{"id":{"repo_id":"varna","oai_identifier":"oai:repository.mu-varna.bg:nls/4154"},"canonical_url":"https://search.dev.ndltd.org/etd/varna/oai:repository.mu-varna.bg:nls/4154","repository":{"repo_id":"varna","name":"Medical University of Varna","base_url":"https://repository.mu-varna.bg/oai/request"},"display":{"title":"Evaluation of Metabolic Risk in Relation to Visceral Adiposity and Physical Activity in Patients with Long-Standing Type 1 Diabetes // Оценка на метаболитния риск във връзка с висцералната мастна маса и физическата активност при пациенти със захарен диабет тип 1 с голяма давност","abstract":"The thesis examines the relation between visceral adipose tissue (VAT), physical activity (PA), and metabolic risk in patients with long-standing type 1 diabetes mellitus (T1DM) with childhood onset. A prospective case–control study was conducted, including 124 patients with T1DM (disease duration >15 years) and 59 healthy controls matched for age, sex, and BMI. Advanced approaches were applied to determine VAT (DXA, CT, MRI) and PA (accelerometry and questionnaires), alongside biochemical and hormonal markers. The results show that half of the participants with T1DM are overweight or obese, and most of them do not achieve adequate glycaemic control. A statistically significant association was identified between insulin dose, age, and VAT volume, but not with HbA1c levels. PA emerges as an important yet underestimated factor—a substantial proportion of patients exhibit low levels of physical activity, which also contributes to the elevated cardiometabolic risk. The conclusions underscore the need for an individualised approach to the early identification of high-risk T1DM patients through an integrated assessment of VAT and PA. The study offers practical guidance for improving secondary prevention in this population.","abstract_html":"The thesis examines the relation between visceral adipose tissue (VAT), physical activity (PA), and metabolic risk in patients with long-standing type 1 diabetes mellitus (T1DM) with childhood onset. A prospective case–control study was conducted, including 124 patients with T1DM (disease duration >15 years) and 59 healthy controls matched for age, sex, and BMI. Advanced approaches were applied to determine VAT (DXA, CT, MRI) and PA (accelerometry and questionnaires), alongside biochemical and hormonal markers. The results show that half of the participants with T1DM are overweight or obese, and most of them do not achieve adequate glycaemic control. A statistically significant association was identified between insulin dose, age, and VAT volume, but not with HbA1c levels. PA emerges as an important yet underestimated factor—a substantial proportion of patients exhibit low levels of physical activity, which also contributes to the elevated cardiometabolic risk. The conclusions underscore the need for an individualised approach to the early identification of high-risk T1DM patients through an integrated assessment of VAT and PA. The study offers practical guidance for improving secondary prevention in this population.","abstract_has_math":false,"creators":["Tsochev, Kaloyan","Цочев, Калоян"],"institution":"Medical University of Varna","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-09-12T13:01:52Z","date_published":"2025-09-12T13:01:52Z","updated_at":"2026-07-27T21:57:01Z","subjects":["visceral adipose tissue","metabolic risk","Type 1 Diabetes","Педиатрия / Paediatrics"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://repository.mu-varna.bg/handle/nls/4154","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Tsochev, Kaloyan","Цочев, Калоян"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025-09-12T13:01:52Z","2025"]},{"key":"dc:publisher","label":"Institution","values":["Medical University of Varna"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["visceral adipose tissue","metabolic risk","Type 1 Diabetes","Педиатрия / Paediatrics"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://repository.mu-varna.bg/handle/nls/4154"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The thesis examines the relation between visceral adipose tissue (VAT), physical activity (PA), and metabolic risk in patients with long-standing type 1 diabetes mellitus (T1DM) with childhood onset. A prospective case–control study was conducted, including 124 patients with T1DM (disease duration >15 years) and 59 healthy controls matched for age, sex, and BMI. Advanced approaches were applied to determine VAT (DXA, CT, MRI) and PA (accelerometry and questionnaires), alongside biochemical and hormonal markers. The results show that half of the participants with T1DM are overweight or obese, and most of them do not achieve adequate glycaemic control. A statistically significant association was identified between insulin dose, age, and VAT volume, but not with HbA1c levels. PA emerges as an important yet underestimated factor—a substantial proportion of patients exhibit low levels of physical activity, which also contributes to the elevated cardiometabolic risk. The conclusions underscore the need for an individualised approach to the early identification of high-risk T1DM patients through an integrated assessment of VAT and PA. The study offers practical guidance for improving secondary prevention in this population.","Дисертацията разглежда връзката между висцералната мастна маса (ВММ), физическата активност (ФА) и метаболитния риск при пациенти с дългогодишен тип 1 захарен диабет (Т1ЗД), заболели в детска възраст. Извършено е проспективно случай-контрола проучване с включени 124 пациенти с Т1ЗД (с давност над 15 години) и 59 здрави контроли, съпоставени по възраст, пол и ИТМ. Прилагани са съвременни методи за оценка на ВММ (DXA, КТ, ЯМР), ФА (акселерометрия и въпросници), както и биохимични и хормонални маркери. Резултатите показват, че половината от участниците с Т1ЗД имат наднормено тегло или затлъстяване и голяма част от тях не постигат добър гликемичен контрол. Установена е статистически значима връзка между инсулиновата доза, възрастта и обема на ВММ, но не и с нивата на HbA1c. ФА се оказва важен, но подценяван фактор – значителна част от пациентите имат ниска двигателна активност, което също допринася за повишения сърдечно-метаболитен риск. Изводите подчертават нуждата от индивидуализиран подход за ранно откриване на високорискови пациенти с Т1ЗД чрез интегрирана оценка на ВММ и ФА. Изследването предлага практически насоки за подобряване на вторичната профилактика при тази популация."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Evaluation of Metabolic Risk in Relation to Visceral Adiposity and Physical Activity in Patients with Long-Standing Type 1 Diabetes // Оценка на метаболитния риск във връзка с висцералната мастна маса и физическата активност при пациенти със захарен диабет тип 1 с голяма давност"]}]}],"canonical_facts":{"dc:creator":["Tsochev, Kaloyan","Цочев, Калоян"],"dc:date":["2025-09-12T13:01:52Z","2025"],"dc:description":["The thesis examines the relation between visceral adipose tissue (VAT), physical activity (PA), and metabolic risk in patients with long-standing type 1 diabetes mellitus (T1DM) with childhood onset. A prospective case–control study was conducted, including 124 patients with T1DM (disease duration >15 years) and 59 healthy controls matched for age, sex, and BMI. Advanced approaches were applied to determine VAT (DXA, CT, MRI) and PA (accelerometry and questionnaires), alongside biochemical and hormonal markers. The results show that half of the participants with T1DM are overweight or obese, and most of them do not achieve adequate glycaemic control. A statistically significant association was identified between insulin dose, age, and VAT volume, but not with HbA1c levels. PA emerges as an important yet underestimated factor—a substantial proportion of patients exhibit low levels of physical activity, which also contributes to the elevated cardiometabolic risk. The conclusions underscore the need for an individualised approach to the early identification of high-risk T1DM patients through an integrated assessment of VAT and PA. The study offers practical guidance for improving secondary prevention in this population.","Дисертацията разглежда връзката между висцералната мастна маса (ВММ), физическата активност (ФА) и метаболитния риск при пациенти с дългогодишен тип 1 захарен диабет (Т1ЗД), заболели в детска възраст. Извършено е проспективно случай-контрола проучване с включени 124 пациенти с Т1ЗД (с давност над 15 години) и 59 здрави контроли, съпоставени по възраст, пол и ИТМ. Прилагани са съвременни методи за оценка на ВММ (DXA, КТ, ЯМР), ФА (акселерометрия и въпросници), както и биохимични и хормонални маркери. Резултатите показват, че половината от участниците с Т1ЗД имат наднормено тегло или затлъстяване и голяма част от тях не постигат добър гликемичен контрол. Установена е статистически значима връзка между инсулиновата доза, възрастта и обема на ВММ, но не и с нивата на HbA1c. ФА се оказва важен, но подценяван фактор – значителна част от пациентите имат ниска двигателна активност, което също допринася за повишения сърдечно-метаболитен риск. Изводите подчертават нуждата от индивидуализиран подход за ранно откриване на високорискови пациенти с Т1ЗД чрез интегрирана оценка на ВММ и ФА. Изследването предлага практически насоки за подобряване на вторичната профилактика при тази популация."],"dc:format":["application/pdf"],"dc:identifier":["http://repository.mu-varna.bg/handle/nls/4154"],"dc:publisher":["Medical University of Varna"],"dc:subject":["visceral adipose tissue","metabolic risk","Type 1 Diabetes","Педиатрия / Paediatrics"],"dc:title":["Evaluation of Metabolic Risk in Relation to Visceral Adiposity and Physical Activity in Patients with Long-Standing Type 1 Diabetes // Оценка на метаболитния риск във връзка с висцералната мастна маса и физическата активност при пациенти със захарен диабет тип 1 с голяма давност"],"dc:type":["thesis"]},"updated_at":"2026-07-27T21:57:01Z"}