ABSTRACT
OBJECTIVE: To assess the metabolic processes in bone tissue and state of thyroid gland depending on iron metabolism parameters in children of pre-pubertal, pubertal and post-pubertal age, living on radiologically contaminated territories after the ChNPP accident. MATERIALS AND METHODS: Children (n = 119) aged 6 to 18 years were examined and the 4 study groups were formed, featuring the childhood, pre-pubertal, pubertal and post-pubertal life periods. Clinical symptoms, iron metabolism parameters (serum iron (SI) and ferritin (SF) content, transferrin saturation coefficient), parameters of bone tissue metabolism (serum creatinine and alkaline phosphatase (APh)), and amino acid content in urine were taken into account. Functional state of thyroid, titers of antibodies to thyroperoxidase (TPOAb) and thyroglobulin (TgAb) were assayed. Results and their discussion are presented depending on the age of children, biochemical parameters of blood, iron metabolism findings, thyroid gland function and individualized radiation doses. RESULTS: In 13.4 % of pubertal and post-pubertal children an elevated content of SI and SF was observed. APh levels were increased in 20.2 % of children (758.9 ± 16.3 U/l) being directly correlated with SI levels (rs = 0.50; Ñ < 0.01). In 16.3 % of children of pubertal and post-pubertal age, in whom the level of SI was above 27 µmol/l, a direct correlation with serum thyroid-stimulating hormone (TSH) level was established in case of the hormone content above 2.5 mU/l (rs = 0.50; Ñ < 0.05). Serum creatinine level directly correlated with glycine content in urine (rs = 0.70), which is a part of collagen, and inversely correlated with serum APh (rs = -0.47), (Ñ < 0.05). Under the levels of SI higher than (15.1 ± 1.2) µmol/l and SF higher than (87.5 ± 6.4) ng/ml, the TPOAb titer was higher than at lower iron concentrations (U-test = 64.5, Ñ < 0.05). The TgAb titer directly correlated with SI (rs = 0.39) and TSH (rs = 0.81) levels (Ñ < 0.01). The average effective radiation dose in children was (0.75 ± 0.10) mSv. A direct correlation was established between the child's radiation dose and age (rs = 0.33; Ñ < 0.05). CONCLUSIONS: Bone metabolism depends on the age of children, characteristics of pubertal period, excess of iron in the body, and functional state of thyroid system, which is involved in collagen formation and protein metabolism.
Subject(s)
Bone and Bones , Ferritins , Iron , Thyroid Gland , Child , Humans , Bone and Bones/metabolism , Creatinine , Ferritins/blood , Thyroid Gland/metabolism , Thyrotropin , Chernobyl Nuclear Accident , Adolescent , Iron/bloodABSTRACT
OBJECTIVE: to establish the relationship between quantitative and qualitative parameters of peripheral blood cells(lymphocytes, neutrophilic granulocytes, monocytes, platelets) depending on the type of somatic diseases andannual internal radiation doses from 137Cs in children - residents of radiologically contaminated territories in thelate period after the Chornobyl Nuclear Power Plant (ChNPP) accident. MATERIALS AND METHODS: There were 175 children included in the study comprising residents of radiologically con-taminated territories (n = 79) aged from 4 to 18 years. Annual internal radiation doses in children from 137Cs rangedfrom 0.004 to 0.067 mSv. Certain blood parameters were assessed in a comparative mode in children having got theradiation doses up to 0.01 mSv and higher. The comparison group (n = 96) included children living in settlementsnot attributed to the radiologically contaminated ones. Incidence and type of somatic diseases and its impact onquantitative and qualitative changes in blood parameters (i.e. lymphocyte, neutrophilic granulocyte, monocyte, andplatelet count) were studied. The cell size, state of nucleus, membranes and cytoplasm, signs of proliferative anddegenerative processes were taken into account. RESULTS: Incidence and type of somatic diseases in children did not depend on the annual internal radiation dose.Number of cases of monocytosis was significantly higher among the children exposed to ionizing radiation than inthe comparison group (16.6 % vs. 7.3 %). There were, however, no correlation between these changes and radiationdoses. Number of activated blood monocytes with cytoplasmic basophilia and residues of nucleoli in nuclei washigher in individuals with internal radiation doses > 0.01 mSv. A direct correlation between the qualitative param-eters of monocytes and internal radiation doses was established (rs = 0.60; Ñ < 0.001), as well as a direct correlationof different strength between qualitative parameters of blood cells, indicating their unidirectional pattern depend-ing on the somatic morbid conditions. Regardless of annual internal radiation dose, there was an increase in thenumber of degenerative and aberrant cells vs. the comparison group (Ñ < 0.05), which could be due to the role ofnon-radiation factors. CONCLUSIONS: Results of the assessment of quantitative and qualitative parameters of peripheral blood cells reflect-ed the state of morbid conditions in children and are of a diagnostic value. The identified dose-dependent changesin monocyte lineage of hematopoiesis may be the markers of impact of long-term radionuclide incorporation withfood in children living in environmentally unfavorable conditions after the ChNPP accident.
Subject(s)
Blood/radiation effects , Chernobyl Nuclear Accident , Hematologic Diseases/blood , Hematologic Diseases/physiopathology , Radiation Exposure/adverse effects , Radiation Injuries/blood , Radiation, Ionizing , Thyroid Gland/radiation effects , Adolescent , Child , Child, Preschool , Female , Humans , Male , Radiation Injuries/physiopathology , Radiation Monitoring/statistics & numerical data , Ukraine/epidemiologyABSTRACT
OBJECTIVE: To determine the influence of iron metabolism on the prognosis of acute lymphoblastic (ALL) and (AML)myeloblastic leukemia at the different phases of chemotherapy in children after Chоrnobyl accident. MATERIALS AND METHODS: 333 children (295 - ALL, 38 - AML) were examined at the stages of chemotherapy. Thecomparison group included 93 children without leukemia. Acute leukemia variants, patients survival, relapses, thenature of disease (live child or died), iron methabolism (morphometric parameters of erythrocytes, SI, SF, STf, TS),manifestations of dyserythropoiesis, bone marrow sideroblast and patients radiation dose were taken into account. RESULTS: In 295 patients with ALL the following variants of leukemia were established: pro-B-ALL in 23, «common¼type of ALL in 224, pre-B-ALL in 29, T-ALL in 19. Thirty eight patients were diagnosed with AML (11 - M1, 19 - M2,8 - M4). Doses of radiation in patients with AL were (2.78 ± 0.10) mSv and they did not correlate with clinical andhematological parameters, disease variant. Relapse rates and shorter survival were in patients with T-ALL, pro-B-ALLand AML with SF levels > 500 ng/ml (p < 0.05). The amount of children with normochromic-normocytic anemias andmanifestations of dysplasia of erythroid lineage elements was greater in the AML than in ALL. SF content in patientswas elevated during chemotherapy and was lower than the initial one only in the remission period. Transferrin wasreliably overloaded with iron: TS (70.2 ± 2.3) % compared with the control group (32.7 ± 2.1) %. Correlationbetween TS and survival of patients was detected (rs = -0.45). Direct correlation between the number of iron granules in erythrocariocytes and SF level (rs = 0.43) was established, indicating the phenomena of ineffective erythropoiesis. CONCLUSIONS: The negative influence of iron excess in the patients body on the hemopoiesis function, manifestations of ineffective erythropoiesis and the course of acute leukemia in children have been established. Changes inferrokinetic processes in children can be the basis of leukemоgenesis development.
