State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine.
Probl Radiac Med Radiobiol. 2020 Dec;25:374-389. doi: 10.33145/2304-8336-2020-25-374-389.
Elucidation of relationship between the levels of thyroid-stimulating hormone (TSH), free serum thyroxine, serum and urine cortisol and parameters of erythroid lineage of hematopoiesis to estimate the thyroid functionin children of prepubertal, pubertal, and postpubertal age permanently residing under a low-dose radiation exposureto determine the premorbid state of thyroid function.
Children aged 3 to 18 years old (n = 203) living in the most intensively radionuclide-contaminated regions of Kyiv, Zhytomyr and Chornihiv oblasts of Ukraine after the Chornobyl NPP accident wereenrolled. Complaints of ossalgia, arthralgia, fatigue, bone fractures in the history, bone dysembryogenetic stigmata,hypermobility syndrome degree, and types of somatic diseases were taken into account. Peripheral blood countparameters, biochemical indices of blood serum were studied, namely the levels of total protein, cholesterol, creatinine and alkaline phosphatase activity. Levels of the free thyroxine, pituitary TSH, serum and daily urine cortisol, anddoses of radiation exposure were determined.
The radiation dose values in children ranged from (0.35 ± 0.09) mSv to (0.54 ± 0.12) mSv. There was nodifference between the parameters of erythroid lineage of hematopoiesis depending on radiation dose. At the levels of serum TSH up to 1.0 μIU/ml no correlation was found with cortisol levels; at TSH levels of 1.0-3.0 μIU/ml thecorrelation coefficient was r = 0.31; at TSH levels higher than 3.0 μIU/ml the correlation coefficient was r = 0.61probably indicating a compensatory role of adrenal cortex in children at risk of thyroid disease development. In children with joint hypermobility grade II there was a higher incidence of dentofacial anomalies (χ2 = 6.9), deformitiesof lower extremities (χ2 = 6.9), and dental caries (χ2 = 4.3) (p < 0.05). There was a direct correlation between theserum TSH level (over 3 μIU/ml) and micrognathia (brachygnathia) (r = 0.62) indicating the impact of thyroid disease on dentofacial development. The TSH at a level of upper limit of the reference range values may contribute toa decreased RBC count in peripheral blood, increased average volume and hemoglobin content in erythrocyte beingassociated with the initial manifestations of thyroid dysfunction.
Abnormal endocrine regulation of hematopoiesis affects the connective tissue, stromal microenvironment of bone marrow, and accordingly the erythroid branch of hematopoiesis in children, which may be relevant inthe development and course of oncohematological diseases.
阐明促甲状腺激素 (TSH)、游离血清甲状腺素、血清和尿液皮质醇水平与造血红细胞系参数之间的关系，以评估永久性低剂量辐射暴露的青春期前、青春期和青春期后儿童的甲状腺功能，确定甲状腺功能的发病前状态。
共纳入乌克兰基辅、日托米尔和切尔尼戈夫地区受切尔诺贝利核电站事故影响的 3 至 18 岁儿童 203 名。考虑了骨骼疼痛、关节痛、疲劳、骨折史、骨骼发育不良迹象、高活动度综合征程度和躯体疾病类型等因素。研究了外周血计数参数和血清生化指标，即总蛋白、胆固醇、肌酐和碱性磷酸酶活性水平。测定游离甲状腺素、垂体 TSH、血清和每日尿皮质醇水平以及辐射暴露剂量。
儿童的辐射剂量值在（0.35±0.09）mSv 至（0.54±0.12）mSv 之间。造血红细胞系的参数与辐射剂量无关。在血清 TSH 水平达 1.0μIU/ml 时，与皮质醇水平无相关性；在 TSH 水平为 1.0-3.0μIU/ml 时，相关系数 r=0.31；在 TSH 水平高于 3.0μIU/ml 时，相关系数 r=0.61，这可能表明在有发生甲状腺疾病风险的儿童中，肾上腺皮质发挥了代偿作用。在关节活动度 II 级的儿童中，牙颌面畸形（χ2=6.9）、下肢畸形（χ2=6.9）和龋齿（χ2=4.3）的发生率更高（p<0.05）。血清 TSH 水平（超过 3μIU/ml）与小下颌（短颌）之间存在直接相关性（r=0.62），表明甲状腺疾病对牙颌面发育有影响。TSH 在上限参考范围值可能导致外周血红细胞计数减少，红细胞平均体积和血红蛋白含量增加，与甲状腺功能障碍的初始表现相关。
造血的内分泌调节异常影响儿童的结缔组织、骨髓基质微环境，进而影响造血的红细胞系，这可能与血液系统肿瘤性疾病的发生和病程相关。
