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Screening for Hemochromatosis and Iron Deficiency in Employees and Primary Care Patients in Western Germany
- Claus Niederau, MD;
- Christoph M. Niederau, MD;
- Stefan Lange, MD;
- Andrea Littauer, MD;
- Nabil Abdel-Jalil, MD;
- Michael Maurer, MD;
- Dieter Haussinger, MD; and
- Georg Strohmeyer, MD
- From Heinrich-Heine-Universitat Dusseldorf, Ruhr-Universitat Bochum, and Mannesmannrohren Werke AG, Dusseldorf, Germany. Acknowledgments: The authors thank Dr. Schrader (Mannesmann-Rohren Werke AG); Drs. Dietrich, Muller-Ost, and Reifferscheid (Henkel AG); and Dr. Christoph-Karababa (Betriebsarzt, University Dusseldorf) for providing data on employees. They thank Drs. Azimi, Dudeck, Ernst, Littauer, Massion, Reinauer, Roper, Scheinder, and Seidenstocker for providing data on outpatients. Grant Support: In part by the Deutsche Forschungsgemeinschaft (Ni 224/6) and the Van Meeteren-Foundation (Dr. Niederau). The grant proposals contained the prospective protocol. Requests for Reprints: Claus Niederau, MD, Department of Medicine, Division of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine-Universitat Dusseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany. Current Author Addresses: Drs. Claus Niederau, Littauer, Abdel-Jalil, Haussinger, and Strohmeyer: Department of Medicine, Division of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine-Universitat Dusseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany.
Abstract
Background: Many physicians still believe that iron overload (hemochromatosis) is an uncommon disorder.
Objective: To estimate the frequency of iron overload and iron deficiency in a group of employees and a group of outpatients.
Design: Prospective screening study.
Setting: Western Germany.
Participants: 3012 asymptomatic employees and 3027 outpatients of nine practitioners.
Measurements: Serum ferritin levels and transferrin saturation were measured. Participants with repeatedly abnormal results had thorough clinical evaluations to identify the cause of iron deficiency or overload.
Results: Gross iron overload (elevated transferrin saturation and ferritin levels) was proven by liver biopsy and phlebotomy treatment in 28 participants (0.4% of female outpatients, 0.7% of male outpatients, 0.2% of female employees, and 0.4% of male employees) and in six siblings of these participants. Of the 34 participants with iron overload, 30 were precirrhotic. Because 60% of an unselected group of employees with elevated transferrin saturation but normal ferritin levels were assumed to have early hemochromatosis, the prevalence of hemochromatosis was estimated to be 1.8% among patients (1.9% in women and 1.6% in men) and 1.0% among employees (1.1% in women and 1.0% in men). Iron deficiency was found in 6.8% of female patients, 2.4% of male patients, 6.0% of female employees, and 0.5% of male employees.
Conclusions: Iron deficiency was more common in women, and iron overload was more common in men. Among male employees, iron overload was almost as common as iron deficiency.
- Copyright ©2004 by the American College of Physicians
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