GENDER DISPARITIES OF CIRCULATORY DISEASE PROGRESS IN THE CHORNOBYL ACCIDENT CLEAN-UP WORKERS AND PHOSPHODIESTERASE 4D GENE rs966221 POLYMORPHISM. / GENDERNI VIDMINNOSTI ROZVYTKU ZAKhVORIuVAN' SYSTEMY KROVOOBIGU V UChASNYKIV LIKVIDATsIÏ NASLIDKIV ChORNOBYL'S'KOÏ AVARIÏ I POLIMORFIZM rs966221 GENA FOSFODIESTERAZY 4D.

OBJECTIVE: Evaluation of the hypertensive disease (HD) and coronary heart disease (CHD) progress in the ChornobylNPP (ChNPP) accident clean-up workers (ACUW) and persons not exposed to ionizing radiation depending on gen-der and genotype of the phosphodiesterase 4D (PDE4D) gene rs966221 polymorphism. MATERIALS AND METHODS: There were male ACUW (ACUWm; n=515) and female ACUW (ACUWf; n=145) involved in thestudy since 2013 till 2018. Participation in the clean-up works took place in 1986-1987. The control group includ-ed male (CGm; n=162) and female (CGf; n=120) persons not exposed to ionizing radiation. All study subjects havehad neither signs nor symptoms of HD or CHD before the ChNPP accident. RESULTS: Review of the Kaplan-Meier survival tables indicated that according to median survival the HD emerged inACUWm and ACUWf in a younger age (47.5 ± 0.6 and 50.7 ± 0.7 years old, respectively) vs. CGm or CGf (54.9 ± 1.1 and54.4 ± 1.1 years, respectively). The same was true for CHD where the median values were (56.8 ± 0.5), (61.2 ± 0.8),(61.6 ± 1.0) and (64.2 ± 1.4) years respectively. Review of cumulative incidence of HD and CHD revealed no associ-ation of the PDE4D gene rs966221 polymorphism with the diseases of concern. The TT gene carrier state comparedto the CC or CT genes features an increased risk of myocardial infarction (MI) 2.9 times in ACUWm, 4-fold in CGm, and5.5 times in CGf (p < 0.05). No any gene carrier state was associated with MI in the ACUWf. Onset of menopause wasfollowed by an increase in HD incidence vs. males. CONCLUSIONS: The male and female ChNPP ACUW were developing HD and CAD at a younger age compared with cor-responding non-irradiated control. In male ACUW in comparison with female ACUW the cumulative morbidity ratefor MI was higher in any age range, whereas for CAD it was higher from 23 to 74 years, and for HD from 25 to 53 yearsof age. In male and female ACUW as well as in non-irradiated control the HD developed much earlier than CHD. Thecarrier state of TT genotype of PDE4D gene rs966221 polymorphism increases the risk of MI in males of all ages, inthe non-irradiated controls it is increased in 65 years for men and in 60 years for women. No data on association ofthe genotype of the described gene polymorphism with MI were found in female ACUW.

Analysis of some risk factors for myocardial infarction in a cohort of the Chornobyl clean-up workers (according to the data of Clinical and Epidemiological Registry).

UNLABELLED: The objective of the paper was to analyze the individual risk factors for coronary heart disease in a group of clean-up workers, who had developed a myocardial infarction (MI) after the Chornobyl NPP accident. METHODS: Data of 525 clean-up workers with a first MI event were analyzed among all uniquely identifiable clean-up workers registered in the Clinical and Epidemiological Registry (CER) of NRCRM. The comparison was carried out with a control group of 110 residents of Kyiv, who had MI within 2004-2009. RESULTS: It was found that the proportion of patients who had MI under 45 years was increased in the first 10 years after the Chornobyl accident, being first of all due to the age structure of the clean-up worker's cohort as a whole. The distribution of patients by age in the following years was close to that in the other MI cohorts described in the literature. The external radiation dose of men who developed MI in the first 5 years after the Chornobyl NPP accident was 39.58 ± 6.72 cSv (median 25 cSv) which exceeded the dose of men who had got the MI later (23.78 ± 2.43 cSv, median 12 cSv; p=0.009). CONCLUSIONS: The quantity of the male patients with minimum number of risk factors was gradually reducing along with time since the Chornobyl accident and accordingly the proportion of patients with three or more risk factors was increased (p=0.001). Incidence of obesity and hypercholesterolemia among male clean-up workers was higher than in the control group of male inhabitants of Kyiv.