Jie Hou1, Lifang Zhu2, Cuicui Chen3, Hongqi Feng4, Dandan Li5, Shuqiu Sun6, Zhifeng Xing7, Xiaoyan Wan8, Xiuhong Wang9, Feng Li10, Xianni Guo11, Peisheng Xiong12, Shengcheng Zhao13, Shujuan Li14, Jinming Liu15, Dianjun Sun16. 1. Institute of Keshan Disease, Chinese Center for Endemic Disease Control and Prevention, Harbin Medical University, Harbin 150081, China. Electronic address: houjie@ems.hrbmu.edu.cn. 2. Institute of Keshan Disease, Chinese Center for Endemic Disease Control and Prevention, Harbin Medical University, Harbin 150081, China. Electronic address: 1270086954@qq.com. 3. Harbin Medical University, Harbin 150081, China. Electronic address: 1572003277@qq.com. 4. Institute of Keshan Disease, Chinese Center for Endemic Disease Control and Prevention, Harbin Medical University, Harbin 150081, China. Electronic address: fenghongqi@ems.hrbmu.edu.cn. 5. Institute of Keshan Disease, Chinese Center for Endemic Disease Control and Prevention, Harbin Medical University, Harbin 150081, China. Electronic address: lidandan0109@163.com. 6. Institute of Keshan Disease, Chinese Center for Endemic Disease Control and Prevention, Harbin Medical University, Harbin 150081, China. Electronic address: sunshuqiu1964@hotmail.com. 7. Heilongjiang Center for Disease Control and Prevention, Harbin 150030, China. Electronic address: xzf_china@163.com. 8. The Second Institute for Endemic Disease Control and Prevention of Jilin Province, Jilin 132000, China. Electronic address: 1013721543@qq.com. 9. Institute of Endemic Disease Control and Prevention in Shandong Province, Jinan 250014, China. Electronic address: wangxh1966@126.com. 10. Sichuan Center for Disease Control and Prevention, Chengdu 610041, China. Electronic address: cdclifeng@163.com. 11. Institute for Endemic Disease Control and Prevention of Shaanxi Province, Xi'an 710082, China. Electronic address: 155086499@qq.com. 12. Hubei Center for Disease Control and Prevention, Wuhan 430079, China. Electronic address: 85799025@qq.com. 13. Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850000, China. Electronic address: zhaoshengcheng_520@163.com. 14. Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China. Electronic address: shujuanwy@163.com. 15. Inner Mongolia Comprehensive Center for Disease Control and Prevention, Huhehot 010031, China. Electronic address: jinming413@126.com. 16. Chinese Center for Endemic Disease Control and Prevention, Harbin Medical University, Harbin 150081, China. Electronic address: hrbmusdj@163.com.
Abstract
PURPOSE: The prevalence of Keshan disease (KD) is low and has reached controlled or eliminated levels even in counties that had a high KD prevalence in the past. Few nationwide surveys on selenium levels in KD areas have been conducted in the past 2 decades. We conducted a cross-sectional study to investigate the selenium levels and their association with KD control and prevention in areas where KD is prevalent. METHODS: We collected 2143 human-hair, 698 soil, 701 rice, 607 flour, 521 corn, and 330 other-food samples from 49 counties with KD and 19 non-KD counties of nine KD provinces of China. The selenium content of samples was examined with hydride generation atomic fluorescence spectrometry. The difference in selenium levels between the KD and non-KD areas was analyzed. Cochran-Armitage trend tests were used to evaluate the association between selenium levels and KD control. RESULTS: The selenium levels in human hair, soil, staple foods, and other foods in the KD areas (0.2996 mg/kg, 0.1380 mg/kg, 0.0190 mg/kg and 0.0076 mg/kg, respectively) were lower than those in the non-KD areas (0.3700 mg/kg, 0.1930 mg/kg, 0.0240 mg/kg and 0.0165 mg/kg, respectively). The Cochran-Armitage tests showed that there was a trend for the selenium standard ratio in the counties to increase in the order of KD uncontrolled, to controlled, to eliminated (Z = 2.229, P < 0.05). CONCLUSION: The residents in the KD areas were found to be selenium-deficient. Improving the supply of staple foods containing selenium levels exceeding 0.025 mg/kg and abundant foodstuffs might contribute to KD control and prevention.
PURPOSE: The prevalence of Keshan disease (KD) is low and has reached controlled or eliminated levels even in counties that had a high KD prevalence in the past. Few nationwide surveys on selenium levels in KD areas have been conducted in the past 2 decades. We conducted a cross-sectional study to investigate the selenium levels and their association with KD control and prevention in areas where KD is prevalent. METHODS: We collected 2143 human-hair, 698 soil, 701 rice, 607 flour, 521 corn, and 330 other-food samples from 49 counties with KD and 19 non-KD counties of nine KD provinces of China. The selenium content of samples was examined with hydride generation atomic fluorescence spectrometry. The difference in selenium levels between the KD and non-KD areas was analyzed. Cochran-Armitage trend tests were used to evaluate the association between selenium levels and KD control. RESULTS: The selenium levels in human hair, soil, staple foods, and other foods in the KD areas (0.2996 mg/kg, 0.1380 mg/kg, 0.0190 mg/kg and 0.0076 mg/kg, respectively) were lower than those in the non-KD areas (0.3700 mg/kg, 0.1930 mg/kg, 0.0240 mg/kg and 0.0165 mg/kg, respectively). The Cochran-Armitage tests showed that there was a trend for the selenium standard ratio in the counties to increase in the order of KD uncontrolled, to controlled, to eliminated (Z = 2.229, P < 0.05). CONCLUSION: The residents in the KD areas were found to be selenium-deficient. Improving the supply of staple foods containing selenium levels exceeding 0.025 mg/kg and abundant foodstuffs might contribute to KD control and prevention.