A Spatial Ecology Study of Keshan Disease and Hair Selenium
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Few spatial ecological studies on hair selenium (Se) and Keshan disease (KD) have been reported. To investigate the relationships of hair Se with KD and economic indicators and to visualize the evidence for KD precise prevention. An ecological study design was employed. The levels of hair Se of 636 adult men (≥ 18 years old) living in rural, general cities and developed cities in 15 KD endemic provinces and 11 KD non-endemic provinces in mainland China were measured using hydride generation atomic fluorescence spectrometry. Spatial description and spatial analysis of hair Se were conducted. The subjects were adults aged. The hair Se level of the residents of KD endemic areas was 0.30 mg/kg, statistically significantly lower than that of non-endemic areas 0.34 mg/kg (Mann–Whitney U test, p = 0.007). The hair Se level of the 636 people was 0.33 mg/kg. The hair Se levels of the residents of the developed cities, general cities, and rural were 0.35 mg/kg, 0.33 mg/kg, and 0.32 mg/kg, respectively, with statistical significance (Kruskal–Wallis H test, P = 0.032). Spatial regression analysis showed that the spatial distribution of hair Se was positively correlated with per capita GDP. Selenium deficiency may still exist among residents living in the KD endemic areas. The results of spatial description and analysis of hair Se provided visualized evidence for targeting key provinces for precise prevention of Keshan disease, including assessment of KD elimination. The hair Se level of the mainland Chinese males was probably between 0.31 and 0.33 μg/g in 2015.
KeywordsKeshan disease Hair selenium Ecological study Spatial epidemiology Elimination assessment Precise prevention
The authors’ responsibilities were as follows—TW: designed the research, wrote the statistical analysis plan, and had primary responsibility for final content; XZ, SL, CY, JH, QL, HL, HZ, ZG, XH, ZW, HW, XG, CX, RZ, XC, YD, YW, and SH: conducted the research and collected the data; XZ: analyzed the data; XZ and TW: wrote the first draft of the manuscript; XZ and TW: interpreted the data; and all authors: contributed to writing and editing the manuscript and read and approved the final manuscript.
The study is supported by the National Natural Science Foundation of China (81773368, 81372938, and 81202154).
Compliance with Ethical Standards
Conflicts of Interest
The authors declare that they have no conflict of interest.
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