DRIVERS OF HYPERFERREMIA IN CHILDREN LIVING ON RADIOLOGICALLY CONTAMINATED TERRITORIES AFTER THE CHNPP ACCIDENT IN UKRAINE.

D A Bazyka, K M Bruslova, L O Liashenko, T I Pushkareva, N M Tsvyetkova, S G Galkina, V G Kondrashova, Zh S Yaroshenko, L O Gonchar, S M Yatsemyrskyi, I V Trychlіb, N V Kavardakova, V G Boyarskyi, T O Chernysh, O M Lytvynets
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Abstract

Objective: assessment of clinical-hematological and metabolic-biochemical parameters of the of bone tissue and hormonal regulation depending on the serum iron content and radiation dose values in children living on radiologically contaminated territories after the ChNPP accident in Ukraine.

Materials and methods: Children (n = 271) living on radiologically contaminated territories (RCT) of Ukraine were involved in the study. Three study groups were formed according to the serum iron level (SIL), namely group I with SIL 10.0-22.0 μmol/l (n = 92), group II with SIL 23.0-34.0 μmol/l (n = 144), and group III with SIL above 35.0 μmol/l (n = 35). Diseases in the family tree, bodyweight at birth, complaints on osalgia, bone fractures, jaw anomalies, dental caries, and obesity were accounted. Morphometric parameters of erythrocytes and hemogram elements were analyzed. Creatinine, alkaline phosphatase, calcium, total protein, iron, cholesterol, bilirubin, and transaminases were assayed in blood serum. The urine content of the 19 free amino acids, serum content of the free thyroxine (FT4), pituitary thyroid-stimulating hormone (TSH), and cortisol were assayed both with bone tissue density. Individual radiation doses were calculated.

Results: In 12.9 % of cases the SIL was > 35.0 μmol/l. Relatives with endocrine diseases were often present in the family tree of children with SIL > 23.0 μmol/l. There were increased urine content of the free amino acids (p < 0.05) and signs of protein degradation under high SIL. Contents of amino acids involved in collagen synthesis and antioxidant status (alanine, serine, glutamine, aspartic acid) and iron metabolism (arginine, leucine) were assayed at the highest levels (p < 0.05). Urinary levels of valine, lysine, and methionine, which are associated with iron metabolism, were decreased (p < 0.05). An inverse correlation (rs = -0.58; p < 0.01) was established between the serum TSH and cortisol levels regardless of the SIL. Serum TSH level directly correlated with urine content of amino acids involved in collagen synthesis. An inverse correlation (rs = -0.55; p < 0.001) was established between the serum TSH level and urine content of tyrosine that is essential for the thyroid hormone (triiodothyronine and thyroxine) synthesis.Cortisol was found having a negative effect on protein synthesis. Inverse correlation was established between the serum cortisol level and urine content of the free amino acids essential for collagen synthesis. There was no dependence of the average radiation dose values on the SIL. An inverse correlation was determined between the patient's radiation dose and SIL > 35.0 μmol/l (rs = -0.29; p < 0.05).

Conclusions: The increased SIL in children living on RCT may occur due to both a genetic predisposition and the acquired factors driving protein and mineral metabolism of bone and their hormonal regulation.

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乌克兰 Chnpp 事故后生活在放射性污染地区的儿童高铁蛋白血症的驱动因素。
目的:根据血清铁含量和辐射剂量值,评估乌克兰 ChNPP 事故后生活在辐射污染地区的儿童骨组织和激素调节的临床血液学和代谢生化参数:研究对象为生活在乌克兰放射性污染地区(RCT)的儿童(n = 271)。根据血清铁含量(SIL)分为三个研究组,即 SIL 为 10.0-22.0 μmol/l 的第一组(n = 92)、SIL 为 23.0-34.0 μmol/l 的第二组(n = 144)和 SIL 超过 35.0 μmol/l 的第三组(n = 35)。家系中的疾病、出生时体重、骨痛主诉、骨折、颌骨畸形、龋齿和肥胖均在统计之列。分析了红细胞的形态参数和血象元素。检测了血清中的肌酐、碱性磷酸酶、钙、总蛋白、铁、胆固醇、胆红素和转氨酶。尿液中 19 种游离氨基酸的含量、血清中游离甲状腺素 (FT4)、垂体促甲状腺激素 (TSH) 和皮质醇的含量均与骨组织密度一起检测。结果显示,12.9%的病例中存在甲状腺功能异常:结果:12.9%的病例 SIL > 35.0 μmol/l。在 SIL > 23.0 μmol/l 的患儿家族中,往往有患有内分泌疾病的亲属。在高 SIL 条件下,尿液中游离氨基酸的含量增加(p < 0.05),并出现蛋白质降解的迹象。参与胶原蛋白合成和抗氧化的氨基酸(丙氨酸、丝氨酸、谷氨酰胺、天门冬氨酸)和铁代谢的氨基酸(精氨酸、亮氨酸)含量最高(p < 0.05)。与铁代谢有关的缬氨酸、赖氨酸和蛋氨酸的尿液水平有所下降(p < 0.05)。血清促甲状腺激素(TSH)和皮质醇(Cortisol)水平之间呈负相关(rs = -0.58;p < 0.01),与 SIL 无关。血清促甲状腺激素水平与尿液中参与胶原蛋白合成的氨基酸含量直接相关。血清促甲状腺激素水平与尿液中甲状腺激素(三碘甲状腺原氨酸和甲状腺素)合成所必需的酪氨酸含量之间呈反向相关(rs = -0.55;p < 0.001)。血清皮质醇水平与尿液中胶原蛋白合成所必需的游离氨基酸含量之间呈负相关。平均辐射剂量值与 SIL 无关。患者的辐射剂量与 SIL > 35.0 μmol/l 之间呈负相关(rs = -0.29; p < 0.05):结论:生活在 RCT 环境中的儿童 SIL 增加可能是由于遗传易感性和后天因素导致的骨蛋白质和矿物质代谢及其激素调节。
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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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