Problems of Radiation Medicine and Radiobiology

O. D. Bazyka, D. O. Bilyi

State institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine

DISEASES OF CIRCULATORY SYSTEM AND COMORBID TYPE II DIABETES MELLITUS IN THE CHORNOBYL ACCIDENT CONSEQUENCES CLEAN-UP WORKERS

Objective. The study was focused on evaluation of peculiarities of the clinical manifestations of type II diabetes mellitus (TIIDM) in the Chornobyl nuclear power plant (ChNPP) accident clean-up workers (ACUW). Materials and methods. The ChNPP ACUW of 1986–1987 period (n = 449, males) and 158 males not exposed to ionizing radiation (the control group, CG) were involved in the study in 2013–2018. Diagnosis of cardiovascular disease (CVD) and type II diabetes mellitus (TIIDM) was established in accordance with diagnostic standards adopted in Ukraine. All study subjects had no signs of CVD, and neither of endocrine disease nor of metabolic disorders before the accident. Results. Clinical course of the TIIDM, depending on the disease severity, onset of angiopathy and polyneuropathy, prevalence of angina pectoris and heart failure were surveyed and analyzed. Concomitant TIIDM was associated with a higher incidence of angina pectoris and heart failure. According to the Kaplan-Meier method of survival estimating the accumulation of new TIIDM cases occurred faster in the ACUW compared with individuals in the CG, however with no statistical significance in subjects aged up to 60 years old (log-rank test χ² = 4.89, p = 0.027). Mean age of the ACUW having comorbid CVD and DM was (54.6 ± 9.7) years, whilst in the CG it was (59.9 ± 10.7) years (p = 0.005). Conclusions. The DM course in the ACUW was not significantly different from non-irradiated control both in severity and such complications as angiopathy of retina and lower extremities, as well as manifestations of lower extremity polyneuropathy. Clinical manifestations of CVD in the form of angina pectoris and heart failure were identical in the ACUW and control group of patients having a comorbid TIIDM. The latter was a factor exacerbating the CVD course and leading to a higher prevalence of angina pectoris and heart failure both in the ACUW and in non-irritated individuals. Accumulation of the new DM cases occurred more rapidly in ACUW vs. non-irradiated control, so they were in average 5 years younger at the time of TIIDM manifestation than the control subjects. Key words: Chernobyl nuclear power plant accident clean-up workers, cardiovascular disease, comorbidity, diabetes mellitus.

Problems of radiation medicine and radiobiology.
2018;23:246-253. doi: 10.33145/2304-8336-2018-23-246-253

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