Perspectives in Iron Metabolism

Finch, Clement A.; Huebers, Helmut A.

doi:10.1056/nejm198206243062504

Cited by 356 publications

(170 citation statements)

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“…Although the main form of iron de®ciency anemia, classically characterized by clinical signs, no longer represents a major problem in industrialized countries, our data indicate that iron depletion (without clinical or biological evidence of anemia) is common in menstruating women and could have deleterious effects upon health (Finch & Huebers, 1982;Cook & Lynch, 1986, particularly in relation to pregancy which carries a high demand for iron (Viteri, 1994). It clearly shows that the choice of the contraceptive method used has a marked effect on iron requirement and iron status.…”

Section: Discussionmentioning

confidence: 82%

Determining factors in the iron status of adult women in the SU.VI.MAX study

et al. 1998

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The iron status of a national sample of adults living in France and participating in the SU.VI.MAX cohort, was assessed using serum ferritin and hemoglobin concentrations. Complete data were obtained for 6648 women 35 ± 60 y old and for 3283 men 45 ± 60 y old. Assessment of iron dietary intakes was realized on a subsample of 3111 women and 2337 men who reported six 24 h dietary records during a one-year period; 22.7% of menstruating women and 5.3% of post-menopausal women presented a total depletion of iron stores (serum ferritin`15 mgal). Iron-de®cient anemias were found in, respectively, 4.4% and less than 1% of these women. Three-quarters of the anemias were related to iron de®ciency in menstruating women. In men, iron depletion and iron de®ciency anemia were very rare. Post-menopausal women had much higher serum ferritin levels than menstruating women. In menstruating women, those using intrauterine devices had signi®cantly lower serum ferritin levels than those without contraception, and much lower than those using oral contraception. The frequency of iron depletion reached 28.1% in women using intrauterine devices, but only 13.6% in those using oral contraceptives. The mean iron intake was 16.7 AE 5.7 mgad in men and 12.3 AE 3.4 mgad in women. Heme iron represented respectively, 11.1 and 10.4% of iron intake. Ninety-three percent of menstruating women had dietary iron intakes lower than recommended dietary allowances (RDA); 52.6% consumed less than two thirds of these RDA. In post-menopausal women and men, respectively 27.7% and 3.6% had dietary intakes lower than RDA. Serum ferritin was positively correlated with meat, ®sh and total iron intake, and negatively correlated with dietary products consumption, calcium and ®ber intake.

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Section: Discussionmentioning

confidence: 82%

Determining factors in the iron status of adult women in the SU.VI.MAX study

et al. 1998

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“…29 Possible explanations for a false-positive test result (HLAidentical sibling without iron overload) are the presence of Incomplete penetrance has been suggested as an explanation for the apparent discrepancy between the gene frequency and identical haplotypes in the parental generation, a genetic recombination, chronic occult blood loss, malabsorption of the prevalence of the clinical disease. 30 However, incomplete penetrance is a clinical concept without a genetic basis. Two iron (celiac disease), or absence of phenotypic expression of the disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical and family studies in genetic hemochromatosis: Microsatellite and HFE studies in five atypical families

et al. 1997

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present in 70% of homozygotes, and an extended ancestral A candidate gene (HFE) has been described for hereditary haplotype including HLA-A3 and other DNA markers on hemochromatosis on chromosome 6. The study of well-dechromosome 6 has been reported. [5][6][7] A candidate gene has fined atypical hemochromatosis families using genetic markbeen described (HFE), 4.5 Mb telomeric to HLA-A. 8 The use ers may increase our understanding of the sensitivity and the of haplotype analysis and the search for recombinations in specificity of genotyping in hemochromatosis. One hundred families are considered to be powerful tools for localizing a and thirteen Canadian families with genetic hemochromatosis gene responsible for a disease. However, in hemochromatowere surveyed to find atypical families as possible examples sis, it had been difficult to prove informative genetic recombiof people with genetic recombinations. All families underwent nations for several reasons: 1) the late presentation of the clinical investigations including iron studies and HLA typing.probands in the fifth or sixth decade often means that parenEach individual was typed at three polymorphic microsatellite tal DNA is not available; 2) ascertainment of the phenotypic loci (D6S105, D6S1260, and D6S299) on chromosome 6. Sixstatus may be difficult and may vary between studies; and teen subjects were studied for the two missense mutations 3) lack of heterogeneity with available DNA markers has described for the candidate gene for hemochromatosis reduced the number of informative family studies. In this (C282Y, H63D). There were eight HLA-identical siblings study, 113 Canadian families with genetic hemochromatosis found in four different families (five men, three women; age were reviewed, and DNA studies are presented in 5 atypical range 30-72) with normal transferrin saturation and ferritin families with potential recombinations. levels. There were two patients identified who were homozy- PATIENTS AND METHODS gous for the C282Y mutation without biochemical evidenceA database of 113 Canadian families that had been investigated of iron overload, and two patients with no evidence of the by family studies was reviewed to search for families with potential mutation with significant iron overload. Our conclusions are genetic recombinations. All families were white with European anas follows: 1) finding HLA-identical siblings without iron overcestry. This study included 4 families in which one or more HLAload does not confirm a genetic recombination, 2) difficulties identical sibling was found without phenotypic expression of the in phenotypic definition of disease and the description of new disease, and 1 family in which two putative homozygotes produced iron overload syndromes that may differ from classical genetic an unaffected son. The diagnosis of hemochromatosis was based HC cause complicated genetic studies, and 3) finding iron-on clinical history, physical examination, and elevated serum ferriloaded patients without a C282Y mutation and patients that tin...

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“…1 Iron deficiency affects more than half a billion people worldwide and is generally caused by acquired factors. It results from any condition in which dietary iron intake does not meet the body's demands, and pathological blood loss frequently contributes to this negative iron balance.…”

Section: Introductionmentioning

confidence: 99%