Keshan disease is an endemic cardiomyopathy of unknown cause in The People’s Republic of China that occurs most frequently in children under 15 years of age and women of child-bearing age. Studies of children 1–9 years old in Mianing County of Sichuan Province have indicated that Keshan disease is a selenium responsive condition. Incidence rates of 9.5–13.5/1000 in 1974–1975 were reduced to 1–2/1000 in children treated with a tablet weekly of 0.5–1 mg sodium selenite. During 1974–1977, only 21 cases of the disease occurred in 36,603 treated children, compared with 106 cases in 9430 untreated children, of whom 53 died and 5 still have insufficient heart function. Occurrence of the disease was invariably associated with a lower selenium content of cereals, and of hair (less than 0.12 ppm Se) in residents from affected, compared with non-affected, areas. The dose relationship between selenium and regional characteristics of Keshan disease suggests that it is probably a biogeochemical disease; other etiological factors have also been considered.

Keshan disease, an endemic cardiomyopathy in China, was prevalent in rural areas located in a long belt region where the selenium content was low in foods. Intervention studies with well controled subjects revealed a prophylactic effect of sodium selenite. Multifocal necrosis and fibrous replacement of the myocardium characterized the histopathological features and myocytolysis was present in most cases. Ultrastructural observations on twelve postmortem cases revealed remarkable changes in many organelles of which mitochondria appeared to be most important in the development of myocardial lesions. Three kinds of specific granules, which have not been found in other reports on cardiomyopathies, were represented and other factors which might also contribute to the aetiology are discussed.

SELENIUM is a trace element that until recently has been considered unimportant in human nutrition, except when ingested in excessive amounts.1 During the past decade, Chinese investigators have shown that selenium deficiency is one of the principal factors responsible for Keshan disease, a "dilated" (congestive) cardiomyopathy that affects persons (mainly children and young women) living in rural areas of a selenium-deficient zone in China.2 3 4 This report describes an Occidental patient in whom selenium deficiency became associated with dilated cardiomyopathy.Case ReportA 43-year-old man had been receiving parenteral alimentation for two years (one liter of FreAmine 11 [an amino acid . . .

1965～1966年在四个公社五个大队共2,321名社员的膳食调查中，发现维生素B1平均摄入量（mg/1,000千卡），病区社员在0.31以下，其中本病患者为0.24；而非病区社员都在0.38以上。提出0.5mg/1,000千卡可作为维生素B1的供给量标准。