A County-Level Spatial Study of Serum Selenoprotein P and Keshan Disease

Yuehui Jia; Ruixiang Wang; Shengqi Su; Lei Qi; Yuanyuan Wang; Yanan Wang; Yuanjie Zou; Xu Liu; Yiyi Zhang; Jie Hou; Hongqi Feng; Qi Li; Tong Wang

doi:10.3389/fnut.2022.827093

A County-Level Spatial Study of Serum Selenoprotein P and Keshan Disease

Front Nutr. 2022 Jan 28:9:827093. doi: 10.3389/fnut.2022.827093. eCollection 2022.

Authors

Yuehui Jia¹, Ruixiang Wang¹, Shengqi Su¹, Lei Qi¹, Yuanyuan Wang¹, Yanan Wang^{1

2}, Yuanjie Zou^{1

3}, Xu Liu^{1

4}, Yiyi Zhang^{1

5}, Jie Hou¹, Hongqi Feng¹, Qi Li⁶, Tong Wang¹

Affiliations

¹ Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, Harbin, China.
² School of Public Health and Management, Binzhou Medical University, Yantai, China.
³ Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China.
⁴ Yidu Central Hospital of Weifang, Weifang, China.
⁵ Yantai Disease Prevention and Control Center, Yantai, China.
⁶ Third Affiliated Hospital of Harbin Medical University, Harbin, China.

Abstract

Background: Keshan disease (KD) is strongly associated with selenium deficiency. Selenoprotein P (SELENOP) is a recognized molecular biomarker of selenoproteins and an important indicator of selenium nutrition. This study was aimed at providing geographically precisely visualized evidence of selenium nutrition at molecular level for assessing KD prevention, control, and elimination on the etiological perspective.

Methods: We used spatial ecological design for this study. The serum SELENOP levels of the residents were measured by ELISA. ArcGIS version 9.0 was used for spatial description, spatial autocorrelation analysis of SELENOP levels and spatial regression with per capita disposable income.

Results: The mean serum SELENOP levels of the 6,382 residents in 1,688 counties were 4.62 ± 1.82 μg/mL. The mean serum SELENOP levels of the residents living in the townships and rural areas of KD endemic counties were not statistically significantly lower than those of the KD non-endemic counties. The mean serum SELENOP levels were globally clustered (Moran's I = 0.03, z = 6.37, and P < 0.0001), and 99.3% (553/557) of the cold spots, identified by local autocorrelation analysis (Getis-Ord-Gi^* analysis), were located in the KD endemic provinces of Shaanxi, Shanxi, Henan, Hebei, Shandong, Inner Mongolia, Gansu, Hubei, Chongqing, Yunnan, and Sichuan. The serum SELENOP level was positively correlated with per capita disposable income (t = 3.52, P = 0.0004).

Conclusions: The results of this study were the geographically precisely visualized evidence of selenium nutrition at molecular level for assessing KD elimination on the etiological perspective. The cold spot counties found by Getis-Ord-Gi^* analysis in the KD endemic provinces should be the high priority of KD precision prevention and control.

Keywords: Keshan disease; elimination assessment; precision prevention and control; selenoprotein P; spatial epidemiology.