African Americans at risk for increased iron stores or liver disease.
OBJECTIVE
We sought to determine the prevalence of elevated measures of iron status in African Americans and whether the combination of serum ferritin concentration >200 microg/L for women or >300 microg/L for men and transferrin saturation in the highest quartile represents increased likelihood of mutation of HFE, self-reported iron overload or self-reported liver disease.


METHODS
A cross-sectional observational study of 27,224 African Americans > or =25 years of age recruited in a primary care setting was conducted as part of the multi-center, multi-ethnic Hemochromatosis and Iron Overload Screening (HEIRS) Study. Measurements included serum ferritin concentration, transferrin saturation, testing for HFE C282Y and H63D, and self-reported iron overload and liver disease.


RESULTS
Serum ferritin concentration >200 microg/L for women or >300 microg/L for men occurred in 5263 (19.3%) of African Americans, while serum ferritin concentration in this range with highest-quartile transferrin saturation (>29% women; >35% men) occurred in 1837 (6.7%). Adjusted odds of HFE mutation (1.76 women, 1.67 men), self-reported iron overload (1.97 women, 2.88 men), or self-reported liver disease (5.18 women, 3.73 men) were greater with elevated serum ferritin concentration and highest-quartile transferrin saturation than with nonelevated serum ferritin concentration (each P <.05).


CONCLUSIONS
Serum ferritin concentration >200 microg/L for women or >300 microg/L for men in combination with transferrin saturation >29% for women or >35% for men occurs in approximately 7% of adult African American primary care patients. Patients with this combination of iron test results should be evaluated for increased body iron stores or liver disease.
Division of Hematology/Oncology, Department of Medicine, Howard University, Washington, DC, USA. fdawkins@obius.jnj.com
Fitzroy W
FW
Dawkins
Victor R
VR
Gordeuk
Beverly M
BM
Snively
Laura
L
Lovato
James C
JC
Barton
Ronald T
RT
Acton
Gordon D
GD
McLaren
Catherine
C
Leiendecker-Foster
Christine E
CE
McLaren
Paul C
PC
Adams
Mark
M
Speechley
Emily L
EL
Harris
Sharon
S
Jackson
Elizabeth J
EJ
Thomson
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D005838:Genotype; D000071020:Hemochromatosis Protein; D006486:Hemosiderosis / Q000208:ethnology; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D006801:Humans; D019190:Iron Overload / Q000208:ethnology*; D008107:Liver Diseases / Q000208:ethnology*; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D015995:Prevalence; D014168:Transferrin / Q000032:analysis
C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D014168:Transferrin; D005293:Ferritins