A spatial study on serum selenoprotein P and Keshan disease in Heilongjiang Province, China

Abstract

Background: Few spatial studies on serum selenoprotein P (SELENOP) and Keshan disease (KD) have been reported at the county-level in Heilongjiang province, China. This study aimed to provide visualized spatial epidemiological evidence of selenium molecular marker in residents living in endemic areas for the precise assessment of prevention, control, and elimination of KD.

Methods: Using a spatial ecological study design, 587 subjects living in cities, townships, and rural areas of 50 KD endemic counties and 37 non-endemic counties in Heilongjiang province were investigated. The serum SELENOP levels of the participants were measured by enzyme-linked immunosorbent assay. Thematic maps were created, and spatial regression analysis was conducted using ordinary least squares.

Results: The mean serum SELENOP level of the 587 subjects was 7.4 ± 3.0 μg/mL. The mean levels of serum SELENOP were higher in cities (7.4 ± 2.9 μg/mL) and townships (7.9 ± 3.2 μg/mL) than in rural areas (6.0 ± 3.0 μg/mL). The mean levels of serum SELENOP were trending towards high levels in non-endemic areas (7.4 ± 3.0 μg/mL) than in KD endemic areas (6.3 ± 3.3 μg/mL). Spatial regression analysis showed that the serum SELENOP level was positively correlated with the per capita gross domestic product.

Conclusion: Selenium deficiency may still exist in some KD endemic counties in Heilongjiang province, including Lingdong, Nenjiang, and Baiquan; these counties should be considered as key areas for precision prevention, control, and elimination of KD. Inclusion of selenium in the national surveillance of KD will provide more evidence for the assessment of KD elimination from a selenium nutrition perspective.

Keywords: Keshan disease; Precision; Public health; Selenium; Selenoprotein P; Spatial epidemiology.