الفهرس 
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Abstract
Background : Obesity is a multifactorial disease associated with multiple cardiometabolic comorbidities and insulin resistance (IR). Lifestyle modifications, including healthy nutritional habits and physical activity, are the main strategies for obesity management. Besides various treatment options, omega-3 polyunsaturated fatty acids (PUFAs) supplementation has been proposed as a potential solution to alleviate several obesity-related issues. Aim : to assess the effect of omega-3 PUFAs combined with dietary intervention on BMI and IR of obese children. Subjects and Methods : This prospective randomized controlled longitudinal study was conducted on sixty obese children and adolescents with BMIs ≥95th percentile for age and sex. They were divided into two groups (thirty children in each group): group A received oral omega-3 PUFAs in addition to a dietary intervention for six months, and group B received only a dietary intervention during the same period. Another thirty healthy children and adolescents with BMIs between the 5th and 85th percentile for sex and age were matched with the obese children groups for age and sex and served as a control group. All participants included in the study underwent a history taking, thorough clinical examination, anthropometric measurements, and various investigations such as ALT, AST, CRP, lipid profile, HOMA-IR, serum adiponectin, serum leptin, the adiponectin-leptin ratio (ALR), and plasminogen activator inhibitor-1(PAI-1). Results: After the therapeutic interventions, group A (omega-3-supplemented) showed significant improvement in waist circumference, serum triglycerides, HDL-C, inflammatory adipokines (leptin, adiponectin, ALR, and PAI-1), and insulin sensitivity markers compared to group B. children. Conclusion: Combining omega-3 PUFAs with dietary intervention improved various obesity-related parameters, enhancing insulin sensitivity markers and reducing inflammatory adipokines in obese children and adolescents. Recommendations: Omega-3 PUFAs supplementation can help improve metabolic and cardiovascular risk factors in obese children. HOMA-IR, serum adiponectin, serum leptin, and serum PAI-1 can screen for IR in obese children and adolescents if the costbenefit ratio is appropriate. Further studies are needed to confirm the optimum doses, frequency of administration, and duration of omega-3 supplementation in obese children and to evaluate the role of inflammatory markers in insulin resistance.