Health-related quality of life in a racially diverse population screened for hemochromatosis: results from the Hemochromatosis and Iron Overload Screening (HEIRS) study.
OBJECTIVE
The HEIRS Study screened 101,168 primary care participants for iron overload with serum transferrin saturation (TS), serum ferritin (SF), and C282Y and H63D mutations of the HFE gene. The objective of this study was to evaluate the impact of screening on participants' well-being.


METHODS
All C282Y homozygotes, participants with an elevated TS and SF concentration, and a control group of phenotype-genotype negative persons, with neither C282Y nor H63D mutations in the HFE gene were recalled for a clinical evaluation. Health-related quality of life was assessed before screening and approximately 1 week after receipt of the results. Health worries were assessed only at follow-up.


RESULTS
Participants (N = 1478) completed both initial and follow-up surveys. After adjusting for model covariates, phenotype and genotype combinations were statistically significant predictors of changes in psychological well-being (P = 0.0001) and general health (P = 0.0014). C282Y homozygotes with transient elevations in TS or SF were significantly more likely to worry about their health compared to study controls. Race, ethnicity, and preferred language subgroups differed on psychological well-being, general health, and health worry.


CONCLUSIONS
Iron phenotype and HFE genotype are associated with health-related quality of life. Health worry was greatest among those considered genetically "at risk. " This may have important implications for multi-ethnic population-based screening studies in which genotype and phenotype are communicated.
Wenzel
Lari B
LB
Center for Health Policy Research, Department of Medicine, University of California, Irvine, California 92697-7550, USA. lwenzel@uci.edu
Anderson
Roger
R
Tucker
Diane C
DC
Palla
Shana
S
Thomson
Elizabeth
E
Speechley
Mark
M
Harrison
Helen
H
Lewis-Jack
Ometha
O
Fadojutimi-Akinsiku
Margaret
M
Eckfeldt
John H
JH
Reiss
Jacob A
JA
Rivers
Charles A
CA
Bookman
Ebony
E
Snively
Beverly M
BM
McLaren
Christine E
CE
D000328:Adult; D005260:Female; D005838:Genotype; D006432:Hemochromatosis / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011788:Quality of Life; D044469:Racial Groups