The Aral Sea ecological disaster zone affects the health status of the population living in this zone. Biochemical parameters are indicators of the metabolic functionality of the body. The article presents data about the biochemical parameters of blood plasma in the male population living in the ecological crisis zone of the Aral Sea region. It is shown that when determining the majority of indicators of biochemical analysis within the physiological norm, there is a significant percentage of people with deviations in these indicators. Such data make it possible to assume about the factors that can affect the entire population and have massive manifestations. Certainly, these factors, include the negative impact of the environment on public health. An increase in gamma — glutamyltransferase was found in 41 % of the subjects, an increase in cholesterol in 38 % and an increase in triglycerides in 34 %. In the inhabitants of the Aral Sea, a correlation was found between the biochemical parameters of blood serum from the dose of chemicals. It was shown that long-term chemical load in the crisis zone of the Aral Sea region causes a deviation of protein metabolism. The results obtained indicate a significant percentage of people with metabolic stress in the process of adaptation to high chemical load.
Introduction
As a result of partial shallowing and drying of the Aral Sea, a technogenic biogeochemical province arose in the Aral Sea region of Kazakhstan [1]. One of the risk factors in the Aral Sea region is persistent chemical pollutants (POPs), which have the ability to influence metabolic processes in the human body, creating conditions for the development of various pathologies [2]. According to the comprehensive sanitary and hygienic assessment (2014 — 2016), the hazard index of environmental pollution in the city of Aralsk is at the level of 48 points, in accordance with this criterion, the territory belongs to the crisis zone [3].
Endotoxins can cause metabolic changes, which in turn is a pathogenetic link in the development of metabolic syndrome, multiple organ failure, and ischemic damage [4–5]. There is no doubt that the greatest effect in the prevention of organ disorders can be achieved at the initial stages, when prenosological mechanisms has a leading role in the pathogenesis of the disease process [6].
It is known that the detoxification of chemical xenobiotics mainly occurs in the liver. Changes in the activity of enzymes in the biological fluid (γ-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase) indicates a dysfunction of the hepatobiliary system. A decrease in the amount or function of hepatic metabolic enzymes (gamma-glutamyl transpeptidase, albumin, alanine aminotransferase, aspartate aminotransferase), indicates an increase in hydrolysis and a violation of biosynthetic processes in the liver. Due to the fact that these enzymes normally bind and remove all toxins during the transport and metabolic function, their reduction (hypoenzinomy) negatively affects the functional state of the body. As a result, there is an accumulation of non-neutralized xenobiotics and various metabolic products and, as a result, endotoxicosis develops. According to the literature data, indicators of biochemical blood test informatively show the severity of metabolic disorders and the degree of adaptation to stressful situations [5, 7–9].
Currently, metabolic disorders are considered as one of the risk factors in the development of many disorders and pathologies. This determines the relevance of the study of metabolic changes in the body in conditions of ecological trouble.
The aim of the work was to determine the state of the metabolic status of men living in the ecological crisis zone of the Aral Sea region.
Methodology
Biochemical blood tests were carried out for 13 parameters of blood plasma — alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), total amylase, total protein, glucose, gamma-glutamyl transferase (GGT), creatinine, urea, alkaline phosphatase (ALP), cholesterol, triglyceride acid (MC), uric acid, medium molecules. A total of 209 men living in the city of Aralsk were examined. Biochemical studies were performed on a StаrDust MC-15 semi-automatic analyzer (Germany, 2010) using reagents from «DyaSys».
To perform a biochemical blood test in men living in the city of Aralsk, a group was formed, which included persons meeting the following criteria: a) age from 18 to 69 years; b) male persons; c) living in the area for at least 10 years; d) having no contact with harmful working conditions.
The research materials were processed by mathematical and statistical methods using Statistica 10.0 software for statistical data processing. Statistical processing of the data included calculating the median, arithmetic means (M), standard errors of arithmetic means (m), confidence intervals (CI), and standard deviation for variables with normal distribution. Normality of distribution was checked by evaluating the Shapiro-Wilk test and the Kolmogorov-Smirnov test. To identify a linear relationship, Pearson's pair correlation coefficient was used for indicators with a normal distribution.
Results and Discussion
Biochemical studies of blood plasma of the male population aged 18–69 years living in the city of Aralsk are presented in Table 1 (quantitative analysis). A quantitative analysis showed that the average values of biochemical parameters in blood plasma of the male population living in the city of Aralsk were within the physiological norm, the exception was the average value of total protein, which exceeded the established norm by 3 units and amounted to 88 g/l. But it is worth noting that several indicators showed an excess of physiological norms at the upper limit of the confidence interval: asat — up to 39 U/L, total protein — up to 92 g/L, GGT — up to 43 U/L and triglycerides — up to 1.9 mmol/l.
Table 1 Biochemical parameters of blood plasma of the male population
living in the city of Aralsk (quantitative analysis)
Blood biochemical parameters (N=209) |
Physiological norms |
М |
CI |
Standard deviation |
ALAT |
Up to 40 units/l |
27 |
20±35 |
1.2 |
ASAT |
Up to 37 units/l |
30 |
24±39 |
1.2 |
Amylase |
Up to 110 units/l |
63 |
49±81 |
1.7 |
Total Protein |
65–85 g/l |
88 |
83±92 |
0.6 |
Glucose |
4.2–6.2 mmol/L |
4.4 |
4.1±4.8 |
0.09 |
GGT |
7–32 units/l |
29 |
24±43 |
1.4 |
Creatinine |
62–115 mmol/l |
75 |
65±84 |
1.1 |
Urea |
1.7–8.3 mmol/l |
3.4 |
2.5±4.4 |
0.1 |
ALP |
Up to 117 units/l |
89 |
75±101 |
1.6 |
Cholesterol |
Up to 5.12 mmol/L |
4.8 |
4.3±5.8 |
0.2 |
Triglycerides |
0.14–1.82 mmol/L |
1.3 |
1±1.9 |
0.1 |
Uric acid |
202–416 mmol/L |
315 |
247±347 |
13.4 |
Medium molecules |
0.2–0.3 units/l |
0.3 |
0.2±0.9 |
0.1 |
Although the mean values were within the physiological norm, it is important to emphasize that this revealed a significant percentage of the subjects with deviations in several biochemical parameters. Frequency biochemical analysis of the blood of the adult male population living in the city of Aralsk aged 18–69 years has revealed that:
- an increase in the ALAT content was observed in 16 % of the examined individuals;
- an increase in ASAT in 27 %;
- an increase in total protein in 61 %;
- an increase in GGT in 41 %, an increase in cholesterol in 38 %;
- an increase in triglycerides in 34 %;
- an increase in medium molecules in 23 %.
There was also a decrease in the content of such biochemical parameters as glucose (28 % of the subjects), creatinine (14 % of the subjects), medium molecules (29 % of the subjects).
Thus, it can be noted that the biochemical parameters for which changes were most often found in frequency analysis are total protein, GGT, cholesterol and triglycerides (Table 2).
Table 2 Biochemical parameters of blood plasma of the male population
living in the city of Aralsk (frequency analysis)
Blood biochemical parameters (N=209) |
Physiological norms |
Percentage of examined, % М±m |
CI |
Standard deviation |
ALAT |
Up to 40 units/l |
|||
within normal limits |
84±2.5 |
84.6±83.9 |
6.4 |
|
above normal limits |
16±2.5 |
16.1±15.4 |
6.4 |
|
ASAT |
Up to 37 units/l |
|||
within normal limits |
73±3.1 |
78.8±66.6 |
9.5 |
|
above normal limits |
27±3.1 |
33.4±21.1 |
9.5 |
|
Amylase |
Up to 110 units/l |
|||
within normal limits |
94±1.6 |
94.5±94.0 |
2.6 |
|
above normal limits |
6±1.6 |
5.9±5.6 |
2.6 |
|
Total Protein |
65–85 g/l |
|||
within normal limits |
39±3.4 |
45.5±32.0 |
11.4 |
|
above normal limits |
61±3.4 |
67.9±54.5 |
11.4 |
|
Glucose |
4.2–6.2 mmol/L |
|||
within normal limits |
68±3.2 |
74.9±61.9 |
10.0 |
|
below normal limits |
28±3.1 |
33.9±21.5 |
10.0 |
|
above normal limits |
4±1.3 |
4.0±3.7 |
1.8 |
|
GGT |
7–32 units/l |
|||
within normal limits |
59±3.4 |
65.7±52 |
11.6 |
|
above normal limits |
41±3.4 |
47.9±34.3 |
11.6 |
|
Creatinine |
62–115 mmol/l |
|||
within normal limits |
85±2.5 |
85±84 |
6.2 |
|
below normal limits |
14±2.4 |
14.7±14.0 |
5.9 |
|
above normal limits |
1±0.7 |
1.1±0.9 |
0.5 |
|
Urea |
1.7–8.3 mmol/l |
|||
within normal limits |
95±1.5 |
94.9±94.5 |
2.4 |
|
below normal limits |
5±1.5 |
4.9±4.6 |
2.2 |
|
above normal limits |
0.5±0.5 |
0.6±0.4 |
0.2 |
|
ALP |
Up to 117 units/l |
|||
within normal limits |
86±2.4 |
86.5±85.8 |
5.7 |
|
above normal limits |
14±2.4 |
14.2±13.5 |
5.7 |
|
Cholesterol |
Up to 5.12 mmol/L |
|||
within normal limits |
62±3.4 |
68.4±54.9 |
11.3 |
|
above normal limits |
38±3.4 |
45.0±31.6 |
11.3 |
|
Triglycerides |
0.14–1.82 mmol/L |
|||
within normal limits |
64±3.3 |
70.7±57.5 |
11.0 |
|
below normal limits |
2±0.9 |
2.1±1.8 |
0.9 |
|
above normal limits |
34±3.3 |
40.5±27.4 |
10.7 |
|
Uric acid |
202–416 mmol/L |
|||
within normal limits |
83±2.7 |
83.2±82.4 |
7.1 |
|
below normal limits |
11±2.2 |
10.9±10.3 |
4.8 |
|
above normal limits |
7±1.8 |
6.8±6.3 |
3.1 |
|
Medium molecules |
0.2–0.3 units/l |
|||
within normal limits |
48±2.7 |
53.3±42.7 |
7.1 |
|
below normal limits |
29±2.4 |
34.1±24.4 |
5.9 |
|
above normal limits |
23±2.2 |
27.2±18.3 |
5.0 |
In 41 % of men, an increase in gamma-glutamyltransferase is observed, which indicates long-term exposure to chemical factors of «low intensity» and, as a reaction of the body, autosensitization processes are possible. A relationship was found between the GGT index and the dose load of sulfates received by inhalation (r = 0.3, p < 0 .05). Based on the revealed correlation, a predictive model was built y = 19.59 + 0.14x, regression coefficient R = 0.3, determination coefficient R2 = 0.052, Fisher coefficient F = 15.45, model estimate p <0.005.
A relationship was found between the urea indicator in people living in the crisis zone and the dose load of sulfur dioxide, which is inhaled (r = 0.31 , p < 0 .05). Based on the revealed correlation, a prognostic model was built at y = 2.41 + 0.02x, regression coefficient R = 0.311, determination coefficient R2 = 0.096, Fisher coefficient F = 60.29, model estimate p < 0.005.
As you know, GGT is a marker reflecting the work of the liver and hepatobiliary tract, including damage to cell membranes under the influence of toxic agents [10], and urea reflects the work of the kidneys and the degree of impairment of the filtration and excretory functions of the organ. Due to the fact that the processes of biotransformation of alien substances occur in the liver, gastrointestinal tract, lungs, kidneys, this can confirm the metabolic mechanisms of the formation of diseases caused by environmental exposure, and indicate the detected correlations [11].
Conclusions
Massive changes in the parameters of biochemical analysis indicate that the reason is extensive, and can affect the spread of traits in whole population. These reasons include the environmental impact of environmental factors on the health of the population, which is also confirmed by correlation analysis and literature data. Apparently, the change in some metabolic parameters in a certain part of the population occurs due to different variations in resistance to environmental environmental factors that affect the body. Because the exposure for each participant of study was the same, the body's reserves aimed at maintaining homeostasis are the key to functioning, neutralization and metabolic stability under conditions of living in unfavorable environmental conditions.
The results obtained indicate a significant tension of the metabolic status in the examined individuals in the process of adaptation to a high chemical load. According to the obtained data, the organs — targets in conditions of ecological trouble are the liver and kidneys, which is consistent with the literature data. Longterm chemical load in the crisis zone of the Aral Sea region in the exposed population, in particular, in persons of reproductive age, causes a violation of protein metabolism. The results obtained indicate a significant percentage of people with metabolic stress in the process of adaptation to high chemical load.
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