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Vol. 21. Núm. 6.
Páginas 500-514 (Noviembre - Diciembre 2007)
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Vol. 21. Núm. 6.
Páginas 500-514 (Noviembre - Diciembre 2007)
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DOI: 10.1157/13112246
Open Access
Exposición a disruptores endocrinos y alteraciones del tracto urogenital masculino (criptorquidia e hipospadias)
Exposure to endocrine disruptors and male urogenital tract malformations [cryptorchidism and hypospadias]
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Mariana F. Fernández??
Autor para correspondencia
marieta@ugr.es

Correspondencia: Mariana F. Fernández Cabrera. Laboratorio de Investigaciones Médicas. Hospital Universitario San Cecilio. Avda. Dr. Oloriz, s/n. 18012 Granada. España.
, Begoña Olmos, Nicolás Olea
Laboratorio de Investigaciones Médicas, Hospital Universitario San Cecilio, Universidad de Granada, Granada, España
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Resumen
Antecedentes

Se ha sugerido que la exposición maternoinfantil a compuestos hormonalmente activos (disruptores endocrinos) tiene en la etapa intrauterina una de sus fases más comprometidas.

Objetivo

Revisar los estudios epidemiológicos, nacionales e internacionales, publicados entre 1990 y el primer trimestre de 2006, que tuvieran como hipótesis la asociación entre la exposición humana a disruptores endocrinos y el riesgo de criptorquidia e hipospadias.

Métodos

Se han buscado artículos en MEDLINE/PubMed mediante las palabras clave: disruptores endocrinos, xenoestrógenos, pesticidas organoclorados y criptorquidia e hipospadias. La selección de los 16 trabajos incluidos se hizo atendiendo al diseño y la población de estudio, las medidas de exposición empleadas, los criterios de exclusión e inclusión establecidos y el análisis estadístico utilizado.

Resultados y conclusiones

Aunque los estudios aquí revisados no son concluyentes para confirmar la asociación entre disruptores endocrinos y riesgo de malformación del tracto genitourinario, tampoco demuestran la falta de tal asociación. Por este motivo parece razonable sugerir que este aspecto de la patología hormonal debería investigarse más en profundidad, resolviendo, al menos, el diagnóstico adecuado de los individuos y la estimación de la exposición a múltiples compuestos químicos, contaminantes ambientales, que actúan conjuntamente a través de mecanismos similares a las hormonas endógenas.

Palabras clave:
Disruptores endocrinos
Estrógenos ambientales
Criptorquidia
Hipospadias
Factores de riesgo
Exposición ocupacional
Pesticidas
Revisión sistemática
Abstract
Background

It has been proposed that the intrauterine period of child-mother exposure to hormonally active compounds (endocrine disruptors) is of critical importance.

Objective

We reviewed all Spanish and English-language epidemiological studies published between 1990 and the first trimester of 2006 that studied the possible association between human exposure to chemical compounds and the risk of cryptorchidism and/or hypospadias.

Methods

The MEDLINE (PubMed) database was searched using the following key words: endocrine disruptors, organochlorine pesticides, xenoestrogens, cryptorchidism and hypospadias. Selection of the 16 studies included was based on the following criteria: study design and population, the measures of exposure used, inclusion and exclusion criteria, and the statistical analysis used.

Results and conclusions

Although the studies reviewed do not conclusively confirm the association between exposure to endocrine disruptors and the risk of male genital malformation, this association cannot be ruled out. Further in-depth investigation of this association is required. Issues that remain to be resolved are the diagnostic classification to be used and appropriate measurement of exposure to multiple chemical compounds and environmental contaminants that act conjointly through mechanisms similar to endogenous hormones.

Key words:
Endocrine disruptors
Environmental estrogens
Cryptorchidism
Hypospadias
Risk factors
Occupational exposure
Pesticides
Systematic rewiew
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