Abstract

Introduction. Excessive intake of heavy metals of natural origin with drinking water increases the risk of the formation of non-infectious diseases of systems and organs, depending on the tropism of the chemical compound. The aim is to study the incidence of disorders of bone density and structure (osteopathies) in children and adolescents who consume drinking water with an increased strontium content due to the geochemical characteristics of the territory. Materials and methods. The observation group consisted of 93 children living in a geochemical province with a stable strontium content of more than 2 MPC in the centralized drinking water supply system. The comparison group included 148 children living in an area where strontium concentration in drinking water does not exceed 1 MPC. The incidence evaluation was carried out according to the official data of statistical materials. The analysis of the average values of the concentration in the blood of strontium, ionized calcium, inorganic phosphorus and alkaline phosphatase activity and the frequency of deviations from the norm of the studied parameters was carried out in the studied groups. The value of bone mineral density (Z-index) was determined according to the results of ultrasonic densitometry. Results. The level of long-term incidence of osteopathies for the period 2010-2019 in children and adolescents, the observation area was 6.59 ± 1.32 and 11.26 ± 2.07 ‰, respectively, which was 1.8 and 2.0 times higher than the level of the comparison territory (p = 0.0003-0.0004 ). The concentration of strontium in the blood of children living in the territory of the geochemical province exceeded 2.1 times the permissible reference (p <0.001) and 2.9 times the index of the comparison group (p = 0.0001). In ¾ children of the observation group, increased content of strontium in the blood was recorded, which was 5.2 times more often than the comparison area (p <0.001). In 57% of cases, the children of the observation group had a reduced level of ionized calcium in the blood (p = 0.0001). Low bone mineral density (Z-index) in the observation group occurred 2.3 times more often (17.2 versus 7.4%, p = 0.019). Significant dependences were established by lowering the level of ionized calcium and the value of the Z-index with increasing strontium content in the blood. Conclusion. In children living in geochemical provinces with an elevated strontium content, an increase in the incidence of osteopathy was noted, manifested by a reduced level of ionized calcium in the blood and low bone mineral density, which must be taken into account for the timely diagnosis and prevention of these conditions.

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