Epidemiologic studies on the etiologic relationship of selenium and Keshan disease
Chinese Medical Journal 92(7): 477-482
1979
ISSN/ISBN: 0366-6999 PMID: 114372 Document Number: 148215
The distribution of Keshan disease shows a belt-like regional distribution throughout China and a focal distribution within the affected belt. The disease is generally found in hilly and mountainous country and nonsalted areas. There are safety islands surrounded by affected areas. These endemic epidemiologic characteristics are consistent with the hair Se level of the local people and the Se contents of their staple grains. All affected areas are relatively Se-poor. For various reasons, Se may play an important role in the etiology of Keshan disease whose occurrence is invariably associated with a lower hair Se content of the population, usually < 0.12 ppm. Wherever the level exceeds 0.2 ppm the district is free from this disease. Results of urinary Se loading tests and whole blood glutathione peroxidase activity measurements reveal that the populations in the affected areas are in a Se-poor status. Sodium selenite supplementation is effective in preventing Keshan disease. Absence of correlation between the seasonal prevalence of Keshan disease and the variations in hair Se contents suggest there may be other factors, including biologic agents. The interrelationships which may be present among the pathogenic factors of the disease are discussed.