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切尔诺贝利事故清理工作人员循环系统疾病进展的性别差异与磷酸二酯酶4D基因rs966221多态性

GENDER DISPARITIES OF CIRCULATORY DISEASE PROGRESS IN THE CHORNOBYL ACCIDENT CLEAN-UP WORKERS AND PHOSPHODIESTERASE 4D GENE rs966221 POLYMORPHISM.

作者信息

Bilyi D O, Nastina O M, Sydorenko G V, Bilous N I, Kursina N V, Pleskach G V, Bazyka O D, Makarevysh O M, Kovaliov O S, Chumak A A, Abramenko I V

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. 2018 Dec;23:263-282. doi: 10.33145/2304-8336-2018-23-263-282.

Abstract

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.

摘要

目的

评估切尔诺贝利核电站(ChNPP)事故清理工作人员(ACUW)和未接触电离辐射人员中高血压疾病(HD)和冠心病(CHD)的进展情况,该评估基于磷酸二酯酶4D(PDE4D)基因rs966221多态性的性别和基因型。

材料与方法

自2013年至2018年,研究纳入了男性ACUW(ACUWm;n = 515)和女性ACUW(ACUWf;n = 145)。清理工作于1986 - 1987年进行。对照组包括未接触电离辐射的男性(CGm;n = 162)和女性(CGf;n = 120)。所有研究对象在ChNPP事故前均无HD或CHD的体征或症状。

结果

对Kaplan - Meier生存表的回顾表明,根据中位生存期,ACUWm和ACUWf出现HD的年龄较年轻(分别为47.5±0.6岁和50.7±0.7岁),而CGm或CGf为(分别为54.9±1.1岁和54.4±1.1岁)。CHD情况相同,其中位值分别为(56.8±0.5)、(61.2±0.8)、(61.6±1.0)和(64.2±1.4)岁。对HD和CHD累积发病率的回顾显示,PDE4D基因rs966221多态性与所关注疾病无关联。与CC或CT基因相比,TT基因携带者状态在ACUWm中发生心肌梗死(MI)的风险增加2.9倍,在CGm中增加4倍,在CGf中增加5.5倍(p < 0.05)。在ACUWf中,没有任何基因携带者状态与MI相关。绝经后HD发病率相对于男性有所增加。

结论

与相应的未受辐射对照组相比,ChNPP的男性和女性ACUW患HD和CAD的年龄更小。与女性ACUW相比,男性ACUW在任何年龄范围内MI的累积发病率更高,而CAD在23至74岁之间更高,HD在25至53岁之间更高。在男性和女性ACUW以及未受辐射的对照组中,HD比CHD发病更早。PDE4D基因rs966221多态性的TT基因型携带者状态增加了所有年龄段男性患MI的风险,在未受辐射的对照组中,男性在65岁、女性在60岁时风险增加。在女性ACUW中未发现所述基因多态性的基因型与MI相关的数据。

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