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1 October 1998 | Volume 129 Issue 7 | Page 587
Hemochromatosis occurs in persons who are homozygous for the C282Y mutation in the HFE gene [1]. Conte and colleagues [2] reported that in patients with type 2 diabetes mellitus, the odds ratio of hemochromatosis was 7.3 (95% CI, 1.3 to 41.9), although the absolute prevalence of hemochromatosis was low [2]. They suggested that screening for hemochromatosis may be beneficial for patients with type 2 diabetes.
The Sandy Lake aboriginal reserve in Northern Ontario, Canada, has the world's third highest population prevalence of type 2 diabetes [3]. To determine whether the HFE C282Y mutation was associated with this high prevalence in the Oji-Cree people of Sandy Lake, we screened for the presence of this mutation in a sample of 728 persons from this community. Of these, almost 40% had either type 2 diabetes or impaired glucose tolerance according to World Health Organization criteria [3]. In the overall sample, we found only 6 heterozygotes for the HFE C282Y mutation and no homozygotes. The HFE C282Y allele frequency (0.004) in the Oji-Cree people was markedly lower than the worldwide frequency of 0.02 and the European frequency of 0.04 [4]. Among the Oji-Cree people, 5 heterozygotes for the HFE C282Y mutation did not have type 2 diabetes and only 1 heterozygote had type 2 diabetes.
Thus, the genetic variant associated with hemochromatosis is almost absent from the Oji-Cree people and is not associated with the presence of type 2 diabetes. This suggests that the high prevalence of type 2 diabetes in these people results from a mechanism other than pancreatic failure due to hemochromatosis.
1. Cuthbert JA. Iron, HFE and hemochromatosis update. J Invest Med. 1997; 45:518-29.
2. Conte D, Manachino D, Colli A, Guala A, Aimo G, Andreoletti M, et al. Prevalence of genetic hemochromatosis in a cohort of Italian patients with diabetes mellitus. Ann Intern Med. 1998; 128:370-3.
3. Harris SB, Gittelsohn J, Hanley AJ, Barnie A, Wolever TM, Gao J, et al. The prevalence of NIDDM and associated risk factors in native Canadians. Diabetes Care. 1997; 20:185-97.
4. Merryweather-Clarke AT, Pointon JJ, Shearman JD, Robson KJ. Global prevalence of putative haemochromatosis mutations. J Med Genet. 1997; 34:275-8. About Letters
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Hemochromatosis and Diabetes Mellitus
TO THE EDITOR:
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University of Western Ontario; London, Ontario N6A 5K8, Canada
University of Toronto; Toronto, Ontario M5G 1X5, Canada
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