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患有2型糖尿病的“碘期”切尔诺贝利核电站事故清理工作人员血清中脂联素总量的含量(文献综述与研究数据)

Serum content of total adipionectin in the ChNPP accident clean up workers of the «iodine period» suffering from type 2 diabetes mellitus (literature review and research data).

作者信息

Dombrovska N S, Pleskach O Ya

机构信息

State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine.

出版信息

Probl Radiac Med Radiobiol. 2017 Dec;22:353-371.

Abstract

OBJECTIVE

assay of the total adiponectin level in the ChNPP accident clean up workers (ACUW) of the «iodine peri od» exposed to ionizing radiation in a young age and suffering now from type 2 diabetes mellitusMaterials and methods. The Chernobyl Nuclear Power Plant accident clean up workers (ACUW) of the iodine period (n=111) exposed to ionizing radiation at a young age (18-35 years) were examined in two groups: Group I (main study group, n=66) of persons with type 2 diabetes mellitus (DM) and Group II (comparison group, n=45) of persons with normal glucose challenge test results. Total radiation doses varied in the range of 10.0-860.0 mSv. Group III (nosological control group, n=20) included persons suffering type 2 DM but not exposed to ionizing radiation (IR) and Group IV were apparently healthy. All study groups were representative by the age. Anthropometric data and parameters of glycemic control were assayed. Index of the homeostatic model for assessing insulin resistance (HOMA IR) was calculated. Level of total adiponectin was assayed by the immune enzyme method. Statistical pro cessing of the data was carried out using Missrosoft® Exxel 2002 software.

RESULTS AND CONCLUSIONS

Serum concentration of total adiponectin in the Chornobyl NPP ACUW of the iodine peri od and suffering type 2 DM despite having normal body weight or overweight or any degree of obesity was signifi cantly lower compared to apparently healthy persons ACUW with and normal glycemic control. Moderate negative correlation was found between the level of total adiponectin and degree of obesity in the ACUW suffering type 2 DM (t = 0.367, p <0.05). With an increase in the duration of the disease there was a decrease in serum concentration of total adiponectin in the Chornobyl NPP ACUW of iodine period suffering type 2 DM and in the group of nosologi cal control. The most favorable type of glycemic profile was peculiar for patients in the main group with higher lev els of total serum adiponectin and the lowest body mass index (up to 25 kg/m2). An increase in the body mass index was accompanied by an adverse combination of abnormalities in glycemic metabolism (increased glucose concen tration, IRI, and HbA1c), insulin resistance (a significant increase in HOMA) against the background of a decrease in concentration of total adiponectin. No significant differences were found in adiponectin levels in dose subgroups. At the same time, the reliable differences between the main group and comparison group were found in the 2-5th dose subgroups, which are due to differences in numbers of people with metabolic syndrome (obesity) in the groups.

摘要

目的

检测年轻时遭受电离辐射且目前患有2型糖尿病的切尔诺贝利核电站事故清理人员(ACUW)的总脂联素水平。

材料与方法。对年轻时(18 - 35岁)遭受电离辐射的碘时期切尔诺贝利核电站事故清理人员(n = 111)进行分组检查:第一组(主要研究组,n = 66)为患有2型糖尿病(DM)的人员,第二组(对照组,n = 45)为葡萄糖耐量试验结果正常的人员。总辐射剂量在10.0 - 860.0 mSv范围内。第三组(疾病对照组,n = 20)包括患有2型糖尿病但未遭受电离辐射(IR)的人员,第四组为明显健康的人员。所有研究组在年龄方面具有代表性。检测人体测量数据和血糖控制参数。计算评估胰岛素抵抗的稳态模型指数(HOMA IR)。采用免疫酶法检测总脂联素水平。使用Microsoft® Exxel 2002软件对数据进行统计处理。

结果与结论

碘时期切尔诺贝利核电站事故清理人员且患有2型糖尿病,无论其体重正常、超重或肥胖程度如何,其血清总脂联素浓度均显著低于血糖控制正常的明显健康的事故清理人员。在患有2型糖尿病的事故清理人员中,总脂联素水平与肥胖程度之间存在中度负相关(t = 0.367,p <0.05)。随着疾病持续时间的增加,碘时期切尔诺贝利核电站事故清理人员且患有2型糖尿病的人群以及疾病对照组的血清总脂联素浓度均下降。主要组中血清总脂联素水平较高且体重指数最低(高达25 kg/m²)的患者具有最有利的血糖谱类型。体重指数增加伴随着血糖代谢异常(血糖浓度、胰岛素释放指数和糖化血红蛋白增加)、胰岛素抵抗(HOMA显著升高)的不良组合,同时总脂联素浓度降低。在剂量亚组中脂联素水平未发现显著差异。与此同时,在第2 - 5剂量亚组中发现主要组与对照组之间存在可靠差异,这是由于各组中代谢综合征(肥胖)患者数量的差异所致。

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