The epidemiological status, environmental and genetic factors in the etiology of Keshan disease.

Keshan disease (KD) is an endemic cardiomyopathy with myocardial lesions for which the precise etiology has not been determined. It was named after the location where it was first identified: Keshan County in China. KD is mainly distributed in a selenium-deficient zone from northeast to southwest China. In recent years, the incidence and prevalence of KD have significantly decreased. Meanwhile, more knowledge was accumulated about the etiology of KD and recent data indicated that genetic factor was involved. In this review, we will first update an overview of the epidemiological status and the environmental and genetic factors involved in this disease.