How I treat hemochromatosis

Adams, Paul C.; Barton, James C.

doi:10.1182/blood-2010-01-261875

Cited by 160 publications

(173 citation statements)

References 94 publications

Supporting

Mentioning

170

Contrasting

Unclassified

Order By: Relevance

“…None of the accepted measures of body iron stores was available for our analyses. 38 SF is commonly used as a surrogate measure of iron stores, 5 although within-person variation of SF is great. 39 The linear correlation of SF with iron removed by phlebotomy to achieve iron depletion in whites with hemochromatosis is positive and significant, but the Pearson correlation coefficient is not particularly high.…”

Section: Discussionmentioning

confidence: 99%

Serum Ferritin, Insulin Resistance, and Metabolic Syndrome: Clinical and Laboratory Associations in 769 Non-Hispanic Whites Without Diabetes Mellitus in the HEIRS Study

ActonRonald

Clayborn²,

BartonJames³

2015

Metabolic Syndrome and Related Disorders

Self Cite

View full text Add to dashboard Cite

Background: In some reports, serum ferritin (SF) has been associated with insulin resistance and metabolic syndrome. Methods: We studied non-Hispanic whites without diabetes mellitus in a postscreening examination. Participants included cases [HFE C282Y homozygosity; and transferrin saturation (TS) > 50% and SF > 300 mg/L (males) and TS > 45% and SF > 200 mg/dL (females), regardless of HFE genotype] and controls [HFE wildtype (wt/wt) and TS/SF 25th-75th percentiles]. We excluded participants with overnight fasts < 8 hr, cirrhosis, hepatitis B or C, pregnancy, or missing data. Observations were age, sex, C282Y homozygosity, body mass index (BMI), systolic and diastolic blood pressures (SBP, DBP), lymphocytes, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), TS, SF, and glucose/insulin. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR) 4th quartile ( ‡ 2.70). Results: A total of 407 women and 362 men (mean age 54 years) included 188 C282Y homozygotes and 371 wt/wt. Significant trends across HOMA-IR quartiles included age, male sex, BMI, SBP, DBP, lymphocytes, ALT, CRP > 0.5 mg/dL (positive), and TS (negative). Multiple regression on HOMA-IR revealed significant associations with male sex, BMI, SBP, lymphocytes, ALT, CRP > 0.5 mg/dL (positive), and DBP and SF (negative). Logistic regression on HOMA-IR 4th quartile revealed significant positive associations with age, male sex, BMI, and lymphocytes. Metabolic syndrome occurred in 53 participants (6.9%). Logistic regression on metabolic syndrome revealed these odds ratios: HOMA-IR 4th quartile [9.1 (4.8, 17.3)] and CRP > 0.5 mg/ dL [2.9 (1.6, 5.4)]. Conclusions: Age, male sex, BMI, and lymphocytes were positively associated with HOMA-IR after correction for other factors. HOMA-IR 4th quartile and CRP > 0.5 mg/dL predicted metabolic syndrome.

show abstract

Section: Discussionmentioning

confidence: 99%

Serum Ferritin, Insulin Resistance, and Metabolic Syndrome: Clinical and Laboratory Associations in 769 Non-Hispanic Whites Without Diabetes Mellitus in the HEIRS Study

ActonRonald

Clayborn²,

BartonJames³

2015

Metabolic Syndrome and Related Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

“…5 Each unit of blood removed depletes 200-250 mg of iron from the blood, which mobilizes an equal amount of iron stored in the tissues to form hemoglobin. 9 Patients with ferroportin mutation-associated iron overload may not tolerate a more aggressive schedule. 10 Serum ferritin is measured every month until it reaches 200 ng/mL and once in 1 to 2 weeks after.…”

mentioning

confidence: 99%

Treatment of Cardiac Hemochromatosis

Aronow¹

2015

Heart Res Open J

View full text Add to dashboard Cite

“…It may also reduce the risk of pituitary dysfunction. Whether phlebotomy improves health related quality of life is debated [13,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life and Pituitary Function in Patients with Hereditary Hemochromatosis: An Observational Study

Dahl

Haaber

Kimer

et al. 2017

GHR

View full text Add to dashboard Cite

Background: Hereditary Hemochromatosis (HH) can lead to complications including cirrhosis, diabetes and osteoporosis and pituitary dysfunction. The recommended initial treatment is phlebotomy adjusted based on ferritin levels. The extent to which HH affects the quality of life is not known. Aim:To evaluate the quality of life patients with HH. Methods:We included all patients with genetically verified HH undergoing phlebotomy at four clinical sites in Denmark. Evidence of complications was systematically assessed. Quality of life was assessed using the Short Form 36 (SF-36) questionnaire. Predictors of the quality of life (SF-36 total score) were evaluated in univariable and multivariable regression analysis.Results: Twenty five patients (median age 60 years; 13 men) were included. The median number of times patients underwent phlebotomy in the year before inclusion was 6 (range 4-8). Four patients had impaired glucose tolerance, two had diabetes, nine had a borderline response to the Synacthen test and two had evidence of hypogonadotropic hypogonadism. In multivariable regression analyses, only ferritin was a significant predictor of the quality of life (P=0.031). Conclusion:This study found that a low ferritin may be having a detrimental effect on the quality of life in patients with HH. Based on the small sample size, we cannot make any definite conclusions. The results suggest that the quality of life may be considered when evaluating treatment goals, e.g., in the elderly with a low risk of complications, but additional research is needed to evaluate our findings.

show abstract

How I treat hemochromatosis

Cited by 160 publications

References 94 publications

Serum Ferritin, Insulin Resistance, and Metabolic Syndrome: Clinical and Laboratory Associations in 769 Non-Hispanic Whites Without Diabetes Mellitus in the HEIRS Study

Serum Ferritin, Insulin Resistance, and Metabolic Syndrome: Clinical and Laboratory Associations in 769 Non-Hispanic Whites Without Diabetes Mellitus in the HEIRS Study

Treatment of Cardiac Hemochromatosis

Quality of Life and Pituitary Function in Patients with Hereditary Hemochromatosis: An Observational Study

Contact Info

Product

Resources

About