Endocrine Abstracts

Objective was to analyze the place of endocrine and metabolic disorders among other comorbid diseases in the Chernobyl accident emergency workers (EW) who had cardiovascular diseases as main pathology.

Materials and methods

The health state was analyzed in 420 male EW, who worked at the Chernobyl NPP at 1986–1987 yrs, and 188 males not exposed to ionizing radiation (the control group, CG). Patients of both groups had a hospital treatment due to cardiovascular pathology during 2011–2019 yrs. For estimation of comorbid diseases the Cumulative Illness Rating Scale (CIRS) was used.

Results

The CIRS total score was significantly higher in EW comparing with CG (10.3 ± 2.9 vs 8.8 ± 3.0 units, P = 0.000). According to relative number of patient with revealed pathology of different CIRS categories, ’Endocrine/metabolic and breast’ ranks 5 following ’Heart’ (1), ’Neurological’ (2), ’Vascular’ (3) and ’Musculoskeletal and skin’ (4) systems. The rest 7 categories (we did not analyze ’Psychiatric illness’) had less patients with corresponding organ systems diseases. In ’Endocrine…’ category mild problems (score 1) was revealed in 34.8% EW, moderate problems (score 2) in 15% and severe/extremely severe (score 3–4) in 6.2% EW. Regardless of score number EW did not differ from CG patients (29.8, 13.8 and 5.9% correspondingly). For comparison in CIRS category ’Heart’ patients with score 1 was 43.6% EW vs 45.7% CG (P > 0.05), score 2–19.5% vs 22.3% (P > 0.05) and score 3–4 – 35.2% vs 26.6% (P < 0.05). By mean score calculated for every category ’Endocrine…’ ranks 4 (0.8 ± 0.9 in both EW and CG, P = 0.293) following ’Vascular’ (2.5 ± 0.8 in EW and 2.3 ± 1.0 in CG, P = 0.06), ’Heart’ (1.9 ± 0.9 in EW and 1.7 ± 0.9 in CG, P = 0.024) and ’Neurological’ (1.6 ± 0.8 in EW and 1.1 ± 1.0 in CG, P = 0). Amongst endocrine and metabolic disorders diabetes mellitus, thyroid gland goiters and obesity govern score presence but the score value was determined by diabetes mellitus severity course and body mass index. Thyroid gland goiters were frequent pathology as well but with mild course.

Conclusions

In patients with cardiovascular diseases as main pathology comorbid endocrine and metabolic disorders met sufficiently frequently in EW and non-irradiated patients and had high score value skipping ahead only cardiovascular, neurological and musculoskeletal diseases.

Keywords: emergency workers of the Chernobyl, cardiovascular disease, comorbidity, Cumulative Illness Rating Scale, endocrine and metabolic disorders.