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    Jan 23, 2021
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    Kashin-Beck osteoarthropathy in rural Tibet in relation to selenium and iodine status.

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    Authors
    Moreno-Reyes, R
    Suetens, C
    Mathieu, F
    Begaux, F
    Zhu, D
    Rivera, M
    Boelaert, M
    Nève, J
    Perlmutter, N
    Vanderpas, J
    Affiliation
    Department of Nuclear Medicine, Erasme Hospital, Brussels, Belgium.
    Issue Date
    1998-10-15
    
    Metadata
    Show full item record
    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.
    Publisher
    Massachusetts Medical Society
    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
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