rs1799945

Orientation

plus

Stabilized

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Geno	Mag	Summary
(C;C)	0	Not a H63D hemochromatosis carrier.
(C;G)	3	One copy of H63D, carrier of hemochromatosis, likely unaffected unless also C282Y carrier.
(G;G)	4	Two copies of H63D, likely affected by mild form of hemochromatosis

Reference

GRCh38 38.1/141

Chromosome

6

Position

26090951

Gene	HFE, LOC108783645

is a	snp
is	mentioned by
dbSNP	rs1799945
dbSNP (classic)	rs1799945
ClinGen	rs1799945
ebi	rs1799945
HLI	rs1799945
Exac	rs1799945
Gnomad	rs1799945
Varsome	rs1799945
LitVar	rs1799945
Map	rs1799945
PheGenI	rs1799945
Biobank	rs1799945
1000 genomes	rs1799945
hgdp	rs1799945
ensembl	rs1799945
geneview	rs1799945
scholar	rs1799945
google	rs1799945
pharmgkb	rs1799945
gwascentral	rs1799945
openSNP	rs1799945
23andMe	rs1799945
SNPshot	rs1799945
SNPdbe	rs1799945
MSV3d	rs1799945
GWAS Ctlg	rs1799945

Merged from

Rs17515604

GMAF

0.08356

Max Magnitude

4

?	(C;C) (C;G) (G;G)	28

rs1799945, also known as H63D or His63Asp, represents a SNP that accounts for a mild form of hereditary hemochromatosis (HH), an iron overload condition in which mutations of certain genes involved in iron metabolism disrupt the body’s ability to regulate uptake of iron, causing increased intestinal iron absorption. The most common form is caused by mutations in the HFE gene, which are inherited recessively. The gene for HH is closely linked to the HLA-A3 locus on the short arm of chromosome 6 [PMID 1278715]. In 1996, HFE, a gene for HH, was found to have two missense mutations [PMID 8696333]. A mutation at amino acid 282 (C282Y) was found to be homozygous in 83 percent of patients with HH. This is a point mutation from guanine to adenine, resulting in a missense mutation from cysteine to tyrosine. Such mutations are commonly found in people with European ancestry, and is more rare in Asian and African populations. Among individuals of northern European descent, hereditary hemochromatosis is the most common inherited identified genetic disorder. However, penetrance differs between different populations.

HFE Gene

The HFE gene encodes the human hemochromatosis protein, which is located on the short arm of chromosome 6 at 6p21.3. The protein regulates iron absorption by regulating the interaction of the transferrin receptor with transferrin. The HFE protein interacts with TFRC, the transferrin receptor protein 1, so its primary mode of action is through regulation of the iron storage hormone hepcidin.

Mutations in the HFE Gene

The three most common HH-causing mutations in the HFE gene (chromosome 6p21.3) are C282Y (A at rs1800562 instead of G), H63D (G at rs1799945 instead of C), and S65C (T at i3002468 instead of A). At least 17 other mutations in the HFE gene have been linked to HH. 60-90% of people with HH have two copies of the C282Y mutation. The H63D mutation is also quite common—about 20% of people carry a copy of the mutation, and about 3% have two copies. This mutation is not as severe as the C282Y mutation, and only causes symptoms when someone has both the H63D and the C282Y mutations. Even then, only a small fraction of people with one copy of each mutation actually exhibit evidence of iron overload. Additionally, those who have two copies of H63D do not exhibit any symptoms and are not at risk for iron overload. The S65C mutation is less common, and will also only cause symptoms if in combination with C282Y. For both H63D/C282Y and S65C/C282Y single mutation individuals, symptoms are usually mild if they develop at all.

Influence on Iron Levels

HH has four main pathophysiological mechanisms [PMID 21452290]: the increased absorption of dietary iron in the upper intestine, 2) decreased expression of hepcidin, 3) altered function of the HFE protein, and 4) tissue injury and fibrogenesis induced by iron. Since the HFE gene encodes for proteins that affect pathways centered around liver hepcidin synthesis, this mechanism will be further explained in more detail. The HFE gene regulates the liver protein hepcidin, which is considered to be the principal iron-regulatory hormone. Levels of hepcidin increase when iron levels increase in the blood, preventing intestinal cells and macrophages from releasing iron into the bloodstream. When iron builds up in the cells, signals are produced to reduce the iron absorption from food. Hepcidin levels decrease when the body needs more iron. Mutations in the HFE gene such as C282Y and H63D decrease hepcidin levels, causing intestinal cells to think more iron is needed. Thus, more iron is absorbed. Concentrations of hepcidin in the urine negatively correlate with the severity of HH.

Symptoms of Hereditary Hemochromatosis

The symptoms of HH depend on the person’s mutation as well as their sex and diet. The older a person, the more likely iron has accumulated in the body over time. Typically, complications may develop later in life between the ages of 40 and 60 in men and in post-menopausal women. If symptoms do develop, these are typically seen in the liver, skin, pancreas, heart, joints, and testes. At first, one may feel symptoms such as joint pain and stiffness, fatigue, abdominal pain, and weight loss. Later symptoms may lead to more serious conditions such as cirrhosis of the liver, cancer, liver failure, diabetes, congestive heart failure, and arthritis.

Symptomatic Findings in Patients with HH

• Liver- hepatomegaly, splenomegaly, liver failure
• Joints- arthritis, swelling, chondrocalcinosis
• Heart- dilated cardiomyopathy, CHF
• Skin- increased pigmentation
• Endocrine- testicular atrophy, hypogonadism
• Hypothyroidism

GWAS snp
PMID	[PMID 21208937]
Trait
Title	Identification of a common variant in the TFR2 gene implicated in the physiological regulation of serum iron levels
Risk Allele	C
P-val	3E-9
Odds Ratio	4.9500 [3.30-6.60] ug/dl decrease

OMIM	613609
Desc
Variant	0002
Related	also

[PMID 22232660] Brain structure in healthy adults is related to serum transferrin and the H63D polymorphism in the HFE gene

GWAS snp
PMID	[PMID 21909115]
Trait
Title	Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk.
Risk Allele	G
P-val	8E-12
Odds Ratio	0.6270 [NR] mmHg increase

ClinVar
Risk	Rs1799945(G;G)
Alt	Rs1799945(G;G)
Reference	Rs1799945(C;C)
Significance	Other
Disease	Hemochromatosis type 1 Microvascular complications of diabetes 7 not specified not provided Hereditary hemochromatosis
Variation	info
Gene	HFE
CLNDBN	Hemochromatosis type 1 Microvascular complications of diabetes 7 not specified not provided Hereditary hemochromatosis
Reversed	0
HGVS	NC_000006.11:g.26091179C>G
CLNSRC	OMIM Allelic Variant UniProtKB (protein)
CLNACC	RCV000000026.10, RCV000000027.4, RCV000117220.2, RCV000175607.2, RCV000394716.1,

[PMID 18194558] A hierarchical and modular approach to the discovery of robust associations in genome-wide association studies from pooled DNA samples.

[PMID 18603647] Functional genetic polymorphisms and female reproductive disorders: Part I: Polycystic ovary syndrome and ovarian response.

[PMID 18795173] Variants in iron metabolism genes predict higher blood lead levels in young children.

[PMID 19084217] Variants in TF and HFE explain approximately 40% of genetic variation in serum-transferrin levels.

[PMID 19165391] Iron metabolism genes, low-level lead exposure, and QT interval.

[PMID 19237423] Is there an optimum endurance polygenic profile?

[PMID 19401444] Body iron stores and glucose intolerance in premenopausal women: role of hyperandrogenism, insulin resistance, and genomic variants related to inflammation, oxidative stress, and iron metabolism.

[PMID 19862010] Multiple loci influence erythrocyte phenotypes in the CHARGE Consortium.

[PMID 20659343] HFE gene variants modify the association between maternal lead burden and infant birthweight: a prospective birth cohort study in Mexico City, Mexico.

[PMID 21553046] Should we screen for hereditary hemochromatosis in healthy Lebanese: a pilot study.

[PMID 21679129] Genotyping of the hemochromatosis HFE p.H63D and p.C282Y mutations by high-resolution melting with the Rotor-Gene 6000(R) instrument.

[PMID 22611049] Lower serum hepcidin and greater parenchymal iron in nonalcoholic fatty liver disease patients with C282Y HFE mutations.

[PMID 23389292] Hemochromatosis (HFE) gene mutations and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

[PMID 23792061] Meta-analyses of HFE variants in coronary heart disease

[PMID 22735619] Sample-to-SNP kit: a reliable, easy and fast tool for the detection of HFE p.H63D and p.C282Y variations associated to hereditary hemochromatosis.

[PMID 25085015] Examination of HFE associations with childhood leukemia risk and extension to other iron regulatory genes

[PMID 25634189] Genetic Variant Coding for Iron Regulatory Protein HFE Contributes to Hypertension, the TAMRISK Study

[PMID 24663082] Influence of diet, menstruation and genetic factors on iron status: a cross-sectional study in Spanish women of childbearing age

[PMID 25880661] Decision Tree Analysis of Genetic Risk for Clinically Heterogeneous Alzheimer's Disease

[PMID 26024779] Association of genetic variants with response to iron supplements in pregnancy

[PMID 26597663] Genetic factors influencing ferritin levels in 14,126 blood donors: results from the Danish Blood Donor Study

[PMID 26690219] Association Studies of HFE C282Y and H63D Variants with Oral Cancer Risk and Iron Homeostasis Among Whites and Blacks.