Objective: To test the hypothesis that the heterozygous state for HFE gene mutations involved in the pathogenesis of hemochromatosis, that may induce an increase of hepatic iron content, may aggravate the liver damage induced by prolonged and excessive use of ethanol.

Patients And Methods: C282Y and H63D mutations of HFE gene were identified through polymerase chain reaction (PCR) on leukocyte DNA, in 125 consecutive patients diagnosed of advanced alcoholic liver disease (109 men, mean age 54 years, SD 11) and 181 healthy controls. All subjects were white Spaniards. RESULTS (CASES/CONTROLS): 1. Genotype distribution: a) mutation C282Y: no homozygotes, 10/23 heterozygotes, 115/158 normal (p = 0.60); b) mutation H63D: 9/5 homozygotes, 46/52 heterozygotes, 70/124 normal (Chi square 6.51, p = 0.039). 2. Allele frequencies: a) mutation C282Y: 240/339 normal, 10/23 mutated (p = 0.21); b) mutation H63D: 186/300 normal, 64/62 mutated (odds ratio 1.66, 95% CI 1.10-2.52, p = 0.01).

Conclusions: Our results suggest that H63D mutation of the HFE gene, but not the C282Y mutation, is associated to the risk of developing advanced liver alcoholic disease.

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Article Synopsis
  • Hereditary hemochromatosis (HH) is the most prevalent genetic disorder in Canada, primarily due to C282Y homozygosity, leading to iron overload and potential organ damage, but with low penetrance.
  • The study examined 23,432 individuals for TSat and ferritin levels as indicators of C282Y homozygosity, finding that C282Y homozygotes had significantly higher median levels compared to other genotypes.
  • TSat was identified as the most effective predictor of C282Y homozygosity, with specific thresholds that could greatly reduce unnecessary genotyping and save costs in healthcare management.
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