HFE mutations and free iron status in type 2 diabetes

Based on the evidence of distinct association between hfe mutants, iron overload, onset of nephropathy and type 2 diabetes mellitus, we proceeded to know its genetic prevalence in the eastern part of India focusing on Southern part of West Bengal, which has a large number of diabetic population. Our pilot study involved 37 diabetic cases and 37 non-diabetic controls whose allele frequency for hfe mutations, onset of nephropathy (by estimating eGFR and urinary ACR), insulin resistance (by estimating HOMA-IR) and iron status (in form of serum ferritin, percentage saturation, and free iron status in forms of ferric and ferrous ions) were studied. Chi square and unpaired t test were used for statistical analyses. A higher number of mutants among diabetics were found whereas C282Y mutants had an earlier onset of T2DM than H63D mutants though neither had any statistical significance. However, a significant difference was found regarding percentage transferrin saturation amongst mutants and non-mutants. The means of ferric to ferrous ratio were significantly different in mutant diabetics and non-mutant diabetics probably due to a higher reducing environment in mutant diabetics. Over the counter use of iron medications should be restricted as India contains a high number of iron loading mutations amongst diabetics.