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Hemochromatosis and Diabetes Mellitus
- Robert A. Hegele, MD;
- Stewart B. Harris, MD; and
- Bernard Zinman, MD
- University of Western Ontario; London, Ontario N6A 5K8, Canada University of Toronto; Toronto, Ontario M5G 1X5, Canada
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TO THE EDITOR:
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.
Robert A. Hegele, MD
Stewart B. Harris, MD
University of Western Ontario; London, Ontario N6A 5K8, Canada
Bernard Zinman, MD
University of Toronto; Toronto, Ontario M5G 1X5, Canada
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
