Kashin–Beck Osteoarthropathy in Rural Tibet in Relation to Selenium and Iodine Status

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 μg per deciliter (157 nmol per liter; normal, 5 to 25 μg 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...