Relación deltre hipotiroidismo subclínico y bocio con el origen del agua consumida por una población del conurbano bonaerense / Relationship of subclinical hypothyroidism and goiter with the origin of water consumed by a population of the Buenos Aires suburbs

El hipotiroidismo subclínico (HS), elevación de tirotrofina con hormonas tiroideas normales, junto al bocio, aumentó la frecuencia en las últimas décadas. Con el objetivo de relacionar la prevalencia de bocio y HS con el consumo de agua subterránea como factor de riesgo etiológico poblacional, se analizaron 879 historias clínicas de un centro médico de Glew, en el conurbano bonaerense Sur. Se estudió la población según edad (20-60 y 12-19 años) y tipo de agua consumida (potabilizada o napa subterránea). El agua subterránea fue consumida por el 70.5% del grupo de 20 a 60 años (n = 559, 79.9% mujeres) y por el 66.3% del grupo de 12 a 19 años (n = 57, 81.4% mujeres). En el grupo de 20 a 60 años la prevalencia de HS en consumidores de agua potabilizada y subterránea fue del 1% y 57.8% (p < 0.0001) y la de bocio de 3.8% y 38.9% (p < 0.0001), respectivamente; con un riesgo atribuible al agua subterránea de 57% para HS y 35% para bocio. En el grupo de 12 a 19 años, la prevalencia de HS fue 6.9% y 52.6% (p < 0.0001) y de bocio 13.8% y 77.2% para los grupos de agua potabilizada y subterránea, (p < 0.0001) respectivamente; con un riesgo atribuible al agua subterránea de 46% para HS y 61% para bocio. El análisis fisicoquímico mostró presencia de nitratos (entre 24 y 83 mg/l) en aguas de pozos y ausencia en agua potable. La prevalencia aumentada de HS y bocio podrían deberse a la acción disruptora tiroidea de los nitratos.

Subclinical hypothyroidism (SH), elevation of the level of thyrotrophin with normal thyroid hormones, along with goiter (glandular size > 25g), increased in recent decades. In order to relate the prevalence of goiter and SH with the consumption of groundwater, as a population etiological risk factor, we analyzed 879 clinical histories from a medical center in the city of Glew in the South Buenos Aires suburbs. The population was studied according to age (20 to 60 and 12 to 19 years) and type of water consumed (potable water or groundwater). Groundwater was consumed by 70.5% of the group from 20 to 60 years old (n = 559, 79.9% women) and by 66.3% of the group from 12 to 19 years old (n = 57, 81.4% women In the group of 20 to 60 years, the prevalence of SH in potable water and groundwater users was 1% and 57.8% (p < 0.0001) and the goiter rate of 3.8% and 38.9% (p < 0.0001) respectively; with an attributable risk to groundwater of 57% for HS, and 35% for goiter In the group of 12 to 19 years, the prevalence of SH was 6.9% and 52.6% (p < 0.0001) and goiter 13.8% and 77.2% for the water and groundwater groups (p>0.0001) respectively, with an attributable risk of 46% for HS y 61% for goiter. The physicochemical analysis showed the presence of nitrates in the range of 24 to 83 mg/l in groundwater and absence in potable water. The increased prevalence of HS and goiter could be due to the thyroid disrupting action of nitrates.

[Relationship of subclinical hypothyroidism and goiter with the origin of water consumed by a population of the Buenos Aires suburbs]. / Relación del hipotiroidismo subclínico y bocio con el origen del agua consumida por una población del conurbano bonaerense.

Subclinical hypothyroidism (SH), elevation of the level of thyrotrophin with normal thyroid hormones, along with goiter (glandular size > 25g), increased in recent decades. In order to relate the prevalence of goiter and SH with the consumption of groundwater, as a population etiological risk factor, we analyzed 879 clinical histories from a medical center in the city of Glew in the South Buenos Aires suburbs. The population was studied according to age (20 to 60 and 12 to 19 years) and type of water consumed (potable water or groundwater). Groundwater was consumed by 70.5% of the group from 20 to 60 years old (n = 559, 79.9% women) and by 66.3% of the group from 12 to 19 years old (n = 57, 81.4% women In the group of 20 to 60 years, the prevalence of SH in potable water and groundwater users was 1% and 57.8% (p < 0.0001) and the goiter rate of 3.8% and 38.9% (p < 0.0001) respectively; with an attributable risk to groundwater of 57% for HS, and 35% for goiter In the group of 12 to 19 years, the prevalence of SH was 6.9% and 52.6% (p < 0.0001) and goiter 13.8% and 77.2% for the water and groundwater groups (p > 0.0001) respectively, with an attributable risk of 46% for HS y 61% for goiter. The physicochemical analysis showed the presence of nitrates in the range of 24 to 83 mg/l in groundwater and absence in potable water. The increased prevalence of HS and goiter could be due to the thyroid disrupting action of nitrates.