الفهرس 
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Abstract
Childhood rheumatologic disorders are multisystem, inflammatory, autoimmune diseases. Symptoms in children may be subtle or absent and often develop over time.The classification of rheumatologic disorders is sometimes difficult due to unknown etiology and heterogeneity in their clinical presentation. The aim of this work was to analyze the possible association between IR and rheumatologic disorders with the aim of early detection of IR and possibility of development of diabetes mellitus.
This case-control study was carried out in the Pediatrics department, Faculty of Medicine, Zagazig University Hospitals.
The patient group included 26 patients having rheumatologic disorders subclassified into 14 cases of SLE, 9 cases of RA and 3 cases of dermatomyositis. The control group included 26 age-matched healthy children.
Full history, clinical examination and investigations were done to all patients including determination of FBG, estimation of total cholesterol, TG, HDL and LDL and estimation of fasting insulin using ELISA method. HOMA IR was calculated according to the formulas in the HOMA model.
The results of this study showed that; there was no statistically significant difference in the age, WBCs and FBG of controls compared to patients with rheumatologic disorders (P=0.1, 0.4, 0.3 respectively) but there was statistically significant difference as regard Hb% and Platelets counts, ESR, CRP, TG, HDL, Fasting insulin level and HOMA IR.
There was no statistically significant difference between the diseased groups in disease duration, ESR, CRP, HDL, LDL, Triglyceride, Cholesterol levels, fasting blood glucose, fasting insulin level and HOMA IR.
There was statistically significant positive correlation between HOMA IR and fasting insulin level in one hand and ESR, CRP, TG, FBG on other hand. Otherwise, there was no statistically significant correlation between HOMA IR and other patient characteristics.
In conclusion, this study was done in an attempt to identify the possible association between IR and rheumatologic disorders in Egyptian children. The present study demonstrated that both SLE, RA and dermatomyositis patients had a higher IR and abnormal insulin secretion than age-matched apparently healthy controls. This conclusion was based on the measurement of fasting insulin concentration and HOMA IR. IR and abnormal insulin secretion were associated with markers for inflammation (ESR and CRP) However, larger case-control studies with more cases would be required in this field. There is a need for studies of other ethnicities and nationalities to confirm the present findings