Violations of macro- and micronutrient support in patients with nodular thyroid pathology from regions injured after the Chornobyl accident

Main Article Content

V.I. Kravchenko
I.A. Luzanchuk
I.N. Andrusyshyna
O.M. Golinko
I.O. Golub

Abstract

Background. The purpose of our study was to determine the state of macro- and micronutrient support of patients with nodular thyroid pathology from the regions injured after the Chornobyl accident. Materials and methods. 65 habitants of the Chernihiv area were examined: 40 — without thyroid pathology (15 men and 25 women) aged 36.62 ± 0.60 years, and 25 (5 men and 20 women) — with the diagnosed nodular goiter. Results. Research of urinary iodine excretion showed that a median in the control group was 95.6 µg/l, among patients with nodular goiter — 89.3 µg/l, indicating the presence of moderate iodine deficiency. Blood thyroglobulin level in patients of control group was 9.26 ± 0.99 ng/l, among patients with nodular goiter — 23.03 ± 4.70 ng/l. Thyroid-stimulating hormone level higher than 4.0 mIU/l was in 8.9 % of patients with nodular goiter and in 5.0 % of persons from the control group. The data of ultrasonic researches demonstrated that the average thyroid volume in patients of control group was 10.1 ± 0.3 cm3, among patients with nodular goiter — 18.6 ± 1.7 cm3. In the group of patients with nodular goiter, the decreased (p < 0.0001) level of macronutrients in blood plasma was detected: calcium was 67.26 ± 3.21 µg/l and magnesium — 14.88 ± 0.35 µg/l, as well as of microelements: zinc content was 0.72 ± 0.04 µg/l (p < 0.0001) and iron — 0.54 ± 0.06 µg/l (p < 0.05), in comparison with the results in the control group. Conclusions. The relative risk (χ2 criterion for the four-course table of connectivity with Fisher’s correction) of nodular goiter development at subzero content of calcium was 2.24 (95% confidence interval (CI) 1.58–2.61), the risk of nodular goiter development at subzero levels of magnesium — 2.56 (95% CI 1.77–3.03).

Article Details

How to Cite
Kravchenko, V., I. Luzanchuk, I. Andrusyshyna, O. Golinko, and I. Golub. “Violations of Macro- and Micronutrient Support in Patients With Nodular Thyroid Pathology from Regions Injured After the Chornobyl Accident”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 13, no. 6, Oct. 2017, pp. 399-06, doi:10.22141/2224-0721.13.6.2017.112879.
Section
Original Researches

References

Oliynyk VA. Thyroid pathology in Ukraine (epidemiology and regional features. Zhurnal praktychnogo likarja.2001;2:5-7. (in Ukrainian).

Knudsen N1, Laurberg P, Perrild H, Bülow I, Ovesen L, Jørgensen T. Risk factors for goiter and thyroid nodules. Thyroid. 2002 Oct;12(10):879-88. doi: 10.1089/105072502761016502.

Pisarikova B, Herzig I, Riha J. Inorganic anions with a potential goitrogenic effect in drinking water supply for humans and animals. Vet Med (Praha). 1996 Feb;41(2):33-9. PMID: 8629316. (in Czech).

Scanelli G. Lithium thyrotoxicosis. Report of a case and review of the literature. Recenti Prog Med. 2002 Feb;93(2):100-3. PMID: 11887342. (in Italian).

Brix TH, Kyvik KO, Hegedus L. Major role of genes in the etiology of simple goiter in females: a population-based twin study. J Clin Endocrinol Metab. 1999 Sep;84(9):3071-5. doi: 10.1210/jcem.84.9.5958.

Knudsen N1, Bülow I, Laurberg P, Ovesen L, Perrild H, Jørgensen T. Parity is associated with increased thyroid volume solely among smokers in an area with moderate to mild iodine deficiency. Eur J Endocrinol. 2002 Jan;146(1):39-43. PMID: 11751065.

Krohn K, Fuhrer D, Bayer Y, et al. Molecular pathogenesis of euthyroid and toxic multinodular goiter. Endocr Rev. 2005 Jun;26(4):504-24. doi: 10.1210/er.2004-0005.

Avcyn AP, Zhavoronkov AA, Rysh MA, et al. Human microelementosis: etiology, classification. Moscow: Medgiz; 1991. 96 p. (in Russian).

Galkina NV, Mazurina NV, Trishina EA. Diffuse euthyroid goiter: epidemiology, etiology and pathogenesis, a role of genetic factors in its development, and treatment. Problems of Endocrinology. 2006;4(52):49-56. (in Russian).

Tliashinova AM, Rustambekova SA. The multicomponent system in the development of thyroid diseases (iodine and endo-exogenous factors). Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2006;2(4):71-4. (in Russian).

Veldanova MV. Role of some strumogenic environmental factors in the origin of goiter epidemic. Trace Elements in Medicine. 2000;1(1):17-25. (in Russian).

Paschke R. Molecular pathogenesis of nodular goiter. Langenbecks Arch Surg. 2011 Dec;396(8):1127-36. doi: 10.1007/s00423-011-0788-5.

Hansen PS, Brix TH, Bennedbaek FN, Bonnema SJ, Kyvik KO, Hegedüs L. Genetic and environmental causes of individual differences in thyroid size: a study of healthy Danish twins. J Clin Endocrinol Metab. 2004 May;89(5):2071-7. doi: 10.1210/jc.2003-031999.

Everett LA, Glaser B, Beck JC, et al. Pendred syndrome is caused by mutations in a putative sulphate transporter gene (PDS). Nat Genet. 1997 Dec;17(4):411-22. doi: 10.1038/ng1297-411.

Masmoudi S, Charfedine I, Hmani M. Pendred syndrome: phenotypic variability in two families carrying the same PDS missense mutation. Am J Med Genet. 2000 Jan 3;90(1):38-44. PMID: 10602116.

Fujiwara H, Tatsumi K, Miki K, et al. Recurrent T354P mutation of the Na+/I- symporter in patients with iodide transport defect. J Clin Endocrinol Metab. 1998 Aug;83(8):2940-3. doi: 10.1210/jcem.83.8.5029.

Matsuda A, Kosugi S. A homozygous missense mutation of the sodium /iodide symporter gene causing iodide transport defect. J Clin Endocrinol Metab. 1997 Dec;82(12):3966-71. doi: 10.1210/jcem.82.12.4425.

Gydee H1, O'Neill JT, Patel A, Bauer AJ, Tuttle RM, Francis GL. Differentiated thyroid carcinomas from children and adolescents express IGF-I and the IGF-I receptor (IGF-I-R). Cancers with the most intense IGF-I-R expression may be more aggressive. Pediatr Res. 2004 Apr;55(4):709-15. doi: 10.1203/01.PDR.0000111282.98401.93.

Yeh MW, Rougier JP, Park JW, et al. Differentiated thyroid cancer cell invasion is regulated through epidermal growth factor receptor-dependent activation of matrix metalloproteinase (MMP)-2/gelatinase. Endocr Relat Cancer. 2006 Dec; 13(4): 1173-83. doi: 10.1677/erc.1.01226.

Balabolkin MI. Solved and unsolved problems of endemic goiter and iodine deficiency states (lecture). Problems of endocrinology. 2005;4(51):31-7. (in Russian).

Tronko MD, Kravchenko VI, Bertolini R, et al. Iodine supplementation and goiter endemia among children in Northern Ukraine. Zhurnal NAMN Ukrai'ny. 2003;9(1):52-61. (in Ukrainian).

Kravchenko VI, Myroniuk NI, Turchyn VI, Luzanchuk IA, Tkachuk LA. The dynamics of iodine status in northern oblasts of Ukraine contaminated as a result of the Chornobyl accident. Endokrynologia. 2006; 11(1):124-33. (in Ukrainian).

Kravchenko VI, Luzanchuk IA. Problem of iodine deficiency in Zhytomyr region 20 years after the Chernobyl accident. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2007;1(7):29-31. (in Ukrainian).

Tronko MD, Mabuchi K, Kravchenko VI, et al. Iodine status and thyroid exposure doses in victims of Chernobyl nuclear accident who are permanent residents of northern regions of Ukraine (Ukrainian-American cohort study). Zhurnal NAMN Ukrai'ny. 2013;19(3):355-64. (in Ukrainian).

Dunn JT, Grutchfield HE, Gutekunst RD, et al. Methods for measuring iodine in urine. Amsterdam, Netherlands: International Council for Control of Iodine Deficiency Disorders; 1993. 71 p.

World Health Organization, UNICEF, ICCIDD. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. 3rd ed. Geneva: WHO; 2007. 97 p.

Brunn J, Block U, Ruf G, Bos I, Kunze WP, Scriba PC. Volumetric analysis of thyroid lobes by real-time ultrasound (author's transl). Dtsch Med Wochenschr. 1981 Oct 9;106(41):1338-40. doi: 10.1055/s-2008-1070506. (in German).

Tsyb AF, Parshin VS, Nestaiko GV, et al. Ultrasound diagnostic of thyroid diseases. Мoscow: Meditsina; 1997. 332 p. (in Russian).

Andrusyshyna IM, Lampeka OG, Golub IO. Comparative evaluation of spectral methods for the detection of macro and microelements in human biological samples. Aktual'ni problemy transportnoi' medycyny. 2009;18(4):75-83. (in Ukrainian).

Andrusyshyna IM, Lampeka OG, Golub IO, Lubjanova IP, Harchenko TD. Methodological recommendations 72.14 / 133.14. Evaluation of violations of mineral exchange in professional contingents by the method of atomic emission spectrometry with an inductively coupled plasma. Kyi'v: Avicena; 2014. 60 p. (in Ukrainian).

Vlasov VV. Introduction to evidential medicine. Moscow: Medya Sfera; 2001. 392 p. (in Russian).

Biglkhol R, Bonita R, K'el'strem T. Bases of epidemiology. Geneve: WHO; 1994. 259 p. (in Russian).

Liakh IuE, Gur'ianov VG. Analysis of the results of medical-biological research and clinical trials in the specialized statistical package MEDSTAT. Vestnik gigieny i epidemiologii. 2004;8(1):155-67. (in Russian).

Koch W, Karim MR, Marzec Z, Miyataka H, Himeno S, Asakawa Y. Dietary intake of metals young adult population of Eastern Poland: Result from a market basket study. J Trace Elem Med Biol. 2016 May;35:36-42. doi: 10.1016/j.jtemb.2016.01.007.

Gietka-Czernel M, Dębska M, Kretowicz P, et al. Iodine status of pregnant women from central Poland ten years after introduction of iodine prophylaxis programme. Endokrynol Pol. 2010 Nov-Dec;61(6):646-51. PMID: 21104637.

Giray B, Arnaud J, Sayek I, Favier A, Hincal F. Trace element status in multinodular goiter. J Trace Elem Med Biol. 2010 Apr;24(2):106-10. doi: 10.1016/j.jtemb.2009.11.003.

Farkhutdinova LM, Nikulicheva VI, Speranskii VV. Clinical and pathogenetic value of microelements in the development of thyroid pathology. Perm Medical Journal. 2006;18(2):6-13. (in Russian).