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Associations Between Selenium Content in Hair and Kashin-Beck Disease/Keshan Disease in Children in Northwestern China: a Prospective Cohort Study

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Abstract

The objective of this study was to investigate the relationship between selenium content in hair and the incidence of Kashin-Beck disease (KBD) and Keshan disease (KD) in China. A prospective cohort study was conducted among children aged 5–12 years with different levels of low-selenium (group 1, Se ≤ 110 ng/g; group 2, 110 < Se ≤ 150 ng/g; and group 3, 150 < Se ≤ 200 ng/g) or selenium-supplemented (group 4, Se > 200 ng/g) exposure. A person-years approach was used to calculate the incidence and rate of positive clinical signs. Relative risk (RR), attributable risk, and etiologic fraction were used to determine the strength of association between selenium and disease incidence. Seven new KBD cases were diagnosed during 3-year follow-up. Positive clinical signs of KBD were found in 17.78 (95% confidence interval [CI] 14.27–21.29) cases per 100 person-years in group 1, 13.28 (9.82–16.74) in group 2, 12.95 (9.34–16.56) in group 3, and 8.18 (5.50–10.85) in group 4. Compared with group 4, the RR (95% CI) of groups 1, 2, and 3 were 2.17 (1.48–3.19), 1.62 (1.07–2.47), and 1.58 (1.03–2.43), respectively. Positive clinical signs of KD were 25.90 (18.62–33.18) cases per 100 person-years in group 1, 5.66 (1.26–10.06) in group 2, 4.60 (0.20–9.00) in group 3, and 14.62 (8.54–20.69) in group 4. Compared with group 4, the RR (95% CI) were 1.77 (1.07–2.93), 0.39 (0.16–0.93), and 0.31 (0.11–0.89), respectively. In children, the onset of KBD was negatively correlated with selenium content within a certain range. However, there may be a U-shaped association between selenium content and KD in children.

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Acknowledgments

We thank the children and families who participated in this study.

Funding

This work was supported by grants from the National Natural Science Foundation of China (81472924, 81620108026), and the Fundamental Research Funds for the Central Universities.

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Authors and Affiliations

  1. School of Public Health, Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission of People’s Republic of China, Xi’an Jiaotong University, No.76 Yan Ta West Road, Xi’an, Shannxi, 710061, People’s Republic of China

    Huan Liu, Fangfang Yu, Wanzhen Shao, Dexiu Ding, Zhidao Yu, Fengshi Chen, Dong Geng, Xiwang Tan, Mikko J. Lammi & Xiong Guo

  2. Department of Integrative Medical Biology, University of Umeå, 901 87, Umeå, Sweden

    Mikko J. Lammi

Authors
  1. Huan Liu
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  2. Fangfang Yu
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  3. Wanzhen Shao
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  4. Dexiu Ding
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  5. Zhidao Yu
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  6. Fengshi Chen
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  7. Dong Geng
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  8. Xiwang Tan
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  9. Mikko J. Lammi
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  10. Xiong Guo
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Contributions

X Guo and Mikko J. Lammi conceived and designed the experiments; DX Ding, ZD Yu, FS Chen, D Geng, and XW Tan performed the experiments; FF Yu, WZ Shao, and H Liu analyzed and interpreted the data; H Liu wrote the paper; and H Liu had primary responsibility for final content. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Mikko J. Lammi or Xiong Guo.

Ethics declarations

This investigation was approved by the Institutional Review Board of Xi’an Jiaotong University. Informed consent was obtained from a parent/guardian of each child at study entry and at follow-up.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Liu, H., Yu, F., Shao, W. et al. Associations Between Selenium Content in Hair and Kashin-Beck Disease/Keshan Disease in Children in Northwestern China: a Prospective Cohort Study. Biol Trace Elem Res 184, 16–23 (2018). https://doi.org/10.1007/s12011-017-1169-x

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