切尔诺贝利核电站事故幸存者甲状旁腺疾病和其他非癌性内分泌紊乱之间的临床代谢和激素关系

O V Kaminskyi, O V Kopylova, D E Afanasyev, I M Muraviova, I G Chikalova, N S Dombrovska
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Thegenerally recognized clinical, anthropometric (body weight, height, thigh volume, body mass index), instrumental(ultrasound examination of thyroid and parathyroid glands), laboratory (biochemical, hormonal), and statisticalmethods were applied. Parametric and nonparametric statistical methods were used in data processing. The value ofp < 0.05 was considered a statistically significant. RESULTS No significant difference was found in the incidence of carbohydrate metabolic disorders in the ChornobylNPP (ChNPP) accident consequences clean-up workers (ACCUW), evacuees from the NPP 30-km exclusion zone, res-idents of radiologically contaminated areas and in the control group in whom the parathyroid hyperplasia wasdetected. There was a significant increase in the incidence of arterial hypertension among ACCUW who had parathy-roid hyperplasia (76.9%) vs. the control group (51.2%). In cases of parathyoid hyperplasia the vitamin D levels weresignificantly lower than without it. Vitamin D insufficiency/deficiency was found in 94% of the surveyed subjects.The average level of parathyroid hormone in blood serum was significantly higher in the ACCUW of «iodine» period withdiagnosed parathyroid hyperplasia than in the control group: (57.2 ± 2.87) pg / ml against (32.74 ± 3.58) pg / ml,p < 0.05. Results of multivariative analysis indicated a strong association of vitamin 25(OH)D insufficiency/defi-ciency with development of thyroid disease, carbohydrate metabolic disorders, cardiovascular disease, osteo-penia/osteoporosis. parathyroid ultrasound scan was at that an effective diagnostic method for primary screeningfor parathyroid hyperplasia and regular monitoring of the treatment efficiency. When examining children bornto parents irradiated after the ChNPPA the parathyroid hyperplasia (58%) and low serum content of vitamin D(11.6 ± 3.5) nmol / l were most often found in children living on radiologically contaminated territories (RCT).A strong correlation was established between the HOMA insulin resistance index and serum content of vitamin D(r = 0.65), parathyroid hormone (r = 0.60), and free thyroxine (r = 0.68) in the group of children born to parents irra-diated after the ChNPPA, having got chronic autoimmune thyroiditis, which indicated a relationship between thy-roid function, impaired carbohydrate and fat metabolism and the state of parathyroids. CONCLUSIONS No difference in the incidence of carbohydrate metabolic disorders was found in the ChNPP ACCUW,evacuees from the 30-km exclusion zone, and residents of radiologically contaminated territories in whom parathy-roid hyperplasia was detected vs. the control group. Patients with parathyroid hyperplasia were found to be defi-cient in vitamin D in 94% of cases, and level of latter was significantly lower than under the normal parathyroid size.There was a significant increase in the incidence of diagnosed arterial hypertension among ACCUW who had parathy-roid hyperplasia vs. the control group: (76.9 ± 3.5)% vs. (51.2 ± 3.7)%. According to multivariate analysis a strongassociation between the vitamin 25(OH)D insufficiency/deficiency and development of thyroid disease, carbohydratemetabolic disorders, cardiovascular disease, and osteopenia/osteoporosis was established. The average level of pa-rathyroid hormone in the blood serum of the ChNPP ACCUW of the «iodine» period with diagnosed parathyroid hyper-plasia was significantly higher (57.2 ± 2.87) pg / ml against (32.74 ± 3.58) pg / ml; p <0,05) in the control group.","PeriodicalId":20491,"journal":{"name":"Problemy radiatsiinoi medytsyny ta radiobiolohii","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"CLINICAL-METABOLIC AND HORMONAL RELATIONSHIPS BETWEEN PARATHYROID DISEASE AND OTHER NON-CANCEROUS ENDOCRINE DISORDERS IN THE CHORNOBYL NPP ACCIDENT SURVIVORS.\",\"authors\":\"O V Kaminskyi,&nbsp;O V Kopylova,&nbsp;D E Afanasyev,&nbsp;I M Muraviova,&nbsp;I G Chikalova,&nbsp;N S Dombrovska\",\"doi\":\"10.33145/2304-8336-2021-26-410-425\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE to investigate the clinical, hormonal-metabolic and structural features of parathyroid injuries in sur-vivors exposed to ionizing radiation after the Chornobyl NPP accident in adulthood and childhood, both with theirconnections to other non-cancerous endocrine disorders, and to establish the respective interhormonal and dys-metabolic relationships. 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Results of multivariative analysis indicated a strong association of vitamin 25(OH)D insufficiency/defi-ciency with development of thyroid disease, carbohydrate metabolic disorders, cardiovascular disease, osteo-penia/osteoporosis. parathyroid ultrasound scan was at that an effective diagnostic method for primary screeningfor parathyroid hyperplasia and regular monitoring of the treatment efficiency. 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引用次数: 1

摘要

目的:探讨切尔诺贝利核电站事故电离辐射幸存者成年期和儿童期甲状旁腺损伤的临床、激素代谢和结构特征及其与其他非癌性内分泌紊乱的关系,并建立相应的激素间和代谢异常关系。材料与方法:以切尔诺贝利核电站事故受难者(n = 224)及其后代(n = 146)的临床电离辐射对内分泌系统的影响与普通人群样本(n = 70)进行比较研究。所有患者均行甲状腺及甲状旁腺超声检查。采用了公认的临床、人体测量(体重、身高、大腿体积、体重指数)、仪器(甲状腺和甲状旁腺超声检查)、实验室(生化、激素)和统计学方法。数据处理采用参数和非参数统计方法。p < 0.05为差异有统计学意义。结果:切尔诺贝利核电站(ChNPP)事故后果清理工人(ACCUW)、核电站30公里隔离区撤离人员、放射性污染区居民与甲状旁腺增生对照组的碳水化合物代谢紊乱发生率无显著差异。与对照组(51.2%)相比,伴有甲状旁腺增生的ACCUW患者动脉高血压的发生率显著增加(76.9%)。在甲状旁腺增生的病例中,维生素D水平明显低于没有维生素D的病例。94%的调查对象存在维生素D不足/缺乏症。诊断为甲状旁腺增生的“碘”期患者血清甲状旁腺激素平均水平显著高于对照组:(57.2±2.87)pg / ml vs(32.74±3.58)pg / ml,p < 0.05。多变量分析结果显示,维生素25(OH)D不足/缺乏与甲状腺疾病、碳水化合物代谢紊乱、心血管疾病、骨质减少/骨质疏松症的发展密切相关。甲状旁腺超声扫描是初步筛查甲状旁腺增生和定期监测治疗效果的有效诊断方法。在对父母受辐照后所生的儿童进行检查时,居住在放射性污染地区的儿童最常发现甲状旁腺增生(58%)和血清维生素D含量低(11.6±3.5)nmol / l (RCT)。慢性自身免疫性甲状腺炎患儿经ChNPPA后辐照组HOMA胰岛素抵抗指数与血清维生素D(r = 0.65)、甲状旁腺激素(r = 0.60)、游离甲状腺素(r = 0.68)含量有较强相关性,提示甲状腺功能、碳水化合物和脂肪代谢受损与甲状旁腺状态有关。结论:与对照组相比,在ChNPP ACCUW、30公里隔离区撤离者和放射污染地区检测到甲状旁腺增生的居民中,碳水化合物代谢紊乱的发生率没有差异。甲状旁腺增生患者有94%缺乏维生素D,且维生素D水平明显低于甲状旁腺正常大小的患者。与对照组相比,患有甲状旁腺增生的ACCUW患者诊断为动脉高血压的发生率显著增加:(76.9±3.5)% vs(51.2±3.7)%。根据多变量分析,维生素25(OH)D不足/缺乏与甲状腺疾病、碳水化合物非代谢紊乱、心血管疾病和骨质减少/骨质疏松症的发展有很强的相关性。诊断为甲状旁腺增生的ChNPP ACCUW“碘”期血清中甲状旁腺激素的平均水平(57.2±2.87)pg / ml明显高于(32.74±3.58)pg / ml;p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CLINICAL-METABOLIC AND HORMONAL RELATIONSHIPS BETWEEN PARATHYROID DISEASE AND OTHER NON-CANCEROUS ENDOCRINE DISORDERS IN THE CHORNOBYL NPP ACCIDENT SURVIVORS.
OBJECTIVE to investigate the clinical, hormonal-metabolic and structural features of parathyroid injuries in sur-vivors exposed to ionizing radiation after the Chornobyl NPP accident in adulthood and childhood, both with theirconnections to other non-cancerous endocrine disorders, and to establish the respective interhormonal and dys-metabolic relationships. MATERIALS AND METHODS Clinical effects of ionizing radiation on the endocrine system in persons affected by theChornobyl NPP accident (n = 224) and their descendants (n = 146), compared with the general population sample(n = 70) were the study object. All patients underwent the ultrasound thyroid and parathyroid examination. Thegenerally recognized clinical, anthropometric (body weight, height, thigh volume, body mass index), instrumental(ultrasound examination of thyroid and parathyroid glands), laboratory (biochemical, hormonal), and statisticalmethods were applied. Parametric and nonparametric statistical methods were used in data processing. The value ofp < 0.05 was considered a statistically significant. RESULTS No significant difference was found in the incidence of carbohydrate metabolic disorders in the ChornobylNPP (ChNPP) accident consequences clean-up workers (ACCUW), evacuees from the NPP 30-km exclusion zone, res-idents of radiologically contaminated areas and in the control group in whom the parathyroid hyperplasia wasdetected. There was a significant increase in the incidence of arterial hypertension among ACCUW who had parathy-roid hyperplasia (76.9%) vs. the control group (51.2%). In cases of parathyoid hyperplasia the vitamin D levels weresignificantly lower than without it. Vitamin D insufficiency/deficiency was found in 94% of the surveyed subjects.The average level of parathyroid hormone in blood serum was significantly higher in the ACCUW of «iodine» period withdiagnosed parathyroid hyperplasia than in the control group: (57.2 ± 2.87) pg / ml against (32.74 ± 3.58) pg / ml,p < 0.05. Results of multivariative analysis indicated a strong association of vitamin 25(OH)D insufficiency/defi-ciency with development of thyroid disease, carbohydrate metabolic disorders, cardiovascular disease, osteo-penia/osteoporosis. parathyroid ultrasound scan was at that an effective diagnostic method for primary screeningfor parathyroid hyperplasia and regular monitoring of the treatment efficiency. When examining children bornto parents irradiated after the ChNPPA the parathyroid hyperplasia (58%) and low serum content of vitamin D(11.6 ± 3.5) nmol / l were most often found in children living on radiologically contaminated territories (RCT).A strong correlation was established between the HOMA insulin resistance index and serum content of vitamin D(r = 0.65), parathyroid hormone (r = 0.60), and free thyroxine (r = 0.68) in the group of children born to parents irra-diated after the ChNPPA, having got chronic autoimmune thyroiditis, which indicated a relationship between thy-roid function, impaired carbohydrate and fat metabolism and the state of parathyroids. CONCLUSIONS No difference in the incidence of carbohydrate metabolic disorders was found in the ChNPP ACCUW,evacuees from the 30-km exclusion zone, and residents of radiologically contaminated territories in whom parathy-roid hyperplasia was detected vs. the control group. Patients with parathyroid hyperplasia were found to be defi-cient in vitamin D in 94% of cases, and level of latter was significantly lower than under the normal parathyroid size.There was a significant increase in the incidence of diagnosed arterial hypertension among ACCUW who had parathy-roid hyperplasia vs. the control group: (76.9 ± 3.5)% vs. (51.2 ± 3.7)%. According to multivariate analysis a strongassociation between the vitamin 25(OH)D insufficiency/deficiency and development of thyroid disease, carbohydratemetabolic disorders, cardiovascular disease, and osteopenia/osteoporosis was established. The average level of pa-rathyroid hormone in the blood serum of the ChNPP ACCUW of the «iodine» period with diagnosed parathyroid hyper-plasia was significantly higher (57.2 ± 2.87) pg / ml against (32.74 ± 3.58) pg / ml; p <0,05) in the control group.
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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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