title: GNPAT variant (D519G) is not associated with an elevated serum ferritin or iron removed by phlebotomy in patients referred for C282Y-linked hemochromatosis.
abstract: BACKGROUND
  Previous studies in high and low expressors has demonstrated that a variant in the GNPAT gene (D519G, Rs11558492, chromosome 1, exon 11) has been associated with severe iron overload in C282Y homozygotes for hemochromatosis. In this study, a GNPAT variant was assessed prospectively in patients referred for HFE testing over a range of serum ferritin levels.
  
  
  METHODS
  Consecutive patients sent for HFE testing were studied for the GNPAT variant using a TaqMan kit assay (Life Technologies, Burlington, ON). Serum ferritin and iron removed by phlebotomy was compared in C282Y homozygotes with and without the GNPAT variant. The frequency of the GNPAT variant in referred patients was compared to a control population of voluntary blood donors without HFE mutations.
  
  
  RESULTS
  There were 533 patients that had GNPAT analysis. The allele frequency for the GNPAT variant in C282Y homozygotes (n = 75) was 0.226 and in wild type control patients (n = 458) was 0.213 (p = .07). Forty-eight percent (of the C282Y homozygotes were heterozygous (n = 28) or homozygous (n = 8) for the GNPAT variant. The mean (log)ferritin and iron removed did not significantly differ between C282Y homozygous with GNPAT homozygotes, GNPAT heterozygotes, and without the GNPAT variant (p = 0.84).
  
  
  CONCLUSIONS
  C282Y homozygotes referred for HFE testing commonly have a GNPAT variant. This GNPAT variant does not appear be a co-modifying gene affecting expression of HFE related hemochromatosis in this population. The GNPAT variant does not predict the severity of iron overload.
authors.affiliation: Department of Medicine and Laboratory Medicine, Western University, London, Ontario, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: Levstik
authors.affiliation: Laboratory Medicine, Western University, London, Ontario, Canada.
authors.forename: Alan
authors.initials: A
authors.lastname: Stuart
authors.affiliation: Department of Medicine and Laboratory Medicine, Western University, London, Ontario, Canada.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Adams
mesh_terms: D000217:Acyltransferases / Q000235:genetics*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005293:Ferritins / Q000097:blood*; D005787:Gene Frequency; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006432:Hemochromatosis / Q000097:blood / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D000071020:Hemochromatosis Protein / Q000235:genetics*; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D007501:Iron / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D018962:Phlebotomy; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D012720:Severity of Illness Index; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D005293:Ferritins; D007501:Iron; D000217:Acyltransferases; C020051:glycerone-phosphate O-acyltransferase