main risk factor of NAFLD. NAFLD is asymptomatic in early stages. Early diagnosis and treatment of risk factor is essential in treatment and slowing down the disease progression.
Aim: This study was designed to detect the relationship between severity of fatty liver and insulin resistance
Method: This cross sectional study was conducted on 20 obese children with NAFLD aged from 4-12 years old in Nutrition clinic at pediatric hospital, Ain Shams University from April 2019 to June 2021. All children subjected to full medical, dietetic history, full anthropometric measurements including weight, height, BMI, waist circumference, hip circumference, waist to hip ratio(WHR), waist to height ratio(WHtR), body composition, laboratory investigations including fasting glucose, fasting insulin and HOMA IR was calculated and Abd US.
Results: We aimed in our study to detect the relationship between the severity of fatty liver and insulin resistance in obese children, we applied our cross sectional study on 20 obese children with the same inclusion and exclusion criteria. The children classification according to sex was 80% male and 20% females, the prevelance of grade 1 mild steatosis was 75% and grade 2 moderate steatosis 25%, 46.7% of children with grade 1 steatosis had moderate insulin resistance and 6.7% had sever insulin resistance. 100.0% of children with grade 2 steatosis have sever insulin resistance. WHR showed highly statistically significant association with NAFLD grade with p value (p<0.001), also WHtR was highly statistical significant association with NAFLD grade with p value (p<0.001).NAFLD grade also was found to be associated with fasting insulin level. There was a statistically significant positive correlation between WHR and WHtR with fasting insulin and HOMA IR.
Conclusion: HOMA IR has highly significant relation with NAFLD grade so, early detection of steatosis by HOMA IR is very important to prevent progression of liver disease