Project "Cardiovascular and Metabolic Risk Related to Visceral Adipose Tissue in Patients with Type 1 Diabetes Mellitus", implemented by a multidisciplinary team from Medical University – Varna, under the guidance of Prof. Dr. Violeta Yotova, DSc, funded under Contract ДН ДН13/3 of 14.12.2017 by the Ministry of Education and Science has been successfully completed.
This project is the first scientific-applied study in our country, aimed at assessing the risk of occurrence of cardiovascular diseases and metabolic disorders in persons with type 1 diabetes mellitus (t1dm), with a long duration and inadequate control. A total of 183 participants (124 with diabetes, duration of diabetes 25.3 ± 8.2 years, 53.2% men) and 59 without diabetes (55.9% men) with similar body mass index (BMI) and age (42.7 ± 10.4 v. 45.1 ± 9.1 years) have been studied. Using different assessment systems, the study has found moderate to high cardiovascular risk in 67 % of the participants with type 1 diabetes. The modern definition of "vascular age" has shown that they are 12.5 years older than the control groups. Patients with t1dm more frequently have arterial hypertension and higher levels of coronary artery calcium scoring (CACS), which can be successfully integrated into the clinical risk assessment in people with diabetes. For the first time in Bulgaria, University Hospital "St. Marina" has introduced a methodology and has measured epicardial adipose tissue, which correlates with BMI and other metabolic indicators. Innovative biomarkers for the assessment of t1dmIn have been developed at the Clinical Laboratory of "St. Marina", which correlate with metabolic risk indicators. Some of them – SHBG, adiponectin, IL-6, HMGB-1, PAI-1, SICAM, as well as the anthropometric index waist/height ratio, show potential for inclusion in the routine risk assessment for type 1 diabetes mellitus. Interesting associations have been found with nutrition, alcohol consumption and educational qualifications of patients. For the first time in Bulgaria, the physical activity (PHA) of patients with type 1 diabetes mellitus has been objectified by accelerometry, compared to that of control groups and correlated with the subjectively assessed PHA. Quality of life and economic indicators have been assessed.
A total of ten young researchers and post-doctoral students have been working on the project, and currently seven doctoral studies, directly related to the outcomes of the project, are underway, and another one is about to be launched in the coming months. Papers and abstracts have been published in journals with IF and SJR, and despite the COVID-19 pandemic, 18 scientific participations have already taken place. Multidisciplinary and inter-institutional relations and conditions for career growth have been established. "It is amazing how cohesively and persistently scientists from different generations and specialties can work together when they are united by key scientific issues, seeking an adequate answer and having the potential to change the fate of plenty of patients," said Prof. Yotova. She is positive that the new directions of scientific research that have arisen as a result of the project lay the foundations for the future work of the team.