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Serum ferritin concentrations and body iron stores in a multicenter, multiethnic primary‐care population
Author(s) -
Gordeuk Victor R.,
Reboussin David M.,
McLaren Christine E.,
Barton James C.,
Acton Ronald T.,
McLaren Gordon D.,
Harris Emily L.,
Reiss Jacob A.,
Adams Paul C.,
Speechley Mark,
Phatak Pradyumna D.,
Sholinsky Phyliss,
Eckfeldt John H.,
Chen WenPin,
Passmore Leah,
Dawkins Fitzroy W.
Publication year - 2008
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.21179
Subject(s) - transferrin saturation , phlebotomy , pacific islanders , medicine , ferritin , serum ferritin , hereditary hemochromatosis , hemochromatosis , serum iron , population , gastroenterology , physiology , anemia , immunology , environmental health
How often elevated serum ferritin in primary‐care patients reflects increased iron stores (normally 0.8 g in men, 0.4 g in women) is not known. The Hereditary Hemochromatosis and Iron Overload Screening (HEIRS) study screened 101,168 primary‐care participants (44% Caucasians, 27% African‐Americans, 14% Asians/Pacific Islanders, 13% Hispanics, 2% others). Follow‐up clinical evaluation was performed in 302 of 333 HFE C282Y homozygotes regardless of iron measures and 1,375 of 1,920 nonhomozygotes with serum ferritin >300 μg/L (men), >200 μg/L (women) and transferrin saturation >50% (men), >45% (women). Quantitative phlebotomy was conducted in 122 of 175 C282Y homozygotes and 122 of 1,102 nonhomozygotes with non‐transfusional serum ferritin elevation at evaluation. The estimated prevalence in the Caucasian population of C282Y homozygotes with serum ferritin >900 μg/L at evaluation was 20 per 10,000 men and 4 per 10,000 women; this constellation was predictive of iron stores >4 g in men and >2 g in women. The estimated prevalence per 10,000 of non‐C282Y homozygotes with serum ferritin >900 μg/L at evaluation was 7 among Caucasians, 13 among Hispanics, 20 among African Americans, and 38 among Asians and Pacific Islanders, and this constellation was predictive of iron stores >2 g but <4 g. In conclusion, serum ferritin >900 μg/L after initial elevations of both serum ferritin and transferrin saturation is predictive of mildly increased iron stores in multiple ethnic populations regardless of HFE genotype. Serum ferritin >900 μg/L in male C282Y homozygotes is predictive of moderately increased iron stores. Am. J. Hematol., 2008. © 2008 Wiley‐Liss, Inc.