Kashin-Beck osteoarthropathy in rural Tibet in relation to selenium and iodine status.

Hdl Handle:
http://hdl.handle.net/10144/27713
Title:
Kashin-Beck osteoarthropathy in rural Tibet in relation to selenium and iodine status.
Authors:
Moreno-Reyes, R; Suetens, C; Mathieu, F; Begaux, F; Zhu, D; Rivera, M; Boelaert, M; Nève, J; Perlmutter, N; Vanderpas, J
Journal:
The New England Journal of Medicine
Abstract:
BACKGROUND AND METHODS: Kashin-Beck disease is a degenerative osteoarticular disorder that is endemic to certain areas of Tibet, where selenium deficiency is also endemic. Because selenium is involved in thyroid hormone metabolism, we studied the relation among the serum selenium concentration, thyroid function, and Kashin-Beck disease in 575 subjects 5 to 15 years of age in 12 villages around Lhasa, Tibet, including 1 control village in which no subject had Kashin-Beck disease. Clinical, radiologic, and biochemical data were collected. RESULTS: Among the 575 subjects, 280 (49 percent) had Kashin-Beck disease, 267 (46 percent) had goiter, and 7 (1 percent) had cretinism. Of the 557 subjects in whom urinary iodine was measured, 66 percent had a urinary iodine concentration of less than 2 microg per deciliter (157 nmol per liter; normal, 5 to 25 microg per deciliter [394 to 1968 nmol per liter]). The mean urinary iodine concentration was lower in subjects with Kashin-Beck disease than in control subjects (1.2 vs. 1.8 microg per deciliter [94 vs. 142 nmol per liter], P<0.001) and hypothyroidism was more frequent (23 percent vs. 4 percent, P=0.01). Severe selenium deficiency was documented in all villages; 38 percent of subjects had serum concentrations of less than 5 ng per milliliter (64 nmol per liter; normal, 60 to 105 ng per milliliter [762 to 1334 nmol per liter]). When age and sex were controlled for in a multivariate analysis, low urinary iodine, high serum thyrotropin, and low serum thyroxine-binding globulin values were associated with an increased risk of Kashin-Beck disease, but a low serum selenium concentration was not. CONCLUSIONS: In areas where severe selenium deficiency is endemic, iodine deficiency is a risk factor for Kashin-Beck disease.
Affiliation:
Department of Nuclear Medicine, Erasme Hospital, Brussels, Belgium.
Publisher:
Massachusetts Medical Society
Issue Date:
15-Oct-1998
URI:
http://hdl.handle.net/10144/27713
PubMed ID:
9770558
Additional Links:
http://content.nejm.org/cgi/reprint/339/16/1112.pdf
Language:
en
Description:
To access this article, click on "Additional Links".
ISSN:
0028-4793
Appears in Collections:
Other Diseases

Full metadata record

DC FieldValue Language
dc.contributor.authorMoreno-Reyes, R-
dc.contributor.authorSuetens, C-
dc.contributor.authorMathieu, F-
dc.contributor.authorBegaux, F-
dc.contributor.authorZhu, D-
dc.contributor.authorRivera, M-
dc.contributor.authorBoelaert, M-
dc.contributor.authorNève, J-
dc.contributor.authorPerlmutter, N-
dc.contributor.authorVanderpas, J-
dc.date.accessioned2008-05-22T15:14:31Z-
dc.date.available2008-05-22T15:14:31Z-
dc.date.issued1998-10-15-
dc.identifier.citationKashin-Beck osteoarthropathy in rural Tibet in relation to selenium and iodine status. 1998, 339 (16):1112-20 N. Engl. J. Med.en
dc.identifier.issn0028-4793-
dc.identifier.pmid9770558-
dc.identifier.urihttp://hdl.handle.net/10144/27713-
dc.descriptionTo access this article, click on "Additional Links".en
dc.description.abstractBACKGROUND AND METHODS: Kashin-Beck disease is a degenerative osteoarticular disorder that is endemic to certain areas of Tibet, where selenium deficiency is also endemic. Because selenium is involved in thyroid hormone metabolism, we studied the relation among the serum selenium concentration, thyroid function, and Kashin-Beck disease in 575 subjects 5 to 15 years of age in 12 villages around Lhasa, Tibet, including 1 control village in which no subject had Kashin-Beck disease. Clinical, radiologic, and biochemical data were collected. RESULTS: Among the 575 subjects, 280 (49 percent) had Kashin-Beck disease, 267 (46 percent) had goiter, and 7 (1 percent) had cretinism. Of the 557 subjects in whom urinary iodine was measured, 66 percent had a urinary iodine concentration of less than 2 microg per deciliter (157 nmol per liter; normal, 5 to 25 microg per deciliter [394 to 1968 nmol per liter]). The mean urinary iodine concentration was lower in subjects with Kashin-Beck disease than in control subjects (1.2 vs. 1.8 microg per deciliter [94 vs. 142 nmol per liter], P<0.001) and hypothyroidism was more frequent (23 percent vs. 4 percent, P=0.01). Severe selenium deficiency was documented in all villages; 38 percent of subjects had serum concentrations of less than 5 ng per milliliter (64 nmol per liter; normal, 60 to 105 ng per milliliter [762 to 1334 nmol per liter]). When age and sex were controlled for in a multivariate analysis, low urinary iodine, high serum thyrotropin, and low serum thyroxine-binding globulin values were associated with an increased risk of Kashin-Beck disease, but a low serum selenium concentration was not. CONCLUSIONS: In areas where severe selenium deficiency is endemic, iodine deficiency is a risk factor for Kashin-Beck disease.en
dc.language.isoenen
dc.publisherMassachusetts Medical Societyen
dc.relation.urlhttp://content.nejm.org/cgi/reprint/339/16/1112.pdfen
dc.rightsArchived with thanks to The New England Journal of Medicineen
dc.subject.meshAdolescenten
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCongenital Hypothyroidismen
dc.subject.meshEndemic Diseasesen
dc.subject.meshFemaleen
dc.subject.meshGoiteren
dc.subject.meshHumansen
dc.subject.meshHypothyroidismen
dc.subject.meshIodineen
dc.subject.meshMaleen
dc.subject.meshOsteoarthritisen
dc.subject.meshRisk Factorsen
dc.subject.meshRural Healthen
dc.subject.meshSeleniumen
dc.subject.meshThyrotropinen
dc.subject.meshThyroxine-Binding Proteinsen
dc.subject.meshTibeten
dc.titleKashin-Beck osteoarthropathy in rural Tibet in relation to selenium and iodine status.en
dc.contributor.departmentDepartment of Nuclear Medicine, Erasme Hospital, Brussels, Belgium.en
dc.identifier.journalThe New England Journal of Medicineen

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