Epidemiology

Alcohol increases clinical severity of hemochromatosis

Last Updated: 2003-07-21 17:00:19 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Excessive alcohol consumption increases the severity of disease in patients with hereditary hemochromatosis, French investigators report. Iron parameters are increased, and the risks of skin pigmentation, diabetes and hepatomegaly are higher.

Dr. Claude F�rec, of INSERM EMI 01-15, Brest, and colleagues included in their study 378 hemochromatosis patients homozygous for the C282Y mutation of the HFE gene. They report in the July 15th issue of the American Journal of Epidemiology that 33 (8.7%) reported excessive alcohol consumption, defined as 60 g/day or more, at their first visit to a blood center.

Serum ferritin averaged 1745.2 �g/mL in those who drank excessively, compared with 968.7 �g/mL among those who drank less (p < 0.0001). Serum iron and transferrin saturation were also significantly higher.

Compared with those who drank less, the risk of diabetes increased in patients who drank more than 60 g of alcohol each day (26.3% versus 11.1%), as did the risk of skin pigmentation (51.5% versus 24.0%). More heavy drinkers had hepatomegaly (25.9% versus 14.3%), although the difference was not significant.

Dr. F�rec's team notes that previous studies documented an additive hepatotoxic effect. In their cohort, alanine aminotransferase and aspartate aminotransferase levels were significantly higher among heavy drinkers.

"Alcohol consumption associated with genetic factors increases the severity of hereditary hemochromatosis and therefore the risk of cirrhosis and cancer," they conclude. The researchers suggest that patients with hemochromatosis be discouraged from consuming excessive quantities of alcohol.

Am J Epidemiol 2003;158:129-134.