Correlation between secondary hyperparathyroidism and comorbid disorders among the Chornobyl NPP accident survivors

Main Article Content

I.M. Muraviova
I.G. Chykalova
D.E. Afanasyev
O.V. Kopylova
O.V. Kaminskyi
I.V. Ulianchenko
L.V. Rozhkivska
E.V. Tepla
O.O. Samoylov

Abstract

Background. Endocrine comorbidity, a concomitant radiation injury of several endocrine glands, is a topical issue in radiation medicine. The purpose of the study was to establish a correlation of secondary hyperparathyroidism with thyroid and pancreatic disorders among the Chornobyl nuclear power plant (NPP) accident survivors. Materials and methods. A blind sample (n = 60) of subjects treated at the radiation endocrinology department in 2019 was selected for the study. Study sample included the Chornobyl NPP accident survivors (group 1, n = 40) and patients not exposed to radiation (group 2, n = 20). The average age of people was 60.2 ± 9.8 years. Decompensation of type 2 diabetes was the most common cause for hospital admission (48.3 %), decompensation of hypothyroidism was in second place (46.7 %). Research methods: clinical, instrumental, laboratory, statistical. Results. Incidence of the increased risk of vitamin D deficiency and excessive parathyroid hormone production in the Chornobyl NPP accident survivors was somewhat higher than in individuals not exposed to radiation (81.08 and 78.12 %; χ2 = 0.257, p = 0.612; 31.12 and 28.08 %; χ2 = 0.462, p = 0.319, respectively). Using a multivariate analysis, the reliable model was obtained confirming the relationship of increased parathyroid hormone level and early subclinical signs of the target organ damage (F = 4.294; p = 0.042), which proves the relevance of using clinical questionnaires. A reliable positive correlation was found between the vitamin D and free thyroxine levels (r = 0.729; p = 0.001), and negative one was found with the thyroid-stimulating hormone content (r = –0.803; p = 0.001). In the Chornobyl NPP accident survivors with type 2 diabetes, a decreased vitamin D concentration correlated with an increased duration of metformin therapy (r = –0.421; p = 0.001) and body mass index (r = –0.787; p = 0.001). It was found that the parathyroid hormone level increases along with the duration of type 2 diabetes and an increase in creatinine clearance (r = 0.724; p = 0.001, and r = 0.799; p = 0.001). Conclusions. Vitamin D deficiency has a negative effect on the course of comorbid disorders (type 2 diabetes and hypothyroidism) and excessive production of parathyroid hormone.

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How to Cite
Muraviova, I., I. Chykalova, D. Afanasyev, O. Kopylova, O. Kaminskyi, I. Ulianchenko, L. Rozhkivska, E. Tepla, and O. Samoylov. “Correlation Between Secondary Hyperparathyroidism and Comorbid Disorders Among the Chornobyl NPP Accident Survivors”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 2, Mar. 2020, pp. 87-92, doi:10.22141/2224-0721.16.2.2020.201291.
Section
Original Researches

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