Effects of Dietary Factors on Selenium Levels of Children to Prevent Kashin-Beck Disease During a High-Prevalence Period in an Endemic Area: a Cohort Study
Effects of Dietary Factors on Selenium Levels of Children to Prevent Kashin-Beck Disease During a High-Prevalence Period in an Endemic Area: a Cohort Study
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DOI：
10.1007/s12011-013-9651-6
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发表时间：
2013-06-01
影响因子：
3.9
通讯作者：
Guo, X.
中科院分区：
文献类型：
--
作者：
Ning, Y. J.;Wang, X.;Guo, X.
硒（Se）补充剂已被用于控制大骨节病（KBD）几十年，但由于大骨节病的患病率下降，不含Se补充剂的饮食的效果尚不清楚。本研究旨在探讨影响大骨节病病区儿童硒营养状况的膳食因素及补硒预防大骨节病的效果。在1992 ~ 1995年大骨节病高发期随机抽取5-12岁儿童593名。一个村庄的儿童接受了补硒（Se+）盐，并与其他16个村庄的3名儿童进行了匹配，这些儿童没有接受补硒（Se-）盐。在基线（1992年4月）、6个月（1992年10月）和每年4月至1995年期间，获得一份调查问卷和测定枕骨头发硒以反映身体硒状态。硒+组发硒含量在各时间点均显著高于硒-组（P < 0.001），且与疑似大骨节病症状的发生率显著相关（P = 0.018）。四种膳食因素对发硒含量均有显著影响。硒+盐摄入（P < 0.001）和经常（P = 0.019）或偶尔（P = 0.001）吃肉/蛋可使硒水平升高。食用收获时霉变的谷物和储藏中霉变的谷物（P < 0.001）以及饮用沟渠水、河水和窖水（P <0.001; P = 0.002; P < 0.001）均降低了硒水平。这些结果表明，硒+盐有显着的效果，在维持硒营养状况的儿童在这个队列研究中，但饮食因素在那些没有硒补充剂的贡献。
Selenium (Se) supplements have been used to control Kashin-Beck disease (KBD) for decades, but the effect of diet without Se supplements is unclear because the prevalence of KBD has decreased. This matched cohort study was undertaken to determine dietary factors affecting selenium nutrition status of children living in KBD areas and the effects of Se supplements in preventing KBD. A total of 593 children aged 5-12 years were randomly selected during the high prevalence period of KBD from 1992 to 1995. Children in one village received Se supplemented (Se+) salt and were matched with three children in 16 other villages who did not receive Se supplemented (Se-) salt. A questionnaire and determinations of occipital hair Se to reflect body Se status were obtained at baseline (April 1992), at 6 months (October 1992), and yearly each April through 1995. Hair Se content in the Se+ group was significantly higher than in the Se- group (P < 0.001) at all time-points and was significantly related to the incidence of suspected KBD symptoms (P = 0.018). Four dietary factors significantly affected hair Se contents. Se levels were increased by consumption of Se+ salt (P < 0.001) and eating meat/egg often (P = 0.019) or occasionally (P = 0.001). Se levels were decreased by consumption of grain mildewed at harvest or in storage (P < 0.001 for each) and drinking ditch, river, or cellar water (P < 0.001; P = 0.002; P < 0.001, respectively). These results show that Se+ salt had a significant effect in maintaining the Se nutrition status of children in this cohort study but that dietary factors in those without Se supplements contributed as well.