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D. A. Bazyka, K. M. Bruslova, L. O. Liashenko, T. I. Pushkareva, N. M. Tsvyetkova,
S. G. Galkina, V. G. Kondrashova, A. L. Zaytseva, L. O. Gonchar, V. F. Kuzmenko, I. V. Trychl³b,
N. V. Kavardakova, T. O. Chernysh, V. D. Pismennyj, O. Y. Pleskach
State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
REGULATION OF BONE TISSUE METABISM IN CHILDREN LIVING IN RADIOACTIVELY CONTAMINATED TERRITORIES AFTER THE CHNPP ACCIDENT
Objective: identification of clinical and metabolic characteristics of osteogenesis and factors affecting bone mineral density (BMD) in children living in radioactively contaminated territories (RCT) after the ChNPP accident for the
use of therapeutic and preventive measures aiming to reduce the incidence of disorders.
Materials and methods. Children aged 4 to 18 years old (n = 539) were involved in the study within 4 age groups,
namely under 7 years old, 7–10 years old, 10–14 years old, older than 14 years old. Studied parameters in children
with a reduced BMD (85–65 relative units and under 65 relative units) were estimated vs. the normative BMD
(100–85 relative units) cases. Diagnosis of osteopenia and osteoporosis in children was established according to
the BMD T-index. Family history of the relatives of children was studied. Body weight at birth, fractures of the long
bones, complaints of osalgia, jaw anomalies, dental caries, presence of obesity, and hypermobility syndrome (HMS)
were assessed. Peripheral blood biochemical tests were performed featuring the serum total protein, alkaline phosphatase (APh), calcium, vitamin D, creatinine, serum iron (SI), ferritin, cortisol, pituitary thyroid-stimulating hormone (TSH), and free thyroxine (FT4) assay. BMD was measured and radiation doses in children were reconstructed.
Results. BMD depended on the age of children. A direct correlation was established between the cholelithiasis and
urolithiasis incidence (ð < 0.01), cancer and endocrine diseases (ð < 0.05) in the relatives of children that had BMD
under 65 relative units. Dental caries developed more often (ð < 0.05), while obesity was less frequent (ð < 0.05) in
the subjects with BMD < 65 relative units. A direct correlation was established between the level of serum creatinine and BMD (ð < 0.01), and there was an inverse correlation between the serum APh level and BMD (ð < 0.001).
Every third child had a vitamin D deficiency. Fractures of long bones and increased content of SI and TSH were characteristic for the children having got osteopenia (BMD within 85–65 relative units), while besides a predisposition
to bone fractures the higher levels of SI, APh, cortisol both with calcium deficiency were found in children with
osteoporosis (BMD < 65 relative units) compared to the general group with a similar BMD. An increased incidence
of HMS was characteristic too. Radiation doses in children with osteopenia were higher than in those with osteoporosis: (1.17 ± 0.09) mSv and (0.92 ± 0.06) mSv respectively (ð < 0.05). No correlation was found between the radiation doses and clinical signs, blood biochemistry or BMD.
Conclusions. Study of the functional mechanisms of bone structures in children, depending on their metabolism,
had made it possible to reveal the factors that affect bone formation in children living in RCT after the ChNPP accident, and to form the population groups for the timely application of therapeutic and preventive measures aiming
to reduce the incidence of disorders of musculoskeletal system.
Key words: children, bone mineral density, osteopenia, osteoporosis, iron metabolism, hormonal regulation, radiation doses, ChNPP accident.
Problems of Radiation Medicine and Radiobiology.
2023;28:225-238. doi: 10.33145/2304-8336-2023-28-225-238
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