Screening for hemochromatosis and iron deficiency in employees and primary care patients in Western Germany.
BACKGROUND
Many physicians still believe that iron overload (hemochromatosis) is an uncommon disorder.


OBJECTIVE
To estimate the frequency of iron overload and iron deficiency in a group of employees and a group of outpatients.


METHODS
Prospective screening study.


METHODS
Western Germany.


METHODS
3012 asymptomatic employees and 3027 outpatients of nine practitioners.


METHODS
Serum ferritin levels and transferrin saturation were measured. Participants with repeatedly abnormal results had thorough clinical evaluations to identify the cause of iron deficiency or overload.


RESULTS
Gross iron overload (elevated transferrin saturation and ferritin levels) was proven by liver biopsy and phlebotomy treatment in 28 participants (0.4% of female outpatients, 0.7% of male outpatients, 0.2% of female employees, and 0.4% of male employees) and in six siblings of these participants. Of the 34 participants with iron overload, 30 were precirrhotic. Because 60% of an unselected group of employees with elevated transferrin saturation but normal ferritin levels were assumed to have early hemochromatosis, the prevalence of hemochromatosis was estimated to be 1.8% among patients (1.9% in women and 1.6% in men) and 1.0% among employees (1.1% in women and 1.0% in men). Iron deficiency was found in 6.8% of female patients, 2.4% of male patients, 6.0% of female employees, and 0.5% of male employees.


CONCLUSIONS
Iron deficiency was more common in women, and iron overload was more common in men. Among male employees, iron overload was almost as common as iron deficiency.
Niederau
C
C
Heinrich-Heine-Universität Düsseldorf, Germany.
Niederau
C M
CM
Lange
S
S
Littauer
A
A
Abdel-Jalil
N
N
Maurer
M
M
Häussinger
D
D
Strohmeyer
G
G
D000328:Adult; D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004651:Employment; D005260:Female; D005293:Ferritins / Q000097:blood; D005858:Germany / Q000453:epidemiology; D006432:Hemochromatosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007221:Industry; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors; D014168:Transferrin / Q000032:analysis
D014168:Transferrin; D005293:Ferritins