Relationship Between Myocardial Injury and Expression of PGC-1α and Its Coactivators in Chronic Keshan Disease.

OBJECTIVE: Keshan disease (KD) is a mitochondrial cardiomyopathy. The present study explored the roles of peroxisome proliferator-activated receptor (PPAR)-γ coactivator-1α (PGC-1α), the key regulator of mitochondrial structure and function, and its coactivators in myocardial injury in chronic KD. Furthermore, the usefulness of these molecules in the diagnosis of chronic KD was assessed. METHODS: In the present case-control study, 43 patients with chronic KD and 30 healthy individuals living in KD endemic areas were included. The myocardial injury indicators and mRNA expression levels of PGC-1α, nuclear respiratory factor 1 (NRF1), PPARα, and estrogen-related receptor alpha (ERRα) in peripheral blood were examined. RESULTS: It was found that the levels of atrial natriuretic peptide, creatine kinase, and lactate dehydrogenase (LDH) were higher in patients with chronic KD, when compared to controls, while the level of bradykinin was lower. Furthermore, the PGC-1α, NRF1 and PPARα mRNA levels were higher in patients with KD. The area under the receiver operating characteristic curve and the optimal diagnostic threshold of LDH was 0.937 and 304.0 U/L, respectively. It is noteworthy that the area under the combined receiver operating characteristic curve was larger, when compared to that for LDH detection alone (Z=2.055, P=0.0399). The area under the curve for the "LDH+PPARα" combination was 0.984, with 96.7% sensitivity and 93.0% specificity. CONCLUSION: The combined detection of LDH and the expression of PPARα can be performed to diagnose the chronic KD.

A Spatial Ecology Study of Keshan Disease and Hair Selenium.

Few spatial ecological studies on hair selenium (Se) and Keshan disease (KD) have been reported. To investigate the relationships of hair Se with KD and economic indicators and to visualize the evidence for KD precise prevention. An ecological study design was employed. The levels of hair Se of 636 adult men (≥ 18 years old) living in rural, general cities and developed cities in 15 KD endemic provinces and 11 KD non-endemic provinces in mainland China were measured using hydride generation atomic fluorescence spectrometry. Spatial description and spatial analysis of hair Se were conducted. The subjects were adults aged. The hair Se level of the residents of KD endemic areas was 0.30 mg/kg, statistically significantly lower than that of non-endemic areas 0.34 mg/kg (Mann-Whitney U test, p = 0.007). The hair Se level of the 636 people was 0.33 mg/kg. The hair Se levels of the residents of the developed cities, general cities, and rural were 0.35 mg/kg, 0.33 mg/kg, and 0.32 mg/kg, respectively, with statistical significance (Kruskal-Wallis H test, P = 0.032). Spatial regression analysis showed that the spatial distribution of hair Se was positively correlated with per capita GDP. Selenium deficiency may still exist among residents living in the KD endemic areas. The results of spatial description and analysis of hair Se provided visualized evidence for targeting key provinces for precise prevention of Keshan disease, including assessment of KD elimination. The hair Se level of the mainland Chinese males was probably between 0.31 and 0.33 µg/g in 2015.

A spatial ecological study of selenoprotein P and Keshan disease.

Few spatial ecological studies on selenoprotein P (SePP) and Keshan disease (KD) have been reported. The main objective of this study is to investigate the relationships of SePP with KD, economic indicators and soil selenium and to visualize the evidence for KD precise prevention and control. An ecological study design was employed. The serum SePP of 2351 subjects living in rural areas, general cities and developed cities in 15 KD endemic provinces and 13 KD non-endemic provinces in China were measured. Spatial description and spatial analysis of SePP were conducted. The subjects were adults aged. The mean serum SePP level of KD endemic area residents was 14.20 mg/L, significantly lower than that in non-endemic areas, 15.30 mg/L (t = - 3.19, P = 0.0010). Serum SePP levels were low among the people in the KD endemic provinces of Shandong, Inner Mongolia, Heilongjiang, etc. The mean serum SePP level of the 2351 people was 15.04 (95% CI: 14.76 and 15.31) mg/L. The mean serum SePP levels of residents in developed cities, general cities and rural areas were 16.54 mg/L, 14.98 mg/L and 14.44 mg/L, respectively, and were significantly different (F = 17.00, P < 0.0010). Spatial regression analysis showed that the spatial distribution of SePP was positively correlated with per capita consumption expenditure and soil selenium. Selenium deficiency may still exist among residents living in the KD endemic provinces. Shandong, Inner Mongolia, and Heilongjiang should be the target provinces, visualized by spatial analysis, for KD precise prevention and control.