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A population-based study of the effect of the HFE C282Y and H63D mutations on iron metabolism

journal contribution
posted on 2003-01-01, 00:00 authored by O Njajou, J Houwing-Duistermaat, Richard Osborne, N Vaessen, J Vergeer, J Heeringa, H Pols, A Hofman, C van Duijn
The C282Y and H63D mutations in the HFE gene are important causes of hemochromatosis. In the elderly, these mutations might be associated with increased morbidity because of the lifelong accumulation of iron. In a population-based sample of the elderly, we determined the value of genotyping for HFE mutations to screen for subclinical hemochromatosis. HFE genotype frequencies were determined in a random group of 2095 subjects (55 years and over). In this random group, we selected within the six genotype groups a total of 342 individuals and measured their serum transferrin saturation, iron and ferritin levels. We also estimated the heritability and parameters needed to evaluate screening, including the sensitivity, specificity, positive and negative predictive values (PPV, NPV) of HFE genotypes. Iron parameters were significantly increased in subjects homozygous, heterozygous or compound heterozygous. The effect of the mutations was more pronounced in men than in women. For the H63D mutation, an allele dose effect was observed. The HFE gene explained about 5% of the variability in serum iron indices. The PPV for hemochromatosis for the C282Y homozygous was 100% in men and 67% in women. The NPV of the wild-type allele was 97% for both men and women. The sensitivity of both mutations was 70% for men and 52% for women and the specificity was 62% for men and 64% for women. Our study shows that the HFE C282Y and H63D are determinants of iron parameters in the elderly and will be effective in detecting individuals at high risk of hemochromatosis. However, when screening based on these two mutations, some individuals with subclinical hemochromatosis will be missed.

History

Journal

European journal of human genetics

Volume

11

Pagination

225 - 231

Publisher

Nature Publishing Group

Location

London, England

ISSN

1018-4813

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2003, Nature Publishing Group