Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Comorbid Conditions in Persons Exposed to Ionizing Radiation and Veterans of the Soviet-Afghan War: A Cohort Study in Kazakhstan

  • Saule Sarkulova (Department of Internal Diseases with Course of Nephrology, Hematology, Allergy and Immunology, Astana Medical University) ;
  • Roza Tatayeva (Department of General Biology and Genomics, L. N. Gumilyov Eurasian National University) ;
  • Dinara Urazalina (Central Clinical Hospital for Veterans of the Patriotic War of the Ministry of Health of the Republic of Kazakhstan) ;
  • Ekaterina Ossadchaya (Department of General Biology and Genomics, L. N. Gumilyov Eurasian National University) ;
  • Venera Rakhmetova (Department of Internal Diseases with Course of Nephrology, Hematology, Allergy and Immunology, Astana Medical University)
  • Received : 2023.07.24
  • Accepted : 2023.10.06
  • Published : 2024.01.31
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Abstract

Objectives: This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet-Afghan war. Methods: This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet-Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations. Results: Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population. Conclusions: The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet-Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.

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References

  1. Vance D, Larsen KI, Eagerton G, Wright MA. Comorbidities and cognitive functioning: implications for nursing research and practice. J Neurosci Nurs 2011;43(4):215-224. https://doi.org/10.1097/JNN.0b013e3182212a04 
  2. Ekusheva EV. Elderly patient with comorbid pathology in the practice of a cardiologist. RMJ Med Rev 2018;11(2):26-29 (Russian). 
  3. Pokrovsky YV, Tetenev FF. Comorbidity in medical practice. Sib Med Rev 2015;4:5-10 (Russian).  https://doi.org/10.20333/25000136-2015-4-5-10
  4. Kabdrakhmanov K. Human consequences of nuclear weapons tests in Kazakhstan. Almaty: Olke; 2003, p. 46 (Russian). 
  5. Nikiforov AM. Medical consequences of the Chornobyl accident. Saint Petersburg: Petersburg State University; 2005, p. 229-233 (Russian). 
  6. Rudnitskiy VA, Semke VY, Garganeeva NP. Neuro-mental disorders associated with concomitant somatic disorders in Chernobyl accident emergency workers. Russ Psychiatr J 2010;6:34-40 (Russian). 
  7. Suskov II, Kuz'mina NS, Suskova VS, Baleva LS, Sipiagina AE. The problem of induced genome instability as the basis of the increased morbidity in children exposed to low-intensity radiation at low doses. Radiats Biol Radioecol 2006;46(2):167-177 (Russian). 
  8. Raghunathan D, Khilji MI, Hassan SA, Yusuf SW. Radiation-induced cardiovascular disease. Curr Atheroscler Rep 2017;19(5):22. https://doi.org/10.1007/s11883-017-0658-x 
  9. Stepanova IeI, Berezovs'kyĭ VIa, Kolpakov IE, Kondrashova VH, Lytvynets' OM. Endothelium dependent vascular reactivity and autonomic homeostasis in children living in radiation-contaminated areas. Lik Sprava 2013;(2):32-38 (Ukrainian). 
  10. Azizova T, Briks K, Bannikova M, Grigoryeva E. Hypertension incidence risk in a cohort of Russian workers exposed to radiation at the Mayak Production Association over prolonged periods. Hypertension 2019;73(6):1174-1184. https://doi.org/10.1161/HYPERTENSIONAHA.118.11719 
  11. Markabayeva A, Bauer S, Pivina L, Bjorklund G, Chirumbolo S, Kerimkulova A, et al. Increased prevalence of essential hypertension in areas previously exposed to fallout due to nuclear weapons testing at the Semipalatinsk test site, Kazakhstan. Environ Res 2018;167:129-135. doi: https://doi.org/10.1016/j.envres.2018.07.016 
  12. Land CE, Kwon D, Hoffman FO, Moroz B, Drozdovitch V, Bouville A, et al. Accounting for shared and unshared dosimetric uncertainties in the dose response for ultrasound-detected thyroid nodules after exposure to radioactive fallout. Radiat Res 2015;183(2):159-173. https://doi.org/10.1667/RR13794.1 
  13. Ron E, Brenner A. Non-malignant thyroid diseases after a wide range of radiation exposures. Radiat Res 201;174(6):877-888. https://doi.org/10.1667/RR1953.1 
  14. Lowe D, Raj K. Premature aging induced by radiation exhibits pro-atherosclerotic effects mediated by epigenetic activation of CD44 expression. Aging Cell 2014;13(5):900-910. https://doi.org/10.1111/acel.12253 
  15. Porovsky YV, Tetenev FF. Factors of inflammation and the state of the microcirculatory bed in patients exposed to low doses of ionizing radiation. Bull New Med Technol 2012;18(2):358-361 (Russian). 
  16. Telkova IL. Cardiovascular disease manifestations in Chernobyl liquidators: 25 years later. Clinico-analytical review. Cardiovasc Ther Prev 2012;11(3):62-69 (Russian). https://doi.org/10.15829/1728-8800-2012-3-62-69 
  17. Chaizhunusova N, Madiyeva M, Tanaka K, Hoshi M, Kawano N, Noso Y, et al. Cytogenetic abnormalities of the descendants of permanent residents of heavily contaminated East Kazakhstan. Radiat Environ Biophys 2017;56(4):337-343. https://doi.org/10.1007/s00411-017-0717-2 
  18. Grosche B, Lackland DT, Land CE, Simon SL, Apsalikov KN, Pivina LM, et al. Mortality from cardiovascular diseases in the Semipalatinsk historical cohort, 1960-1999, and its relationship to radiation exposure. Radiat Res 2011;176(5):660-669. https://doi.org/10.1667/rr2211.1 
  19. Semenova Y, Pivina L, Belikhina T, Manatova A, Abisheva A, Ainabekova E, et al. Mortality due to cerebrovascular accidents in East Kazakhstan over the period of 2013-2017. Eur J Public Health 2018;28(suppl_4):cky218.164. https://doi.org/10.1093/eurpub/cky218.164 
  20. Ivanov VK, Maksiutov MA, Chekin SIu, Petrov AV, Tsyb AF, Biriukov AP, et al. The radiation risks of cerebrovascular diseases among the liquidators. Radiats Biol Radioecol 2005;45(3):261-270 (Russian). 
  21. Ungvari Z, Podlutsky A, Sosnowska D, Tucsek Z, Toth P, Deak F, et al. Ionizing radiation promotes the acquisition of a senescence-associated secretory phenotype and impairs angiogenic capacity in cerebromicrovascular endothelial cells: role of increased DNA damage and decreased DNA repair capacity in microvascular radiosensitivity. J Gerontol A Biol Sci Med Sci 2013;68(12):1443-1457. https://doi.org/10.1093/gerona/glt057 
  22. Pivina LM, Semenova YM, Rakhypbekov TK, Dyussupov AA, Belikhina TI, Manatova AM. Prevalence of depression in the offspring of people exposed to radiation in East Kazakhstan: Almira Manatova. Eur J Public Health 2017;27(suppl_3):ckx189.196. https://doi.org/10.1093/eurpub/ckx189.196 
  23. Krantz DS, Shank LM, Goodie JL. Post-traumatic stress disorder (PTSD) as a systemic disorder: pathways to cardiovascular disease. Health Psychol 2022;41(10):651-662. https://doi.org/10.1037/hea0001127 
  24. Ungvari Z, Pacher P, Csiszar A. Can simvastatin promote tumor growth by inducing angiogenesis similar to VEGF? Med Hypotheses 2002;58(1):858-856. https://doi.org/10.1054/mehy.2001.1465 
  25. Okassova AK, Ilderbayev OZ, Nursafina AZ, Zharmakhanova GM, Rakhimova BB, Yessilbaeva BT, et al. Evaluation of lipid peroxidation under immobilization stress in irradiated animals in experiment. Open Access Maced J Med Sci 2021;9(A):119-122. https://doi.org/10.3889/oamjms.2021.5781 
  26. Mel'nychuk DO, Hryshchenko VA. Exchange of bile pigments under the action of ecopathogenic factors on organism. Ukr Biochem J 2014;86(5):156 (Ukrainian). 
  27. Chulenbayeva L, Ilderbayev O, Suleymeneva D, Kaliyeva A, Kabdykanov S, Nurgaziyev M, et al. Prolonged inhalation exposure to coal dust on irradiated rats and consequences. ScientificWorldJournl 2022;2022:8824275. https://doi.org/10.1155/2022/8824275 
  28. Stepanov V, Vagaitseva K, Kharkov V, Cherednichenko A, Bocharova A, Berezina G, et al. Forensic and population genetic characteristics of 62 X chromosome SNPs revealed by multiplex PCR and MALDI-TOF mass spectrometry genotyping in 4 North Eurasian populations. Leg Med (Tokyo) 2016;18:66-71. https://doi.org/10.1016/j.legalmed.2015.12.008 
  29. Abil'dinova GZh, Kuleshov NP, Sviatova GS. Chromosomal instability parameters in the population affected by nuclear explosions at the Semipalatinsk nuclear test site. Russ J Genet 2003;39:944-947. https://doi.org/10.1023/A:1025391109169 
  30. Ilderbayev O, Zharmakhanova G, Rakhyzhanova S, Musaynova A, Ilderbayeva G, Nursafina A, et al. Immune system response after immobilization stress in the background of ionizing radiation. Trends Sci 2022;19(13):4637. https://doi.org/10.48048/tis.2022.4637 
  31. Salimova AZ, Kutuev IA, Khusainova RI, Akhmetova VL, Sviatova GS, Berezina GM, et al. Analysis of ethnogeographic groups of Kazakhs based on nuclear genome DNA polymorphism. Russ J Genet 2005;41:794-800. https://doi.org/10.1007/s11177-005-0162-1 
  32. Chulenbayeva L, Ilderbayev O, Taldykbayev Z, Ilderbayeva G, Argynbekova A. Phytocorrection of immunological and biochemical changes in the combined impact of coal dust and high dose of radiation. Georgian Med News 2018;(Issue):141-150 (Russian). 
  33. Saade LJ, Tfayli A. Pneumonitis in non-small cell lung cancer patients receiving atezolizumab post chemo-radiation. Asian Pac J Cancer Prev 2023;24(3):737-740. https://doi.org/10.31557/APJCP.2023.24.3.737 
  34. Ilderbayeva G, Zhetpisbaev B, Ilderbayev О, Taldykbayev Zh, Bekeeva S. Metabolic processes of organism in remote period after the combined effects of radiation and emotional stress. Georgian Med News 2016;(250):76-82 (Russian).