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

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

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.1011460

DOI=10.3389/fnut.2022.1011460

ISSN=2296-861X

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 of KD. Hair selenium is one of recognized biomarkers of selenium nutrition. This study was 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 through atomic fluorescence spectrometer. The spatial analysis was performed by 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 its 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 the hair selenium levels, of which 83 (47.7%) 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 (rs = 0.20, P < 0.0001).
Conclusions: The median of the hair selenium levels of inhabitants living in KD endemic counties was significantly lower than that in KD non-endemic counties. The low-low clusters of hair selenium levels of the 83 KD endemic counties identified should be given high priority in KD precision prevention and control. These findings are the geographically precise and visualized evidence for assessing the effectiveness of KD prevention and control at the level of selenium nutrition in terms of etiology.