DISEASES OF CIRCULATORY SYSTEM AND COMORBID TYPE II DIABETES MELLITUS IN THE CHORNOBYL ACCIDENT CONSEQUENCES CLEAN-UP WORKERS.

Abstract

The study was focused on evaluation of peculiarities of the clinical manifestations of type II diabetesmellitus (TIIDM) in the Chornobyl nuclear power plant (ChNPP) accident clean-up workers (ACUW). The ChNPP ACUW of 1986-1987 period (n = 449, males) and 158 males not exposed to ion-izing radiation (the control group, CG) were involved in the study in 2013-2018. Diagnosis of cardiovascular disease(CVD) and type II diabetes mellitus (TIIDM) was established in accordance with diagnostic standards adopted inUkraine. All study subjects had no signs of CVD, and neither of endocrine disease nor of metabolic disorders beforethe accident. Clinical course of the TIIDM, depending on the disease severity, onset of angiopathy and polyneuropathy,prevalence of angina pectoris and heart failure were surveyed and analyzed. Concomitant TIIDM was associated witha higher incidence of angina pectoris and heart failure. According to the Kaplan-Meier method of survival estimatingthe accumulation of new TIIDM cases occurred faster in the ACUW compared with individuals in the CG, however withno statistical significance in subjects aged up to 60 years old (log-rank test χ2 = 4.89, p = 0.027). Mean age of theACUW having comorbid CVD and DM was (54.6 ± 9.7) years, whilst in the CG it was (59.9 ± 10.7) years (p = 0.005). The DM course in the ACUW was not significantly different from non-irradiated control both in sever-ity and such complications as angiopathy of retina and lower extremities, as well as manifestations of lower extrem-ity polyneuropathy. Clinical manifestations of CVD in the form of angina pectoris and heart failure were identical inthe ACUW and control group of patients having a comorbid TIIDM. The latter was a factor exacerbating the CVDcourse and leading to a higher prevalence of angina pectoris and heart failure both in the ACUW and in non-irritat-ed individuals. Accumulation of the new DM cases occurred more rapidly in ACUW vs. non-irradiated control, so theywere in average 5 years younger at the time of TIIDM manifestation than the control subjects.