Is selenium deficiency really the cause of Keshan disease?
Is selenium deficiency really the cause of Keshan disease?
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缺硒真的是克山病的病因吗？
DOI：
10.1007/s10653-010-9331-9
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发表时间：
2011-04-01
影响因子：
4.2
通讯作者：
Wei, Jin
中科院分区：
文献类型：
--
作者：
Lei, Cong;Niu, Xiaolin;Wei, Jin
克山病是一种扩张型心肌病，与膳食硒缺乏密切相关。它以中国东北部的克山县命名，克山县因土壤缺硒而发病率很高。KD是一种基因与环境相互作用的疾病。本文采用多元逐步回归分析方法，对71例川崎病患者和290例正常对照者的主要临床特征及危险因素进行分析。分析的变量包括年龄、性别、KD家族史、血硒水平、谷胱甘肽过氧化物酶-1（GPx-1）活性、GPx-1基因密码子198变异、居住地、异常心电图（ECG）结果和心胸（CT）比值。主要危险因素为GPx-1活性低、家族KD史和居住在流行区。主要临床表现为心电图负荷增加、CT比值和Tei指数增高。公共卫生和临床预防工作可以集中在增加GPx-1活性，以解决KD。缺硒真的是KD的必然原因吗？这根本不是一个确定的问题。对KD的病因学研究尚需进一步深入。
Keshan disease (KD) is a dilated cardiomyopathy closely related with a diet deficient in the mineral selenium. It is named for the northeastern Chinese county Keshan, where the disease prevalence is high because of selenium-deficient soil. KD is a gene-environment interaction disease. Here, we used stepwise multiple regression analysis to analyze the risk factors of the disease and the main clinical features in 71 KD patients and 290 controls. The variables analyzed included age, sex, family history of KD, blood selenium level, glutathione peroxidase-1 (GPx-1) activity, variance at codon198 in GPx-1 gene, residence in an endemic area, abnormal electrocardiography (ECG) findings, and cardiothoracic (CT) ratio. The main risk factors found were low GPx-1 activity, family history of KD and living in an endemic area. The main clinical features were increased cardiac load on ECG and increased CT ratio and Tei index. Public health and clinical prevention efforts could focus on increasing GPx-1 activity to address KD. Is selenium deficiency really the certain cause of KD? This is not at all a settled question. And further study is promptly required to investigate the etiology of KD.