Peculiarities of non-malignant endocrine disease in the Chornobyl NPP accident survivors, and hormonal interaction role

Probl Radiac Med Radiobiol. 2014 Sep;19:256-66.
[Article in En, Ukrainian]

Abstract
in En , Ukrainian

Study objective. Identification of the role of intersystemic hormonal interactions in development of most prevalent central and peripheral non-malignant clinical/metabolic endocrine disorders in the Chornobyl NPP accident (ChNPPA) survivors. Materials and methods. Retrospective assay of non-malignant radiation effects on endocrine system was applied in 18,192 survivors of the ChNPPA. Data from the Clinical/Epidemiological Register of the SI "National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine" for the period of 1993-2003 were involved. Anthropometric values, biochemical and hormonal assay indices, diagnostic thyroid ultrasound data, external radiation dose values were taken into account both with calculated insulin resistance index. Results. Thyroid disease incidence in ChNPPA survivors increased dramatically 10 years upon radiation impact being 39.33 % in average, 14.35 % (р < 0.01 vs. entire population) for nodular goiter, and about 8 % for autoimmune thyroiditis (р < 0.01 vs. the same). As a result of an advanced examination of ChNPPA survivors the incidence of diffuse non-toxic goiter was 40.4 % (χ2Yates = 73.82; р = 0), of nodular goiter - 23.1 % (χ2Yates = 14.13; р = 0.002) vs. values in the control group (4.8 % and 17.6 % respectively). Some hormonal interactions were identified in study subjects indicating the thyroid disease onset under radiation impact through insulin resistance at the background of adipose tissue excess followed by body mass index increase, elevation of serum C-peptide and leptin levels, and onset of lipid metabolic disorders. Conclusions. Significant increase of the incidence of thyroid disease (1.5-3-fold), diabetes mellitus (3-7-fold), pre-obesity and obesity (in 25.67 %), and metabolic syndrome (5-fold) vs. entire population of Ukraine was found in remote terms upon the accident. Intricate pathogenetic intersystemic hormonal interactions were identified predisposing to thyroid disease due to insulin resistance, accompanying hyperinsulinemia, increased body mass index and some other hormonal and biochemical factors.

Meta doslidzhennja. Vyznachyty rol' mizhsystemnyh gormonal'nyh zv’jazkiv u rozvytku najbil'sh poshyrenyh nezlojakisnyh kliniko-metabolichnyh porushen', shho vynykly v central'nij ta peryferychnij lankah endokrynnoi' systemy v osib, jaki zaznaly vplyvu ionizujuchogo vyprominennja vnaslidok avarii' na ChAES. Material ta metody. Provedeno retrospektyvnyj analiz nezlojakisnyh efektiv dii' ionizujuchogo vyprominennja na endokrynnu systemu 18 192 osib, postrazhdalyh vnaslidok avarii' (OPVA) na ChAES, za danymy kliniko-epidemiologichnogo rejestru DU “Nacional'nyj naukovyj centr radiacijnoi' medycyny NAMN Ukrai'ny” za period 1993–2010 rr. Zalucheni antropometrychni dani, laboratorni biohimichni ta gormonal'ni pokaznyky, ul'trazvukove doslidzhennja shhytopodibnoi' zalozy, dozy zovnishn'ogo oprominennja, obchysljuvalysja koeficijenty insulinorezystentnosti. Rezul'taty. Za danymy kliniko-epidemiologichnogo rejestru u OPVA na ChAES chastota patologii' shhytopodibnoi' zalozy pochala pomitno zrostaty cherez 10 rokiv pislja vplyvu radiacijnogo chynnyka, v seredn'omu, stanovyla 39,33 %, dlja vuzlovogo zoba 14,35 % (r < 0,01 do zagal'noi' populjacii') ta dlja hronichnogo autoimunnogo tyreoi'dytu blyz'ko 8% (r < 0,01). Pry provedenni poglyblenogo klinichnogo veryfikacijnogo doslidzhennja OPVA chastota dyfuznogo netoksychnogo zoba stanovyla 40,4 % (χ2Jatsa = 73,82; r = 0), vuzlovogo zoba – 23,1 % (χ2Jatsa = 14,13; r = 0,002) po vidnoshennju do osib z grupy kontrolju (4,8 ta 17,6 %, vidpovidno). V obstezhenyh osib vstanovleni mizhsystemni gormonal'ni zv’jazky, shho svidchat' pro formuvannja tyreoi'dnoi' patologii' pid vplyvom dii' ionizujuchogo vyprominennja zavdjaky insulinorezystentnosti na tli nadlyshkovogo nakopychennja zhyrovoi' tkanyny, shho suprovodzhujet'sja zrostannjam indeksu masy tila, rivniv S-peptydu ta leptynu, vynyknennja lipidnyh porushen'. Vysnovky. Vstanovleno dostovirne pidvyshhennja chastoty patologii' shhytopodibnoi' zalozy (u 1,5–3 razy), cukrovogo diabetu 2 typu (u 3–7 raziv), peredozhyrinnja i ozhyrinnja (na 25,67 %), metabolichnogo syndromu (u 5 raziv) u viddaleni pisljaavarijni terminy u porivnjanni z zagal'noju populjacijeju naselennja Ukrai'ny. Vyjavleni skladni patogenetychni mizhsystemni gormonal'ni vzajemozv’jazky, shho spryjajut' vynyknennju patologii' shhytopodibnoi' zalozy za rahunok rozvytku insulinorezystentnosti, suputn'oi' giperinsulinemii', zbil'shennja indeksu masy tila ta inshyh gormonal'nyh i biohimichnyh chynnykiv.

Keywords: ChNPP accident; accident survivors; diabetes mellitus; endocrine system; ionizing radiation; obesity.