挪威首次献血者和重复献血者中血色素沉着症的患病率。

Prevalence of hemochromatosis among first-time and repeat blood donors in Norway.

作者信息

Bell H, Thordal C, Raknerud N, Hansen T, Bosnes V, Halvorsen R, Heier H E, Try K, Leivestad T, Thomassen Y

机构信息

Department of Medicine, Aker University Hospital, Oslo, Norway.

出版信息

J Hepatol. 1997 Feb;26(2):272-9. doi: 10.1016/s0168-8278(97)80041-4.

DOI:10.1016/s0168-8278(97)80041-4

PMID:9059946

Abstract

BACKGROUND/AIMS: The observed prevalence of hemochromatosis has ranged considerably from 0.05 to 0.37% in studies requiring liver biopsy. We aimed to study the prevalence of genetic hemochromatosis among Norwegian blood donors.

METHODS

We studied 10,552 healthy blood donors (5312 women and 5240 men) using serum ferritin as a screening parameter. If serum ferritin concentration was > or = 100 micrograms/l in women and > or = 200 micrograms/l in men, serum iron and transferrin (measured as total iron binding capacity = TIBC) were measured. Blood donors who repeatedly had a transferrin saturation above 40% and a ferritin concentration above these limits were referred to a hepatologist (H.B.).

RESULTS

Serum ferritin was > or = 100 micrograms/l in 94/5312 (1.8%) women and > or = 200 microliters in 79/5240 (1.5%) men. Of these, 37 persons had a serum ferritin concentration above 100 micrograms/l (females) or above 200 micrograms/l (males) and a transferrin saturation above 40%. Nineteen of them (13 men and 6 women, median age 36 years, range 28-68) were identified as having hemochromatosis on the basis of increased hepatic iron index. Serum ferritin ranged from 111 to 1980 micrograms/l (median 357 micrograms/l and transferrin saturation from 50 to 100% (median 92%), hepatic iron from 48 to 471 mumol/g dry weight (median 118 mumol/g) and hepatic iron index from 1.5 to 12.1 (median 3.0). One person had cirrhosis and none had diabetes. The prevalence of hemochromatosis was significantly higher among first-time blood donors (12 out of 3500 [3.4/1000]) compared with repeat donors (7 out of 7052 [1/1000]), p < 0.005.

CONCLUSIONS

The observed prevalence of hemochromatosis in Norwegian first-time blood donors of 0.34% is comparable to recently observed prevalences in other studies. However, the use of serum ferritin as a first-step screening tool may have failed to detect hemochromatosis in the early stage where iron overload has not yet occurred.

摘要

背景/目的：在需要肝活检的研究中，观察到的血色素沉着症患病率在0.05%至0.37%之间波动较大。我们旨在研究挪威献血者中遗传性血色素沉着症的患病率。

方法

我们以血清铁蛋白作为筛查参数，对10552名健康献血者（5312名女性和5240名男性）进行了研究。如果女性血清铁蛋白浓度≥100微克/升，男性血清铁蛋白浓度≥200微克/升，则测量血清铁和转铁蛋白（以总铁结合力=TIBC衡量）。转铁蛋白饱和度反复超过40%且铁蛋白浓度超过上述限值的献血者被转诊给肝病专家（H.B.）。

结果

94/5312（1.8%）的女性血清铁蛋白≥100微克/升，79/5240（1.5%）的男性血清铁蛋白≥200微克/升。其中，37人的血清铁蛋白浓度超过100微克/升（女性）或超过200微克/升（男性），且转铁蛋白饱和度超过40%。其中19人（13名男性和6名女性，中位年龄36岁，范围28 - 68岁）根据肝脏铁指数升高被诊断为血色素沉着症。血清铁蛋白范围为111至1980微克/升（中位值357微克/升），转铁蛋白饱和度为50%至100%（中位值92%），肝脏铁为48至471微摩尔/克干重（中位值118微摩尔/克），肝脏铁指数为1.5至12.1（中位值3.0）。1人患有肝硬化，无人患有糖尿病。首次献血者中的血色素沉着症患病率（3500人中12例[3.4/1000]）显著高于再次献血者（7052人中7例[1/1000]），p<0.005。