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Effect of ferroportin Q248H polymorphism on iron status in African children^1,2,3

¹ From the Departments of Chemical Pathology (IK and ZARG) and Pediatrics (KJN and PM), University of Zimbabwe College of Health Sciences, Harare, Zimbabwe; the Department of Hematology, Parirenyatwa Group of Hospitals, Harare, Zimbabwe (BM); and the Center for Sickle Cell Disease, Howard University, Washington, DC (IK, ML, and VRG)

Background: Iron deficiency is common in African children, but genetic variations affecting susceptibility have not been identified. The Q248H mutation in ferroportin, a cellular iron exporter regulated by iron status and inflammation, may be associated with high iron stores in African adults.

Objective: The study examined the prevalence of iron deficiency in African children in an area where malaria transmission is low to absent and investigated whether ferroportin Q248H provides protection from iron deficiency.

Design: Complete blood counts, serum markers of iron status and inflammation, and ferroportin Q247H were measured in 208 preschool children in Harare, Zimbabwe. Iron deficiency was defined by serum ferritin and C-reactive protein (CRP) concentrations (definition 1) or by ferritin and the ratio of transferrin receptor to log₁₀ ferritin (definition 2).

Results: Q248H was present in 40 children (38 heterozygotes, 2 homozygotes), elevated CRP was present in 26 (12.5%), and iron deficiency was present in 50 (24.0%) (definition 1) or 55 (26.4%) (definition 2). The interaction between ferroportin Q248H and CRP was significant for ferritin concentrations (P = 0.027) in a 2-factor analysis of variance model. With elevated CRP, the estimated geometric (SE range) ferritin concentration was 74 (52–106) µg/L for Q248H heterozygotes but 24 (20–30) µg/L for wild-type subjects (P = 0.016). With normal CRP, the ferritin concentration was 16 (14–19) µg/L whether or not the mutation was present. After adjustment for age and weight-for-height z score, the odds ratio (OR) for iron deficiency in Q248H heterozygotes was not significant according to definition 1 (OR: 0.53; 95% CI: 0.18, 1.40; P = 0.222) or definition 2 (OR: 0.39; 95% CI: 0.14, 1.07; P = 0.068).

Conclusions: Any effect of Q248H in protecting against iron deficiency may be observable in children exposed to repeated inflammatory conditions. Further studies of iron status and ferroportin Q248H in African children are needed.

Key Words: Ferroportin mutation • African children • iron deficiency • inflammation

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