[No influence of urinary nitrate excretion on the goitre prevalence in Germany].
BACKGROUND
It has long been known that nitrate combined with iodiduria < 100 micro gI(-)/l has a goitrogenic effect. The cause is a partial blockage of the sodium- iodide symporter together with a hindrance to iodide absorption in the intestine. 90% of the intake of nitrate is excreted in urine. Therefore nitraturia provides information about the population. The rare epidemiological studies of the influence of NO(3)(-) on goitre are limited to a small selection of older, regional samples. Our aim was to investigate the role of nitrate in the occurrence of goitre in Germany.


METHODS
Using random samples from 3,059 clinically healthy persons of both sexes between 18 and 70 years old from all over Germany, we examined nitraturia and the prevalence of goitre or nodules, including the corresponding iodiduria. (Sonography: 7.5 MHz linear transducer; nitrate determination: isocratic ion chromatography; iodide determination: cerium-arsenite method.) Both the NO(3)(-) and the iodide excretion in spontaneous urine were measured in relation to 1 g creatinine. Statistical processing: Mann-Whitney U-Test, correlation analysis, multivariate linear regression analysis.


RESULTS
Median for nitraturia: 55.2 mg NO(3)(-)/g creatinine (men 61.5, women 51.5; p < 0.03). Significant increase in regional nitrate excretion from North to South and from East to West. No statistical connection between nitraturia, thyroid size and nodules. In the multivariate linear regression analysis relating to thyroid size/focal lesions, NO(3)(-) played the smallest part among the variables age, gender, body mass index, iodiduria, nitraturia. In the case of iodiduria with < 50 micro g I(-)/g creatinine (n = 71), there was a correlation between nitraturia and thyroid size (r = 0.18; p < 0.05). All persons with a nitraturia of > 60 mg NO(3)(-)/g creatinine (n = 1,166) evidenced a correlation with the thyroid size (r = 0.18; p < 0.01).


CONCLUSIONS
Since alimentary iodine shortage in Germany has been overcome to a large extent (iodiduria 100-200 micro gI(-)/l) and the nitrate content lies clearly below the WHO limit, the goitrogenic effect of nitrate is only of individual and not of epidemiological importance. The slight regional differences in NO(3)(-) excretion are the consequence of the nitrate content in drinking water and have no effect on the thyroid gland.
Klinik für Innere Medizin, Abteilung für Endokrinologie und Stoffwechselkrankheiten, Universität Rostock, Rostock. rainer.hampel@ med.uni-rostock.de
Rainer
R
Hampel
Helmut
H
Zöllner
Anne
A
Glass
Raik
R
Schönebeck
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006043:Goiter, Endemic / Q000453:epidemiology* / Q000652:urine; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000652:urine*; D012307:Risk Factors; D027981:Symporters / Q000037:antagonists & inhibitors; D000099209:Sodium-Iodide Symporters
D009566:Nitrates; D027981:Symporters; D000099209:Sodium-Iodide Symporters