BACKGROUND: Few data exist on the prevalence of genetic hemochromatosis among diabetic patients. OBJECTIVE: To compare the prevalence of genetic hemochromatosis in diabetic patients and a matched control group and to evaluate the accuracy of iron-related indexes in detecting hemochromatosis. DESIGN: Cross-sectional study. SETTING: Diabetes clinics of four hospitals in northern Italy. PATIENTS: 894 diabetic patients (117 with type 1 diabetes and 777 with type 2 diabetes) and 467 matched controls. MEASUREMENTS: Transferrin saturation and serum ferritin levels were measured in all study participants. After secondary iron overload was excluded as the cause of persistently elevated transferrin saturation and serum ferritin levels, liver biopsy was performed and siderosis was estimated semiquantitatively and quantitatively. A hepatic iron index greater than 1.9 was considered diagnostic for hemochromatosis. RESULTS: Hemochromatosis was diagnosed in 12 patients with type 2 diabetes (prevalence, 1.34% [95% CI, 0.7% to 2.3%]) and 1 control (prevalence, 0.2% [CI, 0.1% to 1.4%]; P = 0.032). The odds ratio of hemochromatosis in association with diabetes was 6.3 (CI, 1.1 to 37.7). Measurement of transferrin saturation was the most sensitive test for hemochromatosis. CONCLUSIONS: Genetic hemochromatosis is frequently not diagnosed in patients with diabetes, although it is a hallmark of the disease. Screening for hemochromatosis could be beneficial for patients with diabetes.
BACKGROUND: Few data exist on the prevalence of genetic hemochromatosis among diabeticpatients. OBJECTIVE: To compare the prevalence of genetic hemochromatosis in diabeticpatients and a matched control group and to evaluate the accuracy of iron-related indexes in detecting hemochromatosis. DESIGN: Cross-sectional study. SETTING:Diabetes clinics of four hospitals in northern Italy. PATIENTS: 894 diabeticpatients (117 with type 1 diabetes and 777 with type 2 diabetes) and 467 matched controls. MEASUREMENTS: Transferrin saturation and serum ferritin levels were measured in all study participants. After secondary iron overload was excluded as the cause of persistently elevated transferrin saturation and serum ferritin levels, liver biopsy was performed and siderosis was estimated semiquantitatively and quantitatively. A hepatic iron index greater than 1.9 was considered diagnostic for hemochromatosis. RESULTS:Hemochromatosis was diagnosed in 12 patients with type 2 diabetes (prevalence, 1.34% [95% CI, 0.7% to 2.3%]) and 1 control (prevalence, 0.2% [CI, 0.1% to 1.4%]; P = 0.032). The odds ratio of hemochromatosis in association with diabetes was 6.3 (CI, 1.1 to 37.7). Measurement of transferrin saturation was the most sensitive test for hemochromatosis. CONCLUSIONS:Genetic hemochromatosis is frequently not diagnosed in patients with diabetes, although it is a hallmark of the disease. Screening for hemochromatosis could be beneficial for patients with diabetes.
Authors: Nicole Soranzo; Serena Sanna; Eleanor Wheeler; Christian Gieger; Dörte Radke; Josée Dupuis; Nabila Bouatia-Naji; Claudia Langenberg; Inga Prokopenko; Elliot Stolerman; Manjinder S Sandhu; Matthew M Heeney; Joseph M Devaney; Muredach P Reilly; Sally L Ricketts; Alexandre F R Stewart; Benjamin F Voight; Christina Willenborg; Benjamin Wright; David Altshuler; Dan Arking; Beverley Balkau; Daniel Barnes; Eric Boerwinkle; Bernhard Böhm; Amélie Bonnefond; Lori L Bonnycastle; Dorret I Boomsma; Stefan R Bornstein; Yvonne Böttcher; Suzannah Bumpstead; Mary Susan Burnett-Miller; Harry Campbell; Antonio Cao; John Chambers; Robert Clark; Francis S Collins; Josef Coresh; Eco J C de Geus; Mariano Dei; Panos Deloukas; Angela Döring; Josephine M Egan; Roberto Elosua; Luigi Ferrucci; Nita Forouhi; Caroline S Fox; Christopher Franklin; Maria Grazia Franzosi; Sophie Gallina; Anuj Goel; Jürgen Graessler; Harald Grallert; Andreas Greinacher; David Hadley; Alistair Hall; Anders Hamsten; Caroline Hayward; Simon Heath; Christian Herder; Georg Homuth; Jouke-Jan Hottenga; Rachel Hunter-Merrill; Thomas Illig; Anne U Jackson; Antti Jula; Marcus Kleber; Christopher W Knouff; Augustine Kong; Jaspal Kooner; Anna Köttgen; Peter Kovacs; Knut Krohn; Brigitte Kühnel; Johanna Kuusisto; Markku Laakso; Mark Lathrop; Cécile Lecoeur; Man Li; Mingyao Li; Ruth J F Loos; Jian'an Luan; Valeriya Lyssenko; Reedik Mägi; Patrik K E Magnusson; Anders Mälarstig; Massimo Mangino; María Teresa Martínez-Larrad; Winfried März; Wendy L McArdle; Ruth McPherson; Christa Meisinger; Thomas Meitinger; Olle Melander; Karen L Mohlke; Vincent E Mooser; Mario A Morken; Narisu Narisu; David M Nathan; Matthias Nauck; Chris O'Donnell; Konrad Oexle; Nazario Olla; James S Pankow; Felicity Payne; John F Peden; Nancy L Pedersen; Leena Peltonen; Markus Perola; Ozren Polasek; Eleonora Porcu; Daniel J Rader; Wolfgang Rathmann; Samuli Ripatti; Ghislain Rocheleau; Michael Roden; Igor Rudan; Veikko Salomaa; Richa Saxena; David Schlessinger; Heribert Schunkert; Peter Schwarz; Udo Seedorf; Elizabeth Selvin; Manuel Serrano-Ríos; Peter Shrader; Angela Silveira; David Siscovick; Kjioung Song; Timothy D Spector; Kari Stefansson; Valgerdur Steinthorsdottir; David P Strachan; Rona Strawbridge; Michael Stumvoll; Ida Surakka; Amy J Swift; Toshiko Tanaka; Alexander Teumer; Gudmar Thorleifsson; Unnur Thorsteinsdottir; Anke Tönjes; Gianluca Usala; Veronique Vitart; Henry Völzke; Henri Wallaschofski; Dawn M Waterworth; Hugh Watkins; H-Erich Wichmann; Sarah H Wild; Gonneke Willemsen; Gordon H Williams; James F Wilson; Juliane Winkelmann; Alan F Wright; Carina Zabena; Jing Hua Zhao; Stephen E Epstein; Jeanette Erdmann; Hakon H Hakonarson; Sekar Kathiresan; Kay-Tee Khaw; Robert Roberts; Nilesh J Samani; Mark D Fleming; Robert Sladek; Gonçalo Abecasis; Michael Boehnke; Philippe Froguel; Leif Groop; Mark I McCarthy; W H Linda Kao; Jose C Florez; Manuela Uda; Nicholas J Wareham; Inês Barroso; James B Meigs Journal: Diabetes Date: 2010-09-21 Impact factor: 9.461
Authors: Shamil D Cooray; Neel M Heerasing; Laura A Selkrig; V Nathan Subramaniam; P Shane Hamblin; Cameron J McDonald; Catriona A McLean; Elissa McNamara; Angeline S Leet; Stuart K Roberts Journal: J Med Case Rep Date: 2018-01-26