Lack of association of iron metabolism and Dupuytren's disease.
BACKGROUND
Iron accumulation as seen in genetic haemochromatosis is a major cause of hepatic fibrogenesis. A link between chronic liver disease and Dupuytren's disease (DD) is well established, especially in alcoholics.


OBJECTIVE
The aim of the present study was to test the hypothesis that iron accumulation might cause fibrosis of the palmar aponeurosis leading to DD.


METHODS
We examined iron metabolism, mutations of the HFE gene, serum cholesterol, alcohol consumption, presence of chronic liver disease, diabetes and history of severe manual work in a group of 90 patients who had undergone surgery for a severe form of DD. The tissue removed during surgery was histologically examined to confirm the diagnosis of DD. For a control group, we used 33 healthy subjects with similar profiles.


RESULTS
The DD group consisted of 82 men and 8 women. Chronic liver disease was found in 27% of DD patients, compared with 6.1% of control subjects (P = 0.013). A history of hand traumatization was present in 33% of DD patients vs. 15% of control subjects (P = 0.048). Excessive alcohol consumption was present in 35.5% of DD patients compared with 15.1% of controls (P = 0.029). None of the other tested parameters, including the prevalence of HFE gene mutations, showed a significant difference between the two groups.


CONCLUSIONS
Iron accumulation does not play a major role in the pathogenesis of DD. However, sex, age, manual labour and alcohol consumption are risk factors for progression of DD. We observed a high incidence of chronic liver disease in patients with DD.
Hnanicek
J
J
Center for Research of Diabetes, Metabolism and Nutrition, Charles University, Prague, Czech Republic. hnanicek.jan@seznam.cz
Cimburova
M
M
Putova
I
I
Svoboda
S
S
Stritesky
J
J
Kratka
K
K
Sosna
B
B
Horak
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000378:metabolism; D004387:Dupuytren Contracture / Q000209:etiology* / Q000235:genetics / Q000378:metabolism* / Q000601:surgery; D005260:Female; D006432:Hemochromatosis / Q000150:complications / Q000235:genetics / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008107:Liver Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009790:Occupations; D012307:Risk Factors
D002784:Cholesterol; D007501:Iron