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Cocchi V, Gasperini S, Hrelia P, Tirri M, Marti M, Lenzi M. Novel Psychoactive Phenethylamines: Impact on Genetic Material. Int J Mol Sci 2020; 21:ijms21249616. [PMID: 33348640 PMCID: PMC7766159 DOI: 10.3390/ijms21249616] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/04/2020] [Accepted: 12/15/2020] [Indexed: 12/16/2022] Open
Abstract
Psychedelic and stimulating phenethylamines belong to the family of new psychoactive substances (NPS). The acute toxicity framework has begun to be investigated, while studies showing genotoxic potential are very limited or not available. Therefore, in order to fill this gap, the aim of the present work was to evaluate the genotoxicity by treating TK6 cells with 2C-H, 2C-I, 2C-B, 25B-NBOMe, and the popular 3,4-Methylenedioxymethylamphetamine (MDMA). On the basis of cytotoxicity and cytostasis results, we selected the concentrations (6.25–35 µM) to be used in genotoxicity analysis. We used the micronucleus (MN) as indicator of genetic damage and analyzed the MNi frequency fold increase by an automated flow cytometric protocol. All substances, except MDMA, resulted genotoxic; therefore, we evaluated reactive oxygen species (ROS) induction as a possible mechanism at the basis of the demonstrated genotoxicity. The obtained results showed a statistically significant increase in ROS levels for all genotoxic phenethylamines confirming this hypothesis. Our results highlight the importance of genotoxicity evaluation for a complete assessment of the risk associated also with NPS exposure. Indeed, the subjects who do not have hazardous behaviors or require hospitalization by using active but still “safe” doses could run into genotoxicity and in the well-known long-term effects associated.
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Affiliation(s)
- Veronica Cocchi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
| | - Sofia Gasperini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
| | - Patrizia Hrelia
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
- Correspondence:
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, 44121 Ferrara, Italy; (M.T.); (M.M.)
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, 44121 Ferrara, Italy; (M.T.); (M.M.)
- Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, 44121 Ferrara, Italy
| | - Monia Lenzi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
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2
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Vinchi F, Porto G, Simmelbauer A, Altamura S, Passos ST, Garbowski M, Silva AMN, Spaich S, Seide SE, Sparla R, Hentze MW, Muckenthaler MU. Atherosclerosis is aggravated by iron overload and ameliorated by dietary and pharmacological iron restriction. Eur Heart J 2020; 41:2681-2695. [PMID: 30903157 DOI: 10.1093/eurheartj/ehz112] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/10/2018] [Accepted: 03/07/2019] [Indexed: 12/20/2022] Open
Abstract
AIMS Whether and how iron affects the progression of atherosclerosis remains highly debated. Here, we investigate susceptibility to atherosclerosis in a mouse model (ApoE-/- FPNwt/C326S), which develops the disease in the context of elevated non-transferrin bound serum iron (NTBI). METHODS AND RESULTS Compared with normo-ferremic ApoE-/- mice, atherosclerosis is profoundly aggravated in iron-loaded ApoE-/- FPNwt/C326S mice, suggesting a pro-atherogenic role for iron. Iron heavily deposits in the arterial media layer, which correlates with plaque formation, vascular oxidative stress and dysfunction. Atherosclerosis is exacerbated by iron-triggered lipid profile alterations, vascular permeabilization, sustained endothelial activation, elevated pro-atherogenic inflammatory mediators, and reduced nitric oxide availability. NTBI causes iron overload, induces reactive oxygen species production and apoptosis in cultured vascular cells, and stimulates massive MCP-1-mediated monocyte recruitment, well-established mechanisms contributing to atherosclerosis. NTBI-mediated toxicity is prevented by transferrin- or chelator-mediated iron scavenging. Consistently, a low-iron diet and iron chelation therapy strongly improved the course of the disease in ApoE-/- FPNwt/C326S mice. Our results are corroborated by analyses of serum samples of haemochromatosis patients, which show an inverse correlation between the degree of iron depletion and hallmarks of endothelial dysfunction and inflammation. CONCLUSION Our data demonstrate that NTBI-triggered iron overload aggravates atherosclerosis and unravel a causal link between NTBI and the progression of atherosclerotic lesions. Our findings support clinical applications of iron restriction in iron-loaded individuals to counteract iron-aggravated vascular dysfunction and atherosclerosis.
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Affiliation(s)
- Francesca Vinchi
- Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Otto Meyerhof Zentrum, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany.,Iron Homeostasis Group, Molecular Medicine Partnership Unit (MMPU), Heidelberg University, Im Neuenheimer Feld 350, 69120, Heidelberg & European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117 Heidelberg, Germany.,New York Blood Center (NYBC), Iron Research Program, Lindsley F. Kimball Research Institute (LFKRI), 310 East 67th Street, 10065, New York, NY, USA.,Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Graca Porto
- Centro Hospitalar do Porto-Hospital Santo António, Largo do Prof. Abel Slazar, 4099-001 Porto, Portugal.,Instituto de Biologia Molecular e Celular & Instituto de Investigação e Inovação em Saúde, University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Andreas Simmelbauer
- Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Otto Meyerhof Zentrum, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany.,Iron Homeostasis Group, Molecular Medicine Partnership Unit (MMPU), Heidelberg University, Im Neuenheimer Feld 350, 69120, Heidelberg & European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117 Heidelberg, Germany
| | - Sandro Altamura
- Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Otto Meyerhof Zentrum, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany.,Iron Homeostasis Group, Molecular Medicine Partnership Unit (MMPU), Heidelberg University, Im Neuenheimer Feld 350, 69120, Heidelberg & European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117 Heidelberg, Germany.,Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Sara T Passos
- New York Blood Center (NYBC), Iron Research Program, Lindsley F. Kimball Research Institute (LFKRI), 310 East 67th Street, 10065, New York, NY, USA
| | - Maciej Garbowski
- Hematology Department, University College London Cancer Institute, London, aul O'Gorman Bld, 72 Huntley Street, WC1E 6DD, London, UK
| | - André M N Silva
- Departamento de Quimica e Bioquimica, REQUIMITE-LAQV, Faculdade de Ciencias, University of Porto, Rua Do Campo Alegre, 4169-007 Porto, Portugal
| | - Sebastian Spaich
- Department of Cardiology, Angiology and Pneumonology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Svenja E Seide
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Richard Sparla
- Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Otto Meyerhof Zentrum, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - Matthias W Hentze
- Iron Homeostasis Group, Molecular Medicine Partnership Unit (MMPU), Heidelberg University, Im Neuenheimer Feld 350, 69120, Heidelberg & European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117 Heidelberg, Germany.,European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117 Heidelberg, Germany
| | - Martina U Muckenthaler
- Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Otto Meyerhof Zentrum, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany.,Iron Homeostasis Group, Molecular Medicine Partnership Unit (MMPU), Heidelberg University, Im Neuenheimer Feld 350, 69120, Heidelberg & European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117 Heidelberg, Germany.,European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117 Heidelberg, Germany
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3
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Lenzi M, Cocchi V, Hrelia P. Flow cytometry vs optical microscopy in the evaluation of the genotoxic potential of xenobiotic compounds. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:696-706. [PMID: 28745810 DOI: 10.1002/cyto.b.21546] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND It is now recognized that mutational events play a key role in the development of pathological processes like cancer, cardiovascular, and neurodegenerative disease. Therefore, it is crucial to have Genetics Toxicology tests that allow rapid and accurate identification of the mutagenic potential of a xenobiotic. Currently the most widely used technique is the "In vitro mammalian cell micronucleus test" performed by optical microscopy, but some problems have been highlighted, including the number of cells analyzed, the high subjectivity of the reading at the microscope and the long analysis times. AIM The aim of this work was to develop a study protocol, for the automation of the "In vitro mammalian cell micronucleus test", by flow cytometry (FCM) analysis, to overcome the limits that afflict the optical microscopy. METHODS The study was conducted on peripheral blood lymphocytes treated with three known clastogens and three known aneugens. RESULTS The results obtained by the proposed FCM technique compared with those obtained through the validated method, demonstrated that the increase of micronuclei percentage is perfectly comparable between the two methods. CONCLUSIONS This fact, in view of results supported by a high number of cells analyzed and obtained by an accurate and objective reading, with a considerable reduction of the analysis time, can support a future request for validation of the micronucleus analysis by FCM. © 2017 International Clinical Cytometry Society.
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Affiliation(s)
- Monia Lenzi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Bologna, 40126, Italy
| | - Veronica Cocchi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Bologna, 40126, Italy
| | - Patrizia Hrelia
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Bologna, 40126, Italy
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Yunker LM, Parboosingh JS, Conradson HE, Faris P, Bridge PJ, Buithieu J, Title LM, Charbonneau F, Verma S, Lonn EM, Anderson TJ. The effect of iron status on vascular health. Vasc Med 2016; 11:85-91. [PMID: 16886838 DOI: 10.1191/1358863x06vm656oa] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The effect of increased iron stores on the progression of atherosclerosis and endothelial health remains inconclusive. This study was designed to evaluate the relationship between hemochromatosis genotypes, serum ferritin levels and presymptomatic vascular abnormalities in a cohort of healthy subjects. Carotid intima-media thickness (CIMT) and brachial flow-mediated vasodilation (FMD) were assessed by high-resolution ultrasound in 907 male (47 ± 10 years) participants enrolled in the Firefighters and their Endothelium (FATE) study. Analyses of the hemochromatosis C282Y, H63D and S65C alleles were simultaneously determined by a single nucleotide polymorphism (SNP) primer extension method. It was found that brachial FMD was not related to serum ferritin or hemochromatosis genotype status. The presence of a hemochromatosis-associated genotype ( n = 18) or heterozygosity for the C282Y genotype ( n = 98) was not associated with an increased mean CIMT. After adjustment for conventional risk factors, serum ferritin was also not associated with mean CIMT. In conclusion, neither ferritin nor a hemochromatosis genotype was related to brachial endothelial function or carotid atherosclerosis. The present study does not support the hypothesis that mild to moderately increased iron stores are associated with enhanced atherosclerosis risk.
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Affiliation(s)
- Leanne M Yunker
- Department of Medical Genetics, University of Calgary, Calgary, Alberta, Canada
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Rainero I, Rubino E, Rivoiro C, Valfrè W, Binello E, Zampella E, De Martino P, Gentile S, Fenoglio P, Savi L, Gallone S, Pinessi L. Haemochromatosis Gene (HFE) Polymorphisms and Migraine: An Association Study. Cephalalgia 2016; 27:9-13. [PMID: 17212677 DOI: 10.1111/j.1468-2982.2006.01231.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Several studies have suggested that iron metabolism may be involved in the pathogenesis of migraine. Using a case-control design, we performed an association study in a cohort of Italian migraine patients to evaluate whether a particular allele or genotype of the haemochromatosis gene ( HFE) would modify the occurrence and clinical features of the disease. We genotyped 256 migraine patients and 237 healthy age-, sex- and ethnicity-matched controls for the C282Y and H63D polymorphisms of the HFE gene. Phenotype and allele frequencies of both polymorphisms were similarly distributed in migraine patients and controls. The patients carrying the DD genotype of the H63D polymorphism showed a later age at onset of the disease and an increased number of migraine attacks. Our data suggest that the HFE gene is not a major disease gene for migraine. However, the H63D polymorphism of the HFE gene may be considered a modifying genetic factor in migraine.
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Affiliation(s)
- I Rainero
- Neurology II, Headache Centre, Department of Neuroscience, University of Torino, Torino, Italy.
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Wallace DF, Subramaniam VN. The global prevalence of HFE and non-HFE hemochromatosis estimated from analysis of next-generation sequencing data. Genet Med 2015; 18:618-26. [PMID: 26633544 DOI: 10.1038/gim.2015.140] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 08/27/2015] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The prevalence of HFE-related hereditary hemochromatosis (HH) among European populations has been well studied. There are no prevalence data for atypical forms of HH caused by mutations in HFE2, HAMP, TFR2, or SLC40A1. The purpose of this study was to estimate the population prevalence of these non-HFE forms of HH. METHODS A list of HH pathogenic variants in publically available next-generation sequence (NGS) databases was compiled and allele frequencies were determined. RESULTS Of 161 variants previously associated with HH, 43 were represented among the NGS data sets; an additional 40 unreported functional variants also were identified. The predicted prevalence of HFE HH and the p.Cys282Tyr mutation closely matched previous estimates from similar populations. Of the non-HFE forms of iron overload, TFR2-, HFE2-, and HAMP-related forms are predicted to be rare, with pathogenic allele frequencies in the range of 0.00007 to 0.0005. Significantly, SLC40A1 variants that have been previously associated with autosomal-dominant ferroportin disease were identified in several populations (pathogenic allele frequency 0.0004), being most prevalent among Africans. CONCLUSION We have, for the first time, estimated the population prevalence of non-HFE HH. This methodology could be applied to estimate the population prevalence of a wide variety of genetic disorders.Genet Med 18 6, 618-626.
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Affiliation(s)
- Daniel F Wallace
- Membrane Transport Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - V Nathan Subramaniam
- Membrane Transport Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia
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7
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Lian J, Xu L, Huang Y, Le Y, Jiang D, Yang X, Xu W, Huang X, Dong C, Ye M, Zhou J, Duan S. Meta-analyses of HFE variants in coronary heart disease. Gene 2013; 527:167-73. [PMID: 23792061 DOI: 10.1016/j.gene.2013.06.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/17/2013] [Accepted: 06/03/2013] [Indexed: 11/16/2022]
Abstract
AIM HFE gene variants can cause hereditary hemochromatosis (HH) that often comes along with an increased risk of coronary heart disease (CHD). The goal of our study is to assess the contribution of four HFE gene variants to the risk of CHD. METHODS AND RESULTS We conducted four meta-analyses of the studies examining the association between four HFE gene variants and the risk of CHD. A systematic search was conducted using MEDLINE, EMBASE, Web of Science and China National Knowledge Infrastructure (CNKI), Wanfang Chinese Periodical. RESULTS Meta-analyses showed that HFE rs1799945-G allele was associated with a 6% increased risk of CHD (P=0.02, odds ratio (OR)=1.06, 95% confidence interval (CI)=1.01-1.11). However, no association between the other three HFE gene variants (rs1800562, rs1800730, and rs9366637) and CHD risk was observed by the meta-analyses (all P values>0.05). In addition, the results of our case-control study indicated that rs1800562 and rs1800730 were monomorphic, and that rs1799945 and rs9366637 were not associated with CHD in Han Chinese. CONCLUSIONS Our meta-analysis suggested that a significant association existed between rs1799945 mutation and CHD, although this mutation was rare in Han Chinese.
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Affiliation(s)
- Jiangfang Lian
- Ningbo Medical Center, Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315041, China
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Bellili NM, Foucan L, Fumeron F, Mohammedi K, Travert F, Roussel R, Balkau B, Tichet J, Marre M. Associations of the -344 T>C and the 3097 G>A polymorphisms of CYP11B2 gene with hypertension, type 2 diabetes, and metabolic syndrome in a French population. Am J Hypertens 2010; 23:660-7. [PMID: 20224556 DOI: 10.1038/ajh.2010.44] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Aldosterone can affect both blood pressure (BP) and glucose metabolism. We assessed the association of two polymorphisms -344 T>C and the 3097 G>A in the aldosterone synthase gene (CYP11B2) with prevalent and incident hypertension (HT), type 2 diabetes (T2D), and the metabolic syndrome (MetS). METHODS We studied the 5,212 participants to D.E.S.I.R. (Data from Epidemiologic Study on the Insulin Resistance syndrome), a cohort from French general population. Genotyping was done by a TaqMan assay. Analysis of covariance, multivariate logistic regression (adjusted for age, MetS components) and haplotype analysis were performed. RESULTS The prevalences and 9-year incidences were 16.7 and 36.1% for HT, 2.6 and 6.2% for T2D, and 19.3 and 25.1% for the MetS. Risk for incident HT was reduced with the AA genotype of 3097 G>A, adjusted odds ratios (OR): 0.67; p = 0.04. The prevalence of HT was lower in women carrying the C allele of -344 T>C, OR 0.75; p = 0.03 for the TC genotype and 0.69; p = 0.03 for the CC genotype. In men, incident T2D was associated with both polymorphisms, adjusted OR for -344 T>C: 1.63; p = 0.04 for TC genotype and 2.12; p = 0.008 for CC genotype; for the 3097 G>A: the AA genotype was associated with a lower risk, OR 0.23; p = 0.02. In men, incident MetS was associated with 3097 G>A, OR: 0.57; p = 0.02 for AA genotype. Significant associations between haplotype combinations and the prevalence or incidence of the three diseases were also found. CONCLUSION The -344 T>C and 3097 G>A polymorphisms in the CYP11B2 are associated with T2D, hypertension and the MetS in European subjects with gender variations.
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Porchay-Baldérelli I, Péan F, Emery N, Maimaitiming S, Bellili N, Travert F, Mohammedi K, Roussel R, Marre M, Fumeron F. Relationships between common polymorphisms of adenosine triphosphate-binding cassette transporter A1 and high-density lipoprotein cholesterol and coronary heart disease in a population with type 2 diabetes mellitus. Metabolism 2009; 58:74-9. [PMID: 19059534 DOI: 10.1016/j.metabol.2008.08.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 08/28/2008] [Indexed: 11/23/2022]
Abstract
Patients with type 2 diabetes mellitus (T2D) have a high coronary risk partly because of low levels of high-density lipoprotein-cholesterol (HDL-C). The adenosine triphosphate-binding cassette transporter A1 (ABCA1) plays a key role in HDL metabolism. We studied the association of common single nucleotide polymorphisms (SNPs) in the ABCA1 gene with HDL-C levels and coronary risk in a cohort of subjects with T2D. We studied 5 SNPs: +69C>T, +378G>C, R219K, I883M, and R1587K. The C allele of +378G>C was significantly associated with lower HDL-C concentrations (P = .04); and the M allele of I883M, with higher HDL-C concentrations (P = .03). No significant association was found between these SNPs and the incidence of new coronary events. Nevertheless, cross-sectional data on entry showed that the frequency of K219 was lower in patients with previous coronary heart disease (angina pectoris and/or myocardial infarction) (odds ratio, OR [95% confidence interval, CI] = 0.80 [0.65-0.98], P = .03, after adjustment for multiple risk factors other than HDL-C). The frequency of K1587 was higher in patients with angina pectoris (OR [95% CI] = 1.27 [1.01-1.58], P = .04, after multiple adjustment). The TT genotype of the C69T SNP was less frequent in subjects with prior myocardial infarction (OR [95% CI] = 0.28 [0.13-0.61], P = .001, after multiple adjustment). These associations persisted after further adjustment for HDL-C levels. In conclusion, common genetic variations of ABCA1 had a moderate influence on HDL-C levels and/or coronary heart disease in patients with T2D. These 2 effects were independent.
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Affiliation(s)
- Isabelle Porchay-Baldérelli
- INSERM U695, Genetic Determinants for Type 2 Diabetes and its Vascular Complications, Xavier Bichat Medical School, 16 rue Henri Huchard, 75018 Paris, France
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van der A DL, Rovers MM, Grobbee DE, Marx JJ, Waalen J, Ellervik C, Nordestgaard BG, Olynyk JK, Mills PR, Shepherd J, Grandchamp B, Boer JM, Caruso C, Arca M, Meyer BJ, van der Schouw YT. Mutations in the HFE Gene and Cardiovascular Disease Risk. ACTA ACUST UNITED AC 2008; 1:43-50. [DOI: 10.1161/circgenetics.108.773176] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Whether mutations in the hemochromatosis (HFE) gene increase cardiovascular disease risk is still undetermined. The main reason is the low frequency of the mutations, in particular of the compound C282Y/H63D genotype. We combined the data of 11 observational studies for an individual patient data meta-analysis.
Methods and Results—
Individual patient data were obtained from published as well as unpublished studies that had information available on the C282Y mutation as well as the H63D mutation in relation to coronary heart disease risk. Individual records were provided on each of the 53 880 participants in 11 studies. In total, 10 541 patients with coronary events were documented, of whom 5724 had an acute myocardial infarction. The crude and adjusted association between HFE genotypes and coronary events was examined by logistic regression analysis. We explored potential effect modification of the association between traditional cardiovascular risk factors and coronary events by HFE genotypes. After full adjustment, the odds ratio for coronary heart disease was 1.12 (95% CI, 0.92 to 1.37) for subjects with the compound heterozygous (C282Y/H63D) genotype relative to those with the wild-type/wild-type genotype. The odds ratios for C282Y/C282Y, C282Y/wild-type, H63D/H63D, and H63D/wild-type were 0.78 (95% CI, 0.49 to 1.26), 0.98 (95% CI, 0.90 to 1.07), 1.16 (95% CI, 0.97 to 1.38), and 1.07 (95% CI, 1.00 to 1.14), respectively. There was no evidence for effect modification.
Conclusions—
The results of this large individual patient data meta-analysis do not support the view that HFE gene mutations are associated with an increased risk of coronary heart disease or acute myocardial infarction.
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Affiliation(s)
- Daphne L. van der A
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Maroeska M. Rovers
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Diederick E. Grobbee
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Joannes J.M. Marx
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Jill Waalen
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Christina Ellervik
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - B�rge G. Nordestgaard
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - John K. Olynyk
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Peter R. Mills
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - James Shepherd
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Bernard Grandchamp
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Jolanda M.A. Boer
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Calogero Caruso
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Marcello Arca
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Beat J. Meyer
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
| | - Yvonne T. van der Schouw
- From the National Institute for Public Health and the Environment, Bilthoven, the Netherlands (D.L.v.d.A., J.M.A.B.); Julius Center for Health Sciences and Primary Care (D.L.v.d.A., M.M.R., D.E.G., Y.T.v.d.S.) and Eijkman Winkler Institute for Microbiology, Infectious Diseases, and Inflammation (J.J.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands; Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif (J.W.); Department of Clinical
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11
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Dunn T, Blankenship D, Beal N, Allen R, Schechter E, Moore W, Perveen G, Eichner J. HFE mutations in heart disease. Heart Vessels 2008; 23:348-55. [DOI: 10.1007/s00380-008-1047-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Accepted: 02/05/2008] [Indexed: 11/30/2022]
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12
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Franchini M, Targher G, Montagnana M, Lippi G. Iron and thrombosis. Ann Hematol 2007; 87:167-73. [PMID: 18066546 PMCID: PMC2226003 DOI: 10.1007/s00277-007-0416-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Accepted: 11/11/2007] [Indexed: 11/28/2022]
Abstract
Although essential for cell physiology, an increase or depletion of body iron has harmful effects on health. Apart from iron deficiency anemia and iron overload-related organ tissue damage, there are increasing evidences that body iron status is implicated in atherosclerotic cardiovascular diseases. The hypothesis formulated in 1981 that iron depletion may protect against cardiovascular events is intriguing and has generated a significant debate in the last two decades. Indeed, to study this phenomenon, several investigators have tried to design appropriate experimental and clinical studies and to identify useful biochemical and genetic markers of iron status. The results of the literature on the effect of iron deficiency and overload on vascular health are critically reviewed in this study from a pathogenic and clinical point of view.
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Affiliation(s)
- Massimo Franchini
- Servizio di Immunoematologia e Trasfusione, Centro Emofilia, Azienda Ospedaliera di Verona, Verona, Italy.
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13
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Porchay-Baldérelli I, Péan F, Bellili N, Jaziri R, Marre M, Fumeron F. The CETP TaqIB polymorphism is associated with the risk of sudden death in type 2 diabetic patients. Diabetes Care 2007; 30:2863-7. [PMID: 17666459 DOI: 10.2337/dc07-0869] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Type 2 diabetic patients have a high risk of coronary heart disease (CHD) and sudden death. This cardiovascular risk can be partly attributed to low levels of HDL cholesterol. The B2 allele of the CETP TaqIB polymorphism has been repeatedly reported to be associated with high HDL cholesterol levels in both healthy and type 2 diabetic subjects, but its association with CHD is unclear. We investigated the association of the CETP TaqIB polymorphism with CHD, and sudden death in particular, in a prospective cohort of type 2 diabetic patients. RESEARCH DESIGN AND METHODS The CETP TaqIB polymorphism was genotyped in 3,124 type 2 diabetic subjects with high cardiovascular risk: the Noninsulin-Dependent Diabetes, Hypertension, Microalbuminuria, Proteinuria, Cardiovascular Events, and Ramipril (DIABHYCAR) study. We used Cox regression analysis to estimate the impact of the TaqIB single nucleotide polymorphism on the CHD events (myocardial infarction or sudden death) during follow-up. RESULTS The incidence of CHD was higher in B1B1 homozygotes than in B2 carriers (P = 0.02). This effect was mainly due to sudden death (hazard ratio [B1B1 vs. B2+] = 1.51 [95% CI = 1.05-2.18]). Although the B1 allele was associated in a dose-dependent fashion with lower HDL cholesterol (P < 0.001), the association with sudden death persisted after adjustment for multiple risk factors, including HDL cholesterol levels. CONCLUSIONS In type 2 diabetic patients, the CETP TaqIB polymorphism is a good genetic predictor of cardiac mortality. This association is partly independent of the effect on HDL cholesterol levels.
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Affiliation(s)
- Isabelle Porchay-Baldérelli
- Institut National de la Santé et de la Recherche Médicale, U695, Genetic Determinants for Type 2 Diabetes and Its Vascular Complications, Paris, France
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14
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Ellervik C, Tybjaerg-Hansen A, Appleyard M, Sillesen H, Boysen G, Nordestgaard BG. Hereditary hemochromatosis genotypes and risk of ischemic stroke. Neurology 2007; 68:1025-31. [PMID: 17389307 DOI: 10.1212/01.wnl.0000257814.77115.d6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We tested the hypothesis that the HFE genotypes H63D/H63D, H63D/wild type, C282Y/H63D, C282Y/C282Y, and C282Y/wild type are risk factors for symptomatic carotid atherosclerosis, ischemic cerebrovascular disease (ICVD), and ischemic stroke. METHODS We performed an age- and gender-matched case-control study of 701 cases with symptomatic carotid atherosclerosis vs 2,777 controls, and a prospective study of 9,178 individuals from the Danish general population followed for 24 years, during which 504 developed ICVD, of whom 393 had ischemic stroke. RESULTS Genotype was not consistently associated with symptomatic carotid atherosclerosis. The cumulative incidences of ICVD and ischemic stroke by age were increased for H63D/H63D vs wild type/wild type (log-rank: p = 0.003 and p < 0.001). H63D/H63D vs wild type/wild type had an age- and multifactorially adjusted hazard ratio of 2.0 (95% CI: 1.2 to 3.2; p = 0.007) and 2.1 (1.3 to 3.5; p = 0.004) for ICVD and of 2.4 (1.4 to 4.0; p = 0.001) and 2.8 (1.7 to 4.6; p < 0.001) for ischemic stroke; these remained significant after correction for multiple comparisons. Other hereditary hemochromatosis genotypes were not associated with ICVD or ischemic stroke. CONCLUSIONS Hereditary hemochromatosis H63D homozygosity predicts a two- to threefold risk of ICVD and ischemic stroke.
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Affiliation(s)
- C Ellervik
- Department of Clinical Biochemistry, Herlev University Hospital, Herlev, Denmark
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15
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Abstract
Fe homeostasis is maintained by regulation of Fe absorption to balance largely unregulated body Fe losses. The majority of human subjects maintain relatively constant Fe stores; however, Fe deficiency and Fe overload are common conditions. Fe overload is frequently associated with mutations in genes of Fe metabolism. The present paper summarises present knowledge of these mutations as well as indicating other genes that animal studies have implicated as candidates for influencing body Fe stores.
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Affiliation(s)
- Johanne McGregor
- Division of Life Sciences, King's College London, London SE1 9NN, UK
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16
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Tavani A, Gallus S, Bosetti C, Parpinel M, Negri E, La Vecchia C. Dietary iron intake and risk of non-fatal acute myocardial infarction. Public Health Nutr 2007; 9:480-4. [PMID: 16870020 DOI: 10.1079/phn2005869] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjectiveThe relation between several measures of body iron and atherosclerotic disease, particularly acute myocardial infarction (AMI), is debated. This is of specific interest since iron is frequently included in supplementation and fortification of foods. We assessed the relation between dietary iron intake and the risk of non-fatal AMI.DesignCase–control study. The information was collected by interviewers using a food-frequency questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple unconditional logistic regression models, including terms for energy and alcohol intakea, as well as for sociodemographic factors, tobacco and other major recognised risk factors for AMI.SettingMilan, Italy, between 1995 and 1999.SubjectsCases were 507 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 478 patients admitted to hospital for a wide spectrum of acute conditions unrelated to known or potential AMI risk factors.ResultsCompared with patients in the lowest tertile of total iron intake, the OR was 0.48 (95% CI 0.29–0.82) for those in the highest tertile. The corresponding value for haem iron was 0.71 (95% CI 0.48–1.06), for non-haem, non-alcohol iron was 0.80 (95% CI 0.51–1.24) and for iron derived from alcoholic beverages was 0.60 (95% CI 0.40–0.90). Sex-specific OR for total iron intake were not heterogeneous.ConclusionsIn this Italian population dietary iron intake was inversely related to AMI risk. This inverse association may depend on other nutrients present in the major sources of iron in the Italian diet.
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Affiliation(s)
- Alessandra Tavani
- Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, I-20157 Milan, Italy.
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17
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Porchay I, Péan F, Bellili N, Royer B, Cogneau J, Chesnier MC, Caradec A, Tichet J, Balkau B, Marre M, Fumeron F. ABCA1 single nucleotide polymorphisms on high-density lipoprotein-cholesterol and overweight: the D.E.S.I.R. study. Obesity (Silver Spring) 2006; 14:1874-9. [PMID: 17135600 DOI: 10.1038/oby.2006.217] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The adenosine triphosphate-binding cassette A1 (ABCA1) gene plays a key role in reverse cholesterol transport. Some ABCA1 gene polymorphisms have been associated with high-density lipoprotein-cholesterol (HDL-C) concentrations. The aim of this study was to assess the effect of three polymorphisms, C69T, G378C, and G1051A (R219K), on HDL-C levels and their interaction with BMI in more than 5000 French whites from the D.E.S.I.R. (Data from an Epidemiological Study on the Insulin Resistance syndrome) cohort study. The T allele of the C69T single nucleotide polymorphism (SNP) was associated with higher HDL-C levels in normal-weight men (BMI <25 kg/m(2)). The C allele of the G378C SNP was associated with lower HDL-C in overweight subjects (BMI > or =25 kg/m(2)). For the G1051A SNP, in the normal-weight group, the minor A allele was significantly associated with higher HDL-C levels. In contrast, in overweight people, the minor allele was associated with lower HDL-C levels. After accounting for multiple testing, empiric p values remained significant for the associations between G378C SNP and HDL-C in the overweight group and between G1051A SNP and HDL-C in the normal-weight group. This study suggests that ABCA1 gene polymorphisms modulate HDL-C concentrations, in interaction with BMI, and, thus, they might influence cardiovascular risk in the general population.
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Affiliation(s)
- Isabelle Porchay
- Institut National de la Santé et de la Recherche Médicale, Unité 695, Xavier Bichat School of Medicine, Paris, France
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18
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van der A DL, Peeters PHM, Grobbee DE, Roest M, Marx JJM, Voorbij HM, van der Schouw YT. HFE mutations and risk of coronary heart disease in middle-aged women. Eur J Clin Invest 2006; 36:682-90. [PMID: 16968463 DOI: 10.1111/j.1365-2362.2006.01711.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although heterozygosity for the C282Y mutation in the HFE gene has been associated with an increased risk of cardiovascular events, epidemiological studies remain inconclusive. The aim of the present study was to obtain further evidence as to whether HFE mutations are associated with risk of coronary heart disease (CHD) in middle-aged women. We used data of a cohort of 15 236 Dutch middle-aged women to investigate whether C282Y carriers and H63D carriers are at increased risk of coronary heart disease compared with non-carriers. MATERIALS AND METHODS Women were included in the study between 1993 and 1997 and were followed until 1 January 2000 for cardiovascular events. HFE genotyping was performed on all 211 coronary heart disease cases and a randomly selected sample from the baseline cohort (n = 1526). A weighted Cox proportional hazards model was used to estimate crude, age-adjusted and multivariate adjusted hazard ratios for C282Y and H63D carriership in relation to coronary heart disease. RESULTS Compared with non-carriers, those that carried the C282Y allele were not at increased risk for CHD (HR = 1.25, 95% CI = 0.74-2.09). Neither did we find an association between the H63D mutation and CHD risk (HR = 0.73, 95% CI = 0.43-1.24). CONCLUSIONS Our results are in accordance with similar studies to date, for which we present a meta-analysis. HFE mutations appear not to affect the risk of coronary heart disease.
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19
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Ellervik C, Tybjaerg-Hansen A, Grande P, Appleyard M, Nordestgaard BG. Hereditary Hemochromatosis and Risk of Ischemic Heart Disease. Circulation 2005; 112:185-93. [PMID: 15998685 DOI: 10.1161/circulationaha.104.496075] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
We tested the hypothesis that the hereditary hemochromatosis genotypes C282Y/C282Y, C282Y/H63D, or C282Y/wild-type are risk factors for ischemic heart disease (IHD) and myocardial infarction (MI).
Methods and Results—
We performed a prospective study of 9178 individuals from the Danish general population followed up for 24 years, during which 1035 and 511 developed IHD and MI, respectively, and a case-control study of 2441 and 1113 IHD and MI cases versus 8080 controls. C282Y/C282Y, C282Y/H63D, and C282Y/wild-type versus wild-type/wild-type individuals were not associated with increased risk of IHD or MI in prospective studies, overall or stratified by gender. We had 90% power to detect a hazard ratio for IHD of 3.4 for C282Y/C282Y, 1.9 for C282Y/H63D, and 1.3 for C282Y/wild-type versus wild-type/wild-type. Furthermore, these genotypes were not associated with increased risk of IHD or MI in case-control studies, overall or stratified by gender. We had 90% power to detect an odds ratio for IHD of 3.6 for C282Y/C282Y, 1.8 for C282Y/H63D, and 1.3 for C282Y/wild-type versus wild-type/wild-type.
Conclusions—
In these studies, hereditary hemochromatosis C282Y/C282Y, C282Y/H63D, and C282Y/wild-type genotypes were not associated with IHD or MI; however, the study lacked the power to exclude the possibility that C282Y/C282Y and C282Y/H63D individuals have a modestly increased risk of IHD or MI.
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Affiliation(s)
- Christina Ellervik
- Department of Clinical Biochemistry, Herlev University Hospital, Herlev, Denmark
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20
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You SA, Wang Q. Ferritin in atherosclerosis. Clin Chim Acta 2005; 357:1-16. [PMID: 15963791 DOI: 10.1016/j.cccn.2005.02.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2004] [Revised: 01/25/2005] [Accepted: 02/01/2005] [Indexed: 11/20/2022]
Abstract
Iron, an essential element for many important cellular functions in all living organisms, can catalyze the formation of potentially toxic free radicals. Excessive iron is sequestered by ferritin in a nontoxic and readily available form in a cell. Ferritin is composed of 24 subunits of different proportions of two functionally distinct subunits: ferritin H and L. The former is involved in ferroxidase activity necessary for iron uptake and oxidation of ferrous iron, while the latter is involved in nucleation of the iron core. The expression of ferritin is under delicate control and is regulated at both the transcriptional and posttranscriptional levels by iron, cytokines and oxidative stress. Elevated ferritin levels are associated with an increased risk of atherosclerotic coronary artery disease (CAD), the leading cause of death and illness in developed countries. Serum ferritin levels are a good indicator of iron stores in the body. In fact, epidemiological studies have suggested that elevated serum ferritin levels are associated with an increased risk of CAD and myocardial infarction (MI), though inconsistent results were obtained in some other studies. Moreover, recent proteomics and molecular biology studies have shown that ferritin levels in arteries are increased in diseased tissues, which further supports the link of ferritin to CAD/MI. Future studies will determine whether increased ferritin levels can serve as a distinct biomarker for the incidence of CAD/MI and distinguish whether increased ferritin levels are a cause of CAD or a consequence of the disease process.
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Affiliation(s)
- Sun-Ah You
- Center for Molecular Genetics, Department of Molecular Cardiology, ND4-38, Lerner Research Institute, and Center for Cardiovascular Genetics, The Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, USA
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21
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Kartikasari AER, Georgiou NA, Visseren FLJ, van Kats-Renaud H, van Asbeck BS, Marx JJM. Intracellular Labile Iron Modulates Adhesion of Human Monocytes to Human Endothelial Cells. Arterioscler Thromb Vasc Biol 2004; 24:2257-62. [PMID: 15486315 DOI: 10.1161/01.atv.0000147406.00871.b3] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Elevated iron stores and high plasma iron concentration have been linked to an increased risk of atherosclerosis. Iron may thereby affect the interaction of monocytes to endothelium, an initial event in the formation of atherosclerotic plaques. METHODS AND RESULTS Addition of 10 mumol/L non-transferrin-bound iron to the incubation medium caused a 2-fold increase in monocyte adhesion to human umbilical vein endothelial cells (HUVECs). A concordant increase in the expression of the following adhesion molecules was observed: vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and endothelial selectin on HUVECs as well as very late antigen-4, and lymphocyte function-associated antigen-1 on monocytes. The inclusion of either deferiprone or salicylaldehyde isonicotinoylhydrazone counteracted these effects. Intracellular iron chelation by deferoxamine was completed only after 10 hours of incubation, shown by reversal of iron-quenched intracellular calcein signal, and concurrently the effects of iron were blunted. The membrane-impermeable chelator, diethylenetriamine pentaaceticacid, failed to negate iron effects, even after 48 hours of treatment. Furthermore, only membrane-permeable superoxide or hydroxyl radical scavengers were capable of preventing HUVEC activation by iron. CONCLUSIONS Non-transferrin-bound iron increases the level of intracellular labile iron, which promotes monocyte recruitment to endothelium and may thereby contribute to the pathogenesis of atherosclerosis. Iron-induced adhesion molecule expression was observed, and this event may involve the production of oxygen radicals.
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Affiliation(s)
- Apriliana E R Kartikasari
- Eijkman-Winkler Center for Medical Microbiology, Infectious Diseases, and Inflammation and Eijkman Graduate School for Immunology and Infectious Diseases, University Medical Center Utrecht, The Netherlands
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22
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Abstract
This article briefly discusses the cardiac status of liver transplant recipients and their preoperative cardiac evaluation. It describes in detail perioperative and early and late postoperative complications as well as the cardiac problems associated with immunosuppression. The preoperative cardiovascular status of patients is important in determining how they cope with the stresses imposed by liver transplantation. Minor early cardiac events are common and may influence longer term cardiac morbidity. Immunosuppressive therapy may have short term effects but is likely to adversely affect long term cardiac risk.
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Goland S, Beilinson N, Kaftouri A, Shimoni S, Caspi A, Malnick SDH. Hemochromatosis mutations are not linked to dilated cardiomyopathy in Israeli patients. Eur J Heart Fail 2004; 6:547-50. [PMID: 15302000 DOI: 10.1016/j.ejheart.2003.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2003] [Revised: 09/17/2003] [Accepted: 11/13/2003] [Indexed: 11/26/2022] Open
Abstract
AIMS Hemochromatosis is a condition in which iron loading impairs the function of many organs, including the heart. Congestive heart failure with left ventricular dilatation is commonly found in patients with hemochromatosis. Two missense mutations (C282Y and H63D) have been shown to be responsible for the majority of cases of hemochromatosis. METHODS AND RESULTS We examined 156 patients with congestive heart failure due to dilated cardiomyopathy. Details were recorded of clinical and echocardiographic parameters. DNA was extracted from peripheral blood and checked for the presence of the C282Y and H63D mutations by a commercially available single nucleotide primer extension assay. A control group of 98 healthy blood donors was also checked for the presence of these mutations. Of the 157 patients, 42 (26.75%) had at least one mutation. Five (3.65%) were homozygotic for the H63D mutation and 37 (23.6%) were heterozygotic for the H63D mutation. The C282Y mutation was not present. In a control population of 98 healthy blood donors, 27 (27.6%) were heterozygous for the H63D population and none had the C282Y mutation (no significant difference between the patients with cardiomyopathy and the healthy blood donors, chi(2) test 0.754). There was a non-significant trend to a difference in the prevalence of homozygotic H63D between the cardiomyopathy patients and the healthy blood donors (3.18% vs. 0%, P=0.076, chi(2) test). There was no statistically significant difference between the cardiomyopathy patients with and without the mutations in terms of age, gender, hemoglobin, iron, transferrin, ferritin, presence of diabetes mellitus, hypertension and previous coronary artery bypass grafting. CONCLUSION In our population of patients with dilated cardiomyopathy, there was no evidence for hemochromatosis being an important etiology.
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Affiliation(s)
- Sorel Goland
- Heart Institute, Kaplan Medical Center, Rehovot 76100, Israel.
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24
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Opinion of the Scientific Panel on Dietetic products, nutrition and allergies [NDA] related to the Tolerable Upper Intake Level of Iron. EFSA J 2004. [DOI: 10.2903/j.efsa.2004.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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25
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Gunn IR, Maxwell FK, Gaffney D, McMahon AD, Packard CJ. Haemochromatosis gene mutations and risk of coronary heart disease: a west of Scotland coronary prevention study (WOSCOPS) substudy. Heart 2004; 90:304-6. [PMID: 14966054 PMCID: PMC1768115 DOI: 10.1136/hrt.2003.015149] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To measure the frequency of genotypes of the HFE (haemochromatosis) gene in patients recruited to the west of Scotland coronary prevention study (WOSCOPS), and relate them to the subsequent occurrence of coronary clinical events. DESIGN Nested case-control study, drawing samples of DNA from the biological bank of a cohort study. PATIENTS Men aged 45-64 years in 1989, with moderate hypercholesterolaemia and no evidence of coronary heart disease at baseline. INTERVENTIONS Follow up for a mean period of 4.9 years. Typing for C282Y and H63D mutations of the HFE gene in 482 subjects with a subsequent coronary event and 1104 without an event. RESULTS The C282Y mutation was present in 81 of 482 cases (16.8%) and 182 of 1104 controls (16.5%). Comparing the prevalence of gene mutations in the cases and controls, there were no significant differences. The hazard ratio for C282Y heterozygotes was 1.03 (95% confidence interval (CI) 0.77 to 1.36) and for C282Y/H63D compound heterozygotes 1.04 (95% CI 0.50 to 2.14). Prespecified subgroup analyses of the pravastatin, placebo, smoking, and non-smoking groups showed no significant differences between cases and controls. Repeating the analyses after adjusting for possible confounding factors produced no change in the results. CONCLUSIONS In a population of moderately hypercholesterolaemic middle aged Scottish men who did not have any evidence of coronary heart disease at baseline, the presence of a C282Y mutation in the HFE gene did not predict the occurrence of coronary events over a mean follow up of 4.9 years.
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Affiliation(s)
- I R Gunn
- Department of Biochemistry, Wishaw General Hospital, Wishaw, Strathclyde, UK.
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Hetet G, Devaux I, Soufir N, Grandchamp B, Beaumont C. Molecular analyses of patients with hyperferritinemia and normal serum iron values reveal both L ferritin IRE and 3 new ferroportin (slc11A3) mutations. Blood 2003; 102:1904-10. [PMID: 12730114 DOI: 10.1182/blood-2003-02-0439] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Unexplained hyperferritinemia is a common clinical finding, even in asymptomatic persons. When early onset bilateral cataracts are also present, the hereditary hyperferritinemia-cataract syndrome (HHCS), because of heterozygous point mutation in the L ferritin iron-responsive element (IRE) sequence, can be suspected. We sequenced the L ferritin exon 1 in 52 DNA samples from patients referred to us for molecular diagnosis of HHCS. We identified 24 samples with a point mutation/deletion in the IRE. For the 28 samples in which no IRE mutation was present, we also genotyped HFE mutations and sequenced both H ferritin and ferroportin genes. We found an increased frequency of His63Asp heterozygotes (12 of 28) but no H ferritin mutations. We identified 3 new ferroportin mutations, producing, respectively, Asp157Gly, Gln182His, and Gly323Val amino acid replacements, suggesting that these patients have dominant type 4 hemochromatosis. This study demonstrates that both L ferritin IRE and ferroportin mutations can account for isolated hyperferritinemia. The presence of cataract does not permit the unambiguous identification of patients with HHCS, although the existence of a family history of cataract was only encountered in these patients. This raises the intriguing possibility that lens ferritin accumulation might be a factor contributing to age-related cataract in the general population. Additional causes of isolated hyperferritinemia remain to be identified.
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Affiliation(s)
- Gilles Hetet
- INSERM U409, Faculte Xavier Bichat, 16 rue Henri Huchard, BP 416, 75870 Paris cedex 18, France
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Campbell S, George DK, Robb SD, Spooner R, McDonagh TA, Dargie HJ, Mills PR. The prevalence of haemochromatosis gene mutations in the West of Scotland and their relation to ischaemic heart disease. Heart 2003; 89:1023-6. [PMID: 12923017 PMCID: PMC1767801 DOI: 10.1136/heart.89.9.1023] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Excess iron stores have been postulated to enhance the risk of ischaemic heart disease. This study aims to determine whether the two major mutations of the haemochromatosis (HFE) gene (C282Y and H63D) are associated with ischaemic heart disease (IHD) or myocardial infarction (MI). DESIGN Cross sectional case-control study. SETTING The geographical area studied by the MONICA (monitoring trends and determinants in cardiovascular disease) heart attack register for North Glasgow in Scotland, UK. PATIENTS 1009 control subjects chosen at random from general practitioner registers were studied. Additionally, 924 subjects who had survived a first MI sustained between 1985 and 1992 were identified from the MONICA register. MAIN OUTCOME MEASURES C282Y and H63D mutations, previous MI, and presence or absence of IHD. RESULTS Mutant gene prevalences in the whole control population were as follows: C282Y: homozygote 0.9%, heterozygote 17.7%; H63D: homozygote 2.1%, heterozygote 25.5%; and compound heterozygote: 2.4%. Analysis by chi(2) test and logistic regression analysis did not identify any significant difference in genotype prevalence between normal control, IHD control, and MI survivor groups. CONCLUSIONS The C282Y homozygote and heterozygote prevalences are among the highest reported worldwide. No association between IHD or MI and HFE genotype was identified. However, these results need to be interpreted in the light of the cross sectional case-control nature of the study.
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Affiliation(s)
- S Campbell
- Department of Gastroenterology, Gartnavel General Hospital, Glasgow, UK
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Abstract
Hemochromatosis is the clinical expression of iron overload and occurs as hereditary and secondary variants. In hereditary hemochromatosis, an inborn error in iron metabolism results in excess absorption of dietary iron, which gradually accumulates in the liver, pancreas, and heart. The most common form of hereditary hemochromatosis is related to homozygosity for the C282Y mutation in the HFE gene. Early diagnosis is essential because hereditary hemochromatosis is common, severe, and treatable. Early manifestations consist of asthenia, arthralgia, and serum transferrin saturation elevation. The C282Y mutation should be looked for to confirm the diagnosis in the patient and family members. Measurement of serum transferrin saturation followed by genetic testing in individuals with values above 45% is a reasonable screening strategy.
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Affiliation(s)
- Gérard Chalès
- Rheumatology department, Hôpital Sud, 16, boulevard de Bulgarie, BP 59129, 35065 Rennes, cedex 2, France.
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Candore G, Balistreri CR, Lio D, Mantovani V, Colonna-Romano G, Chiappelli M, Tampieri C, Licastro F, Branzi A, Averna M, Caruso M, Hoffmann E, Caruso C. Association between HFE mutations and acute myocardial infarction: a study in patients from Northern and Southern Italy. Blood Cells Mol Dis 2003; 31:57-62. [PMID: 12850485 DOI: 10.1016/s1079-9796(03)00065-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is interest in the role of iron in age-related diseases such as atherosclerosis. Tissue iron deposition could be harmful, because Fe(2+) can react with H(2)O(2) to form OH(-) radicals and Fe(2+) can react with O(2) to form reactive oxygen species. Free radicals react with cell membranes and cell organelles and could lead to the development of atherosclerosis by initiating lipid peroxidation. Hereditary hemochromatosis provides an opportunity for studying the effects of iron on cardiovascular disease. Some studies have shown that individuals who carried HFE mutations may be at greater risk of developing coronary heart disease than those without the mutations. In contrast, a large number of studies have reported no association between HFE mutations and coronary heart disease. These studies have possible confounding factors, such as the homogeneity of the population in term of geographical origin among others. We studied the relation between HFE mutations and acute myocardial infarction in two case-control studies involving two sets of subjects representing different age groups from different geographic regions in Italy. The first one was composed of 172 older patients (139 males and 33 females; mean age 67) and 207 healthy controls (91 males and 116 females; mean age 46) from Emilia-Romagna. The second one was composed of younger 77 patients (75 males and 2 females; mean age 41) and 172 healthy controls (75 males and 97 females, mean age: 38) from Sicily. All patients were genotyped for ApoE alleles, since the ApoE- epsilon 4 allele is considered a risk factor for cardiovascular diseases and can interfere with other genetic and environmental factors by modifying susceptibility to this disease. DNA typing for C282Y and H63D HFE alleles was performed also. There were no significant differences in frequencies of the different HFE alleles between acute myocardial infarction patients and controls in cohorts of both old and young patients. Also taking into account the presence or absence of the ApoE- epsilon 4 allele, no significant differences in H63D allele frequencies were observed. Thus, our study, performed in two samples of genetically homogeneous patients and controls, does not support the suggestion that HFE mutations may be associated with acute myocardial infarction in susceptible individuals.
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Affiliation(s)
- Giuseppina Candore
- Gruppo di studio sull'immunosenescenza, Dipartimento di Biopatologia e Metodologie Biomediche, Università di Palermo, Palermo, Italy
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Gaenzer H, Marschang P, Sturm W, Neumayr G, Vogel W, Patsch J, Weiss G. Association between increased iron stores and impaired endothelial function in patients with hereditary hemochromatosis. J Am Coll Cardiol 2002; 40:2189-94. [PMID: 12505233 DOI: 10.1016/s0735-1097(02)02611-6] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We studied associations between iron status and early functional and structural vascular abnormalities in patients with hereditary hemochromatosis (HH). BACKGROUND Iron may be involved in atherogenesis, and patients bearing a genetic mutation associated with HH are possibly at risk of developing coronary heart disease. METHODS We studied the vascular properties of 41 HH patients who had homozygosity for the C282Y mutation, along with 51 age-matched control subjects, by determination of endothelium-dependent dilation (EDD) of the brachial artery and intima-media thickness (IMT) of the carotid artery. RESULTS Male HH patients who were not receiving phlebotomy therapy showed a reduced EDD and increased IMT compared with controls and HH patients receiving therapy. In female HH patients, irrespective of treatment status, vascular parameters were not different from those of controls, and none of these patients had severe iron overload. In HH patients, increased iron load was significantly associated with reduced EDD and increased IMT. Moreover, we found a positive correlation between body iron stores and indicators of oxidative stress. When previously untreated male HH patients were re-investigated after intensive phlebotomy therapy, a significant improvement in EDD was observed (2.6 +/- 1.3% before vs. 5.5 +/- 2.1% after treatment, p = 0.0015). CONCLUSIONS Impaired endothelial function and increased IMT are associated with iron overload, with subsequent induction of oxidative stress, and are not linked to a genetic disability in HH patients. Consequent iron-depletion therapy normalizes endothelial function and may thus reduce the increased risk of cardiovascular events. Female patients may be at a reduced risk, presumably due to continuous iron loss by menstruation.
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Affiliation(s)
- Hannes Gaenzer
- Department of Internal Medicine, University Hospital, Innsbruck, Austria
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Fuchs J, Podda M, Packer L, Kaufmann R. Morbidity risk in HFE associated hereditary hemochromatosis C282Y heterozygotes. Toxicology 2002; 180:169-81. [PMID: 12324192 DOI: 10.1016/s0300-483x(02)00389-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Hereditary hemochromatosis (HHC) is a late-onset, autosomal recessive disorder leading to a chronic iron overload syndrome, finally causing diabetes, cardiomyopathy and liver disease. HHC is the most common single gene disorder in northern Europeans that occurs with a frequency of approximately 0.5%, and most of these patients carry the C282Y and H63D mutation in the HFE gene on chromosome 6p21.3. The vast majority of HHC patients are homozygous for the C282Y mutation, but HHC phenotypes are observed in other genotypes. Expression of the disease, in those homozygous for the C282Y mutation, is highly variable depending on the various features of the population studied. C282Y heterozygotes have slightly increased iron stores and in absence of other genetic and/or environmental factors do usually not develop the HHC phenotype. It is currently a matter of debate whether C282Y heterozygotes may have an increased risk for morbidity. Different studies investigating the association of C282Y heterozygocity with morbidity have given conflicting results, as is exemplified by extrahepatic cancers, cardiovascular diseases, alcoholic liver disease, and diabetes. However, there are examples of clear and unambiguous disease associations, such as with sporadic pophyria cutanea tarda. It remains to be seen whether a strong correlation between the C282Y heterozygous state and distinct pathological conditions will exist and large-scale genotyping studies will help to identify such potential risk groups in the future.
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Affiliation(s)
- Jurgen Fuchs
- Department of Dermatology, Medical School, J.W. Goethe University, Frankfurt, Germany.
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Waalen J, Felitti V, Gelbart T, Ho NJ, Beutler E. Prevalence of coronary heart disease associated with HFE mutations in adults attending a health appraisal center. Am J Med 2002; 113:472-9. [PMID: 12427496 DOI: 10.1016/s0002-9343(02)01249-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE Mutations of the HFE gene that cause hereditary hemochromatosis may be associated with an increased risk of cardiovascular disease. We examined the relation between two HFE mutations (C282Y and H63D), indicators of iron homeostasis, and the prevalence of coronary heart disease in a large population of white adults. SUBJECTS AND METHODS We conducted a cross-sectional study of 30,916 white adults aged 25 to 98 years who attended a health appraisal center and underwent screening for HFE mutations. Coronary heart disease and cardiovascular risk factors were ascertained by questionnaire and medical records. RESULTS Overall, 12% (1798/15,362) of men and 7% (1074/15,554) of women had a history of coronary heart disease. Of 10 HFE genotypes tested (five genotypes by sex), only men with the C282Y/H63D genotype (compound heterozygotes) had a significantly higher prevalence of coronary heart disease compared with men with no HFE mutations (odds ratio = 1.6; 95% confidence interval: 1.1 to 2.4; P = 0.01) after adjusting for cardiovascular risk factors. Elevated serum ferritin levels (>250 ng/mL) were associated with a lower prevalence of coronary heart disease in men (10% [255/2209] vs. 12% [1515/12,461] in controls, P = 0.008), which was not significant after adjusting for use of aspirin and anticoagulants. There were no significant associations between elevated transferrin saturation in either men or women, or between elevated serum ferritin levels or HFE mutations in women, and the prevalence of coronary heart disease. CONCLUSION The results do not support a consistent association between HFE mutations or serum iron indicators and the prevalence of coronary heart disease.
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Affiliation(s)
- Jill Waalen
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, California 92037, USA.
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Sempos CT. Do body iron stores increase the risk of developing coronary heart disease? Am J Clin Nutr 2002; 76:501-3. [PMID: 12197991 DOI: 10.1093/ajcn/76.3.501] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christopher T Sempos
- Department of Social and Preventive Medicine, the State University of New York at Buffalo, 14214-3000, USA.
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Bozzini C, Girelli D, Tinazzi E, Olivieri O, Stranieri C, Bassi A, Trabetti E, Faccini G, Pignatti PF, Corrocher R. Biochemical and Genetic Markers of Iron Status and the Risk of Coronary Artery Disease: An Angiography-based Study. Clin Chem 2002. [DOI: 10.1093/clinchem/48.4.622] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background: Iron may promote coronary atherosclerotic disease (CAD) by increasing lipid peroxidation. Studies on biochemical or genetic markers of body iron stores as risk factors for CAD have yielded conflicting results.
Methods: We studied 849 individuals with a clear-cut definition of the CAD phenotype, i.e., with (CAD; n = 546) or without (CAD-free; n = 303) angiographically documented disease. We determined serum ferritin, as a biochemical estimate of iron stores, and the C282Y mutation in the HFE gene, i.e., the main cause of hemochromatosis in Caucasians. The relationships of ferritin with serum markers of either inflammation [C-reactive protein (CRP)] or lipid peroxidation (malondialdehyde) were also investigated.
Results: Mean ferritin concentrations were slightly higher in CAD vs CAD-free individuals, but this difference disappeared after adjusting for sex and CRP. Ferritin was significantly correlated with CRP (Spearman’s test, ρ = 0.129; P <0.001). Heterozygotes for Cys282Tyr were 4.8% among the CAD group and 6.6% among the CAD-free group (P = 0.26). The prevalence of high concentrations of stored iron, defined as ferritin concentrations above the sex-specific upper quintiles of the control distribution, was also similar in the two groups. There was a higher prevalence of “iron depletion” in CAD-free vs CAD females (20% vs 8.8%, respectively), but this difference disappeared after adjustment for age and other cardiovascular risk factors (odds ratio, 0.66; 95% confidence interval, 0.21–2.08). No differences in iron markers were found in CAD patients with or without myocardial infarction.
Conclusions: Our results do not support a role for biochemical or genetic markers of iron stores as predictors of the risk of CAD or its thrombotic complications.
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Affiliation(s)
| | | | | | | | | | - Antonella Bassi
- the Institute of Clinical Chemistry, University of Verona, 37134 Verona, Italy
| | | | - Giovanni Faccini
- the Institute of Clinical Chemistry, University of Verona, 37134 Verona, Italy
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Affiliation(s)
- Jing Ma
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Meir J Stampfer
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
- Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA 02115
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Claeys D, Walting M, Julmy F, Wuillemin WA, Meyer BJ. Haemochromatosis mutations and ferritin in myocardial infarction: a case-control study. Eur J Clin Invest 2002; 32 Suppl 1:3-8. [PMID: 11886425 DOI: 10.1046/j.1365-2362.2002.0320s1003.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Iron accumulation may contribute to coronary heart disease by catalysing free radical formation and promoting oxidation of low-density lipoprotein cholesterol. Epidemiological studies of iron status and coronary heart disease are conflicting. DESIGN To test whether genetic haemochromatosis is associated with myocardial infarction, we determined the prevalence of three mutations in the HFE gene (Cys282Tyr, His63Asp and Ser65Cys) in a 2 : 1 case-control study including 177 patients who survived an acute myocardial infarction and 89 controls. Genotypes were determined by PCR amplification of genomic DNA followed by restriction enzyme digestion. We also studied the relationship between plasma ferritin and myocardial infarction. RESULTS The carrier frequencies of these three mutations were not statistically different among patients and controls (Cys282Tyr: 1.4 vs. 10.1%; His63Asp: 26.5 vs. 31.5%; Ser65Cys: 2.8 vs. 1.1%). Mean ferritin levels were elevated among patients (176 +/- 155 microg L(-1)) compared with controls (131 +/- 106 microg L(-1), P = 0.015). Subjects with plasma ferritin concentrations of 300 microg L(-1) or more had a 2.9-fold (95% CI: 1.2-7.3, P = 0.02) unadjusted risk for a myocardial infarction compared with those with normal levels. In a univariate analysis, ferritin was significantly associated with myocardial infarction. Upon multiple regression analysis adjusting for smoking, hypertension, diabetes, body-mass index and total cholesterol, significance was no longer present. CONCLUSIONS No direct association was found between genetic haemochromatosis and myocardial infarction among Swiss whites. Raised ferritin levels among patients suggest a role of increased iron stores in myocardial infarction, but iron overload was not an independent risk factor for Swiss coronary heart disease patients.
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Affiliation(s)
- Dirk Claeys
- Swiss Heart Center, Thrombosis Research Laboratory, Kinder Klinik G4, University Hospital Bern, CH-3010 Bern, Switzerland.
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Sullivan JL, Zacharski LR. Hereditary haemochromatosis and the hypothesis that iron depletion protects against ischemic heart disease. Eur J Clin Invest 2001; 31:375-7. [PMID: 11380586 DOI: 10.1046/j.1365-2362.2001.00830.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- J L Sullivan
- University of Florida College of Medicine, Gainesville, FL, USA.
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