title: Low Population Selenium Status Is Associated With Increased Prevalence of Thyroid Disease.
abstract: BACKGROUND
  Epidemiological studies have supported the premise that an adequate selenium intake is essential for thyroid gland function.
  
  
  OBJECTIVE
  The objective was to investigate whether the prevalence of thyroid disease differed in two areas that were similar, except for very different soil/crop selenium concentrations.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  The setting was two counties of Shaanxi Province, China, here defined as adequate- and low-selenium.
  
  
  METHODS
  A total of 6152 participants were selected by stratified cluster-sampling.
  
  
  METHODS
  Participants completed demographic and dietary questionnaires and underwent physical and thyroid ultrasound examinations. Serum samples were analyzed for thyroid function parameters and selenium concentration. Serum selenium was compared between different demographic, dietary, and lifestyle categories in the two counties. The relationship between selenium status, dietary factors, and pathological thyroid conditions was explored by logistic regression.
  
  
  RESULTS
  Complete data sets were available from 3038 adequate-selenium participants and 3114 low-selenium participants in whom median (interquartile range) selenium concentrations differed almost 2-fold (103.6 [79.7, 135.9] vs 57.4 [39.4, 82.1] μg/L; P = .001). The prevalence of pathological thyroid conditions (hypothyroidism, subclinical hypothyroidism, autoimmune thyroiditis, and enlarged thyroid) was significantly lower in the adequate-selenium county than in the low-selenium county (18.0 vs 30.5%; P < .001). Higher serum selenium was associated with lower odds ratio (95% confidence interval) of autoimmune thyroiditis (0.47; 0.35, 0.65), subclinical hypothyroidism (0.68; 0.58, 0.93), hypothyroidism (0.75; 0.63, 0.90), and enlarged thyroid (0.75; 0.59, 0.97).
  
  
  CONCLUSIONS
  Low selenium status is associated with increased risk of thyroid disease. Increased selenium intake may reduce the risk in areas of low selenium intake that exist not only in China but also in many other parts of the world.
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Qian
authors: Q
authors: Wu
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Margaret P
authors: MP
authors: Rayman
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Hongjun
authors: H
authors: Lv
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Lutz
authors: L
authors: Schomburg
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Bo
authors: B
authors: Cui
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Chuqi
authors: C
authors: Gao
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Pu
authors: P
authors: Chen
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Guihua
authors: G
authors: Zhuang
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Zhenan
authors: Z
authors: Zhang
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Xiaogang
authors: X
authors: Peng
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Hua
authors: H
authors: Li
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Yang
authors: Y
authors: Zhao
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Xiaohong
authors: X
authors: He
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Gaoyuan
authors: G
authors: Zeng
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Fei
authors: F
authors: Qin
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Peng
authors: P
authors: Hou
authors: Department of Endocrinology (Q.W., H.Lv, B.C., C.G., P.C., P.H., B.S.), The First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Xi'an Jiaotong University Health Science Center (Q.W., G.Zh.), Xi'an, Shaanxi 710061, China; Department of Nutritional Sciences (M.P.R.), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Institut für Experimentelle Endokrinologie (L.S.), Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany; Ziyang County People's Hospital (Z.Z., X.H., F.Q.), Shaanxi 710032, China; Ningshan County People's Hospital (X.P., Y.Z., G.Ze.), Shaanxi 711600, China; and Ziyang County Center for Disease Control and Prevention (H.Li), Shaanxi 710032, China.
authors: Bingyin
authors: B
authors: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D018556:Crops, Agricultural / Q000737:chemistry / Q000254:growth & development; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000097:blood / Q000503:physiopathology* / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009929:Organ Size; D015995:Prevalence; D012306:Risk; D012643:Selenium / Q000032:analysis / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use; D012720:Severity of Illness Index; D012987:Soil / Q000737:chemistry; D013961:Thyroid Gland / Q000473:pathology / Q000503:physiopathology*; D013967:Thyroiditis, Autoimmune / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D012987:Soil; D012643:Selenium