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BackgroundMutations in HFE, a gene defect that can disrupt iron metabolism, have been implicated in increasing the risk of developing amyotrophic lateral sclerosis (ALS).ObjectiveTo further establish the association between ALS and HFE mutations by investigating whether HFE mutations are associated with an increased risk of developing ALS in a population in The Netherlands and by pooling our results with those from previous studies.DesignRetrospective study.SettingTertiary referral center for neuromuscular disorders.ParticipantsGenotyping for 2 common HFE mutations was performed in 289 patients with ALS and 5886 population-based controls in The Netherlands between January 1, 2000, and December 31, 2004.Main outcome measuresDevelopment of ALS and clinical phenotype were compared among the different HFE genotypes, adjusting for known prognostic factors such as age at onset and sex.ResultsHomozygosity for H63D was associated with an increased risk of developing ALS (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.1-4.1). After pooling our results with those from previous studies, a positive association between H63D homozygotes (OR, 2.7; 95% CI, 1.7-4.4), heterozygotes (OR, 1.5; 95% CI, 1.0-2.1), and mutation carriers (OR, 1.7; 95% CI, 1.1-2.5) was found. Within the patient group, heterozygosity for the H63D mutation was associated with a higher age at onset.ConclusionsThese findings suggest that H63D mutations in HFE play a role in the pathogenesis of ALS in various populations. This association might involve a later-onset subset of ALS.

Original publication




Journal article


Archives of neurology

Publication Date





63 - 67


Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.


Humans, Amyotrophic Lateral Sclerosis, Genetic Predisposition to Disease, Asparagine, Histidine, Membrane Proteins, Histocompatibility Antigens Class I, Confidence Intervals, Odds Ratio, Retrospective Studies, DNA Mutational Analysis, Gene Frequency, Genotype, Mutation, Adult, Aged, Aged, 80 and over, Middle Aged, Netherlands, Female, Male, Hemochromatosis Protein