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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Iron overload in africa
New England Journal of Medicine, Volume 326, No. 2, Year 1992
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Description
Background and Methods: In contrast to hemochromatosis, which in white populations is inherited through a gene linked to the HLA locus, iron overload in sub-Saharan Africa is believed to result solely from increased dietary iron derived from traditional home-brewed beer. To examine the hypothesis that African iron overload also involves a genetic factor, we used likelihood analysis to test for an interaction between a gene (the hypothesized iron-loading locus) and an environmental factor (increased dietary iron) that determines transferrin saturation and unsaturated iron-binding capacity. We studied 236 members of 36 African families chosen because they contained index subjects with iron overload. Linkage to the HLA region was tested with use of lod scores.Results: In the index subjects, increased iron was present in both hepatocytes and cells of the mononuclearphagocyte system. Among family members with increased dietary iron due to the consumption of traditional beer, transferrin saturation in serum was distributed bimodally, with 56 normal values (<60 percent saturation) and 44 elevated values; the mean serum ferritin concentration was five times higher in the subjects with elevated transferrin saturation (P<0.005). The pedigree analysis provided evidence of both a genetic effect (P<0.005) and an effect of increased dietary iron (P<0.005) on transferrin saturation and unsaturated iron-binding capacity. In the most likely model, increased dietary iron raised the mean transferrin saturation from 30 to 81 percent and lowered the mean unsaturated iron-binding capacity from 38 to 13 μmol per liter in subjects heterozygous for the iron-loading locus. The hypothesis of tight linkage to HLA was rejected.Conclusions: Iron overload in Africa may be caused by an interaction between the amount of dietary iron and a gene distinct from any HLA-linked gene. (N Engl J Med 1992;326:95–100.). © 1992, Massachusetts Medical Society. All rights reserved.
Authors & Co-Authors
Gordeuk, Victor R.
Zimbabwe, Harare
Godfrey Huggins School of Medicine
Mukiibi, Joshua M.
Zimbabwe, Harare
Godfrey Huggins School of Medicine
Nkanza, Neal
Zimbabwe, Harare
Godfrey Huggins School of Medicine
Chapanduka, Zivanai
Zimbabwe, Harare
Godfrey Huggins School of Medicine
Hasstedt, Sandra J.
United States, Salt Lake City
University of Utah Health Sciences
Samowitz, Wade
United States, Salt Lake City
University of Utah Health Sciences
Edwards, Corwin Q.
United States, Salt Lake City
University of Utah Health Sciences
West, George
Zimbabwe, Harare
Blood Transfusion Service
Ndambire, Solomon
Zimbabwe, Harare
Blood Transfusion Service
Emmanual, Jean
Zimbabwe, Harare
Blood Transfusion Service
Randall, Maurice
Zimbabwe, Kadoma
Sanyati Baptist Hospital
Boone, Paul
Zimbabwe, Kadoma
Sanyati Baptist Hospital
Romano, Paula
United States, Hershey
Penn State Health Milton S. Hershey Medical Center
Martell, Robert W.
South Africa, Cape Town
University of Cape Town
Yamashita, Toyoko
United States, Cleveland
Case School of Medicine
Effler, Paul
United States, Cleveland
Case School of Medicine
Brittenham, Gary M.
United States, Cleveland
Case School of Medicine
Statistics
Citations: 282
Authors: 17
Affiliations: 7
Identifiers
Doi:
10.1056/NEJM199201093260204
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Genetics And Genomics
Study Approach
Qualitative