Problems of Radiation Medicine and Radiobiology

N. S. Dombrovska, O. M. Nastina, V. I. Voloshko, O. Ya. Pleskach

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

MORPHOLOGICAL AND FUNCTIONAL MYOCARDIAL ABNORMALITIES IN THE CHORNOBYL NPP ACCIDENT CLEAN-UP WORKERS OF «IODINE» PERIOD HAVING GOT TYPE 2 DIABETES MELLITUS

Objective. Evaluation of morphological and functional myocardial abnormalities in the Chornobyl NPP (ChNPP) accident clean-up workers (ACUW) of the «iodine» period exposed to ionizing radiation at a young age and having got the type 2 diabetes mellitus (T2DM).
Materials and methods. The ChNPP ACUW of «iodine» period (n=111) exposed to ionizing radiation (IR) at a young age (18–35 years) were involved in the study. Subjects having got the T2DM were included in study Group I (n = 66), persons with normal glucose challenge test were selected as a comparison Group II (n = 45). External radiation doses (ERD) ranged from 10 to 860 mSv. The Group III (clinical control) included persons having got the T2DM with no radiation exposure in a history (n=20). Group IV was the normative one. There was no statistical difference between the groups in age, sociodemographic characteristics and level of education. Echocardiography and cardiac Doppler sonography were performed in one- and two-dimensional regimens according to the recommendations of the European Association of Echocardiography. Total adiponectin and proinflammatory cytokine (TNF-α and IL-6) concentrations were assayed by the immunoenzyme method. Statistical processing of data was carried out using the Microsoft® Exel 2002 software.
Results. Myocardial remodeling in the ChNPP ACUW of a «iodine» period having the T2DM occurred through a significant increase of its linear parameters. Volumetric parameters (EDV, ESV and their indexes) were within maximum permissible limits significantly exceeding however the values in the Group IV. There was aт increase in myocardial mass of the left ventricle and its indices with the formation of structural-geometric abnormalities, mainly in the form of concentric hypertrophy with a decrease in the myocardial contractile capacity. There was no differences of the vast majority of key morphometric parameters of myocardium in the dose subgroups, while in persons with ERD > 500 mSv the incidence of serious left ventricular hypertrophy (LVMMI > 149 g/m2) significantly exceeded this value in individuals with lower ERD. At a maximum ERD the more intense fibroplastic processes were observed in myocardium [a significant increase in the interstitial collagen volumetric fraction (ICVF)] as compared to the cases with ERD up to 50 mSv. Intensification of myocardial fibroblastic processes occurred in the comparizin group and group off clinical control. In combination with concentric myocardial hypertrophy this may lead to an increased risk of cardiovascular complications. Strong negative correlation was revealed between the parameters of left ventricular structure in diastole and adiponectin level in the ChNPP ACUW of a «iodine» period with diagnosed T2DM, highlighting its cardioprotective effect. At the same time, the content of FNP-α and IL-6 proinflammatory cytokines had a positive correlation with the main parameters of abnormal myocardial remodeling, indicating the possibility of their role in unfavorable cardiovascular modifications.
Conclusions. The decreased adiponectin level and elevated levels of TNF-α and IL-6 in the ChNPP ACUW of a «iodine» period having got the T2DM are the meaningful factors in progression of LV geometric remodeling. Together with fibroplastic processes (a significant increase in ICVF) this may be a basis for the development of myocardial remodeling processes, namely a concentric hypertrophy, which is a prerequisite for the development of complications in cardiovascular system.
Key words: type 2 diabetes mellitus, morphological and functional myocardial characteristics, total adiponectin, proinflammatory cytokines, ChNPP.

Problems of radiation medicine and radiobiology.
2018;23:302_330. doi: 10.33145/2304-8336-2018-23-302-330.

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