A county-level spatial epidemiological study of hair selenium and Keshan disease

Yuehui Jia; Guijin Li; Ruixiang Wang; Chen Feng; Lei Qi; Yuanyuan Wang; Shengqi Su; Yuanjie Zou; Xu Liu; Yanan Wang; Yiyi Zhang; Linlin Du; Huixin Sun; Shuxiu Hao; Jie Hou; Hongqi Feng; Qi Li; Tong Wang

doi:10.3389/fnut.2022.1011460

A county-level spatial epidemiological study of hair selenium and Keshan disease

Front Nutr. 2022 Nov 7:9:1011460. doi: 10.3389/fnut.2022.1011460. eCollection 2022.

Authors

Yuehui Jia^{1

2}, Guijin Li¹, Ruixiang Wang¹, Chen Feng¹, Lei Qi¹, Yuanyuan Wang¹, Shengqi Su¹, Yuanjie Zou^{1

3}, Xu Liu⁴, Yanan Wang^{1

5}, Yiyi Zhang^{1

6}, Linlin Du¹, Huixin Sun¹, Shuxiu Hao¹, Jie Hou¹, Hongqi Feng¹, Qi Li⁷, Tong Wang¹

Affiliations

¹ Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, Harbin, China.
² School of Public Health, Qiqihar Medical University, Qiqihar, China.
³ Institute of Environmental and Occupational Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China.
⁴ Department of Emergency Management, Yidu Central Hospital of Weifang, Weifang, China.
⁵ School of Public Health and Management, Binzhou Medical University, Yantai, China.
⁶ Department of Food Hygiene, Yantai Disease Prevention and Control Center, Yantai, China.
⁷ Department of Gynecological Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China.

Abstract

Background: No spatial analysis of hair selenium and Keshan disease (KD) on a nationwide county-level has been performed. Selenium deficiency is a recognized environmental risk factor for KD. Hair selenium is one of the recognized biomarkers of selenium nutrition. This study aimed to perform a geographically precise and visualized assessment of the achievement of KD prevention and control at the level of selenium nutrition in terms of etiology.

Methods: A spatial ecological study was conducted. The hair selenium content of the residents was assayed using an atomic fluorescence spectrometer. The spatial analysis was performed using ArcGIS.

Results: The median of the hair selenium levels of the 3,028 participants in the 1,174 counties was 0.38 mg/kg, and the content of inhabitants in KD endemic counties was significantly lower than that in KD non-endemic counties (0.34 vs. 0.39 mg/kg, z = -10.03, P < 0.0001). The proportion of Se-deficient and Se-marginal counties in KD endemic counties was significantly higher than that in KD non-endemic counties (59.4 vs. 29.0%, z = -7.45, P < 0.0001). The global autocorrelation analysis was not statistically significant (Moran's I = 0.0005, P = 0.68). Local autocorrelation analysis identified 174 low-low clusters of hair selenium levels, 83 (47.7%) of which are KD endemic counties located in KD endemic provinces of Henan, Gansu, Shaanxi, Inner Mongolia, Jilin, and Heilongjiang. The hair selenium featured a positive correlation with per capita GDP (r _s = 0.20, P < 0.0001).

Conclusion: The median of the hair selenium levels of inhabitants living in KD endemic counties was significantly lower than that in KD non-endemic counties. All the 83 KD endemic counties with low-low clusters of hair selenium levels should be prioritized in KD precision prevention and control. These findings are geographically precise and visualized evidence of the assessment of the effectiveness of KD prevention and control at the level of selenium nutrition in terms of etiology.

Keywords: Keshan disease; hair selenium; precision assessment; small area study; spatial autocorrelation analysis.