par Moreno Reyes, Mario Rodrigo
Référence Comprehensive Handbook of Iodine, Elsevier Inc., page (685-700)
Publication Publié, 2009
Partie d'ouvrage collectif
Résumé : This chapter deals with diseases where both iodine and selenium deficiency play a role in disease causation and particularly with Kashin-Beck Disease (KBD). KBD is an osteoarthropathy endemic in China and Tibet. The condition appears between the ages of 5 and 15 years, and leads to varying degrees of disability throughout adult life. The disorder affects joint and growth plate cartilages. The etiology of KBD is probably of environmental origin. Selenium deficiency has been proposed as the main etiological factor, because KBD is geographically associated with it. Despite the fact that more than 20 trace elements have been subsequently suggested as etiological factors in KBD, iodine deficiency was never mentioned again until 1998. A cross-sectional survey conducted in Tibet reported an association at the individual level between iodine deficiency and KBD in an area where goiter and KBD were both endemic. The association of KBD with a poorly diversified diet suggests that the etiology of the disease is linked to diet, affecting populations' deficient not only in iodine and selenium, but also in other nutrients. KBD is clearly associated with poor nutritional status, in particular of the Tibetan rural population. Considering the limited resources and many health problems facing the Tibetan population, it seems at this point inappropriate to advocate for specific programs of selenium supplementation, as long as the benefits of such supplementation are not clearly demonstrated. Iodine deficiency remains a health problem in Tibet. Measures to improve the iodine intake of the Tibetan population must be strengthened. © 2009 Elsevier Inc. All rights reserved..