Clinical and epidemiological features of chronic liver disease among the East Kazakhstan residents exposed to radiation from the Semipalatinsk nuclear weapons test site

Zauresh Zhumadilova, N. R. Barkibaeva, Nurlan Aukenov, Kassym Laura Talgatkyzy, Assiya A. Kussainova, Yu Shakhvorostova, A M Grjibovski

2014

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DOI 10.1093/eurpub/cku166.117
Data confidence 70 medium
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Abstract

Background The East Kazakhstan is a territory with radioecological distress caused by nuclear weapons tests performed from 1949 to 1989 at the former Semipalatinsk Test Site. The individual effective doses of external exposure in these areas range between 250-500 mSv. The goal of the study is epidemiological assessment of the chronic liver diseases in the region adjacent to the Semipalatinsk Nuclear Test Site. Methods A cros-sectional study. A total of 2510 people were examined in the radiation risk zones. Those subjected to radiation exposure were overwhelming majority – 85.18% (2138 people). After the screening in order to verify the diagnosis we determined serological markers of viral, autoimmune liver diseases, assessed the lipid peroxidation and antioxidant status, investigated immune-cytokine profile. The age of the chronic liver diseases (CLD) in the region was stratified which allowed estimating the dose-dependent effects of ionizing radiation as a possible etiologic factor in the CLD formation. Results The screening totally found 295 patients with chronic liver diseases. In the pathology structure, a non-alcoholic fatty liver disease (NFLD) was prevalent with 57.98%, the age-stratification revealed NFLD prevalence in the descendants of those who had been subjected to ionizing radiation, in 3rd generation along with the high frequency of circulatory system diseases and endocrine pathology. The prevalence of autoimmune liver disease was 19% among the descendants of the second generation, the incidence – 39.96 cases per 10,000 population. Regardless of the CLD form, immunological abnormalities, underlying the progression of liver disease, were determined in all patients. So even with NFLD an increase in circulating immune complexes by 1.4 times, decrease of CD3+ and CD4+ by 16% and 19% (p˂0.05) respectively were registered. Conclusion Ionizing radiation may influence the clinical and epidemiological patterns of cronic liver disease and contribute to disease progression. Key message Ionizing radiation may influence the clinical and epidemiological patterns of cronic liver disease and contribute to disease progression.