Introduction. The relevance of the research is attributed to the increased incidence of autoimmune thyroiditis in children, especially those dwelling in contaminated areas. Our objective was to study effects of environmental exposures to industrial chemicals on the course of autoimmune thyroiditis. Materials and methods. In order to establish the relationship between specific features of the course of autoimmune thyroiditis and adverse environmental exposures, we conducted a comparative study of incidence rates of thyroid diseases including thyroiditis, cytotoxicity testing, thyroid status assessment, antioxidant activity assays, and thyroid ultrasound. The observation group consisted of 98 children living the area with the developed metallurgical industry while the comparison group included 23 children living in a recreation area. The groups were matched by age and socio-economic characteristics. Results. We established that thyroiditis incidence rates in the industrially polluted area were almost thrice as high as those in the relatively clean area. The observation group was characterized by smoothed sexual differentiation, earlier development of the autoimmune thyroiditis, higher (up to 1.6 times) frequency of typical diffuse structural changes, and increased thyroid gland. Blood levels of metals having a direct cytotoxic effect on the thyroid gland were 2.0 to 6.7 times higher than normal in the cases compared to their matched controls. The correlation and regression analysis established contribution of chemicals to the increased incidence of autoimmune thyroiditis in children (zinc), antibodies to thyroid gland tissue (lead), thyroid-stimulating hormone (nickel), and decreased resistive indices (lead). Conclusion. High blood levels of lead, nickel and zinc were among the factors having an adverse effect on the course of AIT and thyroid function.
Introduction. The combination of iodine deficiency and the negative impact of environmental factors determines the pathomorphism of thyroid diseases, including autoimmune thyroiditis (AIT). The purpose of the study was to establish clinical, laboratory, and ultrasound features of autoimmune thyroiditis in children living under the influence of metallurgical production. Materials and methods. AIT children residing in the zone of influence of the enterprises of the metallurgical industry (one hundred two cases) and outside the exposure zone (46 people) underwent a comparative analysis of the results of clinical and laboratory research, ultrasound imaging of thyroid gland tissues. Results. During the period 2010-2020, the increase in the incidence of thyroiditis in the territory with metallurgical production enterprises exceeded the average indicator in the Perm region by 1.5 times. Children from the test group had concentrations of lead, manganese, nickel, chromium and zinc in their blood higher than the regional background level. These elevated concentrations were detected in them by 1.7-5.5 times more frequent than in their counterparts from the reference group. The number of AIT cases elevated by 2 times in the exposed boys; diffuse lesions of the thyroid gland and combination of AIT with other diseases, by 1.3 times (p = 0.03-0.04). Levels of IgA and IgG in blood serum were by 2.7 times higher in the test group (p = 0.015-0.043); TSH contents, by 2.3 times higher (p = 0.096); free T4 contents, by 5.4 times lower (p = 0.057). Limitations of the study. Children living at the only one subject of the Russian Federation; a comparatively small sampling; selected study of compounds with direct thyreo-cytotoxic effects Conclusions. Incidence of thyroid gland diseases and thyroiditis in territories with developed metallurgic industry is higher than on territories with a relative favorable sanitary-hygienic situation. Children with elevated contents of metals in their blood had disorders of thyroid and immune status, thyroid gland disease and concomitant damage to other systems in the body. The mathematical relationships indicate the possible influence of metals on the formation of AIT.
Introduction. High loads, intensification of education, characterize the modern educational process and contribute to the negative dynamics of the health indices of modern schoolchildren. The aim of the study is to investigate the features of the autonomous and thyroid status of schoolchildren exposed to the different intensity of the educational process. Material and methods. The objects of the study were schoolchildren with the different intensity of the educational process, students of schools. Hygienic evaluation of the educational process was carried out taking into account the requirements of Sanitary Regulations and Norms 2.4.2.2821-10. The data analysis of the survey, laboratory studies, electrocardiography, cardiointervalography and ultrasound scanning of the thyroid gland was performed. Results. The reduction of the duration of small changes, the excess of the volume of daily and weekly academic load up to 20.0% with a comparative hygienic assessment of the educational process regimes, in schools with an in-depth study of the subjects of the physical and mathematical cycle. Characterized by a large expenditure of time on homework, shorter sleep, high involvement in the additional educational process for students of specialized schools. Arrhythmias were by 1.7 times more common in students of the physical and mathematical school. Relative risk increased by 4.6 times. The activity of the sympathetic part of the autonomic nervous system was found to be elevated in 50% of schoolchildren enrolled in an in-depth program. Violations of the volume and structure of the thyroid gland occurred up to 2.6 times more often. The relative risk of activating the synthesis of antibodies to thyroglobulin and thyroperoxidase was higher by 5.7 times. Relationships are established between the blood level of cortisol and the frequency of registration of arrhythmias, the degree of activation of antibody production, the parameters of the thyroid gland. Discussion. The obtained data are consistent with the results of domestic studies and can serve as the basis for expanding the list of studies during preventive medical examinations of minors. Conclusion. In educational institutions with in-depth study of the subjects of the physical and mathematical cycle, the educational process is more intensive, which leads to the activation of the sympathetic part of the autonomic nervous system, an increase in the risk of developing autonomic dysfunctions, arrhythmias, and thyroid status disorders.
The comparative analysis of thyroid status of students with different intensity of the educational process was carried out. It is established that educational process was more intense at school with profound studying of profile subjects due to the lack of the area falling on one pupil, the increased and irrationally distributed educational and extra-curricular loading. More pronounced disorders of thyroid metabolism and a fourfold increase in the relative risk of antibody formation to thyroid tissues were revealed in students of «innovative» schools. Changes in the volume and structure of the thyroid gland were detected up to 3.6 times more often in school students with advanced study subjects than in children of secondary school. Reliable connections are established between the number of antibodies to thyroperoxidase, thyroid volume and the content of MDA and cortisol.
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