Jacobs Esther M G, Hendriks Jan C M, van Deursen Cees Th B M, Kreeftenberg Herman G, de Vries Richard A, Marx Joannes J M, Stalenhoef Anton F H, Verbeek André L M, Swinkels Dorine W
Department of Clinical Chemistry 441, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
J Hepatol. 2009 Jan;50(1):174-83. doi: 10.1016/j.jhep.2008.08.014. Epub 2008 Oct 14.
BACKGROUND/AIMS: In families of patients with clinically detected hereditary hemochromatosis (HH) early screening has been suggested to prevent morbidity and mortality. Here, we aim to identify determinants for iron overload in first-degree family members of C282Y homozygous probands with clinically detected HH.
Data on HFE-genotype, iron parameters, demographics, lifestyle factors and health, were collected from 224 Dutch C282Y homozygous patients with clinically diagnosed HH and 735 of their first-degree family members (FDFM), all participating in the HEmochromatosis FAmily Study (HEFAS).
The best predictive multivariable model forecasted 45% of variation of the serum ferritin levels. In this model severity of iron overload in the proband significantly predicted serum ferritin levels in FDFM. Other significant determinants in this model consisted of C282Y homozygosity, compound heterozygosity, age at testing for serum ferritin and supplemental iron intake, whereas a low body mass index showed a protective effect.
This study provides a model to assess the risk of development of iron overload for relatives of probands with HH. These results might be instrumental in the development of an optimal strategy for future family screening programs.
背景/目的:对于临床诊断为遗传性血色素沉着症(HH)患者的家族,建议进行早期筛查以预防发病和死亡。在此,我们旨在确定临床诊断为HH的C282Y纯合先证者的一级家庭成员中铁过载的决定因素。
收集了224例临床诊断为HH的荷兰C282Y纯合患者及其735名一级家庭成员(FDFM)的HFE基因型、铁参数、人口统计学、生活方式因素和健康数据,他们均参与了血色素沉着症家族研究(HEFAS)。
最佳预测多变量模型预测了血清铁蛋白水平45%的变化。在该模型中,先证者中铁过载的严重程度显著预测了FDFM的血清铁蛋白水平。该模型中的其他重要决定因素包括C282Y纯合性、复合杂合性、检测血清铁蛋白时的年龄和补充铁摄入量,而低体重指数显示出保护作用。
本研究提供了一个模型,用于评估HH先证者亲属发生铁过载的风险。这些结果可能有助于制定未来家庭筛查计划的最佳策略。