Zeng Qingyu, Li Guijin, Wang Ruixiang, Lv Cunqi, Hao Shuxiu, Li Jiacheng, Sun Huixin, Du Linlin, Wang Cheng, Zhang Yu, Wang Xinshu, Jia Yuehui, Li Qi, Wang Tong
Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, Harbin, 150081, China.
NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, 150081, China.
Biol Trace Elem Res. 2025 Feb 14. doi: 10.1007/s12011-025-04547-8.
Selenium deficiency is strongly associated with Keshan disease (KD). It is essential to investigate serum selenium levels from the perspective of etiological surveillance and evaluation of the populations at-risk. This research aims to identify areas at high risk of selenium deficiency using spatial epidemiological methods and to provide a scientific basis for targeted selenium supplementation. This cross-sectional study measured serum selenium levels using an atomic fluorescence spectrometer among 6,643 residents in KD endemic and non-endemic counties across China, applying spatial epidemiological methods, including global autocorrelation and local Moran's I analysis, to identify spatial clustering. Additionally, ordinary least squares regression was used to assess the correlation between serum selenium levels and per capita disposable income. The median serum selenium level among participants was 66.69 μg/L. Serum selenium levels of residents in KD endemic areas were significantly lower than those in non-endemic areas. A total of 72 counties were classified as selenium-deficient, 638 as selenium-marginal, and 967 as selenium-sufficient. Spatial clustering analysis identified 375 clusters of low selenium levels. Regression analysis revealed a positive correlation between serum selenium levels and per capita disposable income. The geographical distribution of serum selenium levels exhibits significant spatial clustering. The low-low clustering areas in provinces such as Sichuan, Shaanxi, Gansu and Yunnan should be prioritized for selenium nutrition interventions and surveillance. Furthermore, areas with low incomes may need enhanced strategies for selenium supplementation.
硒缺乏与克山病（KD）密切相关。从病因学监测和对高危人群评估的角度调查血清硒水平至关重要。本研究旨在利用空间流行病学方法确定硒缺乏的高危地区，并为有针对性的补硒提供科学依据。这项横断面研究使用原子荧光光谱仪测量了中国克山病流行县和非流行县的6643名居民的血清硒水平，应用包括全局自相关和局部莫兰指数分析在内的空间流行病学方法来识别空间聚集性。此外，使用普通最小二乘法回归评估血清硒水平与人均可支配收入之间的相关性。参与者的血清硒水平中位数为66.69μg/L。克山病流行地区居民的血清硒水平显著低于非流行地区。共有72个县被归类为缺硒地区，638个为边缘缺硒地区，967个为硒充足地区。空间聚集性分析确定了375个低硒水平聚集区。回归分析显示血清硒水平与人均可支配收入呈正相关。血清硒水平的地理分布呈现出显著的空间聚集性。四川、陕西、甘肃和云南等省份的低-低聚集区应优先进行硒营养干预和监测。此外，低收入地区可能需要加强补硒策略。
