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Zinc protoporphyrin/heme ratio for diagnosis of preanemic iron deficiency.
Pediatrics. 1999 Sep; 104(3):e37.Ped

Abstract

OBJECTIVE

Iron deficiency anemia is known to impair cognitive and psychomotor development. The zinc protoporphyrin/heme (ZPP/H) ratio is a simple, accurate, and sensitive laboratory screening test that detects early iron depletion before the onset of anemia. The objective of this work was to evaluate this test in a primary pediatric practice setting.

METHODS

The iron status of a cohort of 361 children was screened during routine examinations at a community pediatric practice. Whole blood hemoglobin concentration, hematocrit ratio, serum transferrin saturation, ferritin concentration, and the ZPP/H ratio were measured. The ZPP/H ratio then was evaluated as a single indicator of iron status by comparing it with other tests for detecting the onset of iron deficiency and for monitoring recovery after iron supplementation.

RESULTS

Significant age- and sex-related differences in the ZPP/H ratio were found. In this cohort, serum ferritin concentration and the ZPP/H ratio independently identified the same fraction of iron-deficient patients (3%-4%), and both tests were more specific than was either hemoglobin or hematocrit. A concordance of three iron status parameters changed the prediction of iron deficiency to </=1%. Children <3 years of age and adolescent girls had significantly higher ZPP/H results.

CONCLUSION

The prevalence of iron deficiency anemia in the typical healthy American pediatric population is low, but iron deficiency without anemia remains relatively common at some stages of development. Increase in the ZPP/H ratio is demonstrated to be a sensitive, specific, and cost-effective test for identifying preanemic iron deficiency in a community pediatric practice. anemia, nutrition, development.

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Authors+Show Affiliations

Rettmer RL
Department of Laboratory Medicine, University of Washington, Seattle, Washington 98195, USA.
Carlson TH
No affiliation info available
Origenes ML
No affiliation info available
Jack RM
No affiliation info available
Labb RF
No affiliation info available

MeSH

AdolescentAge FactorsAnemia, Iron-DeficiencyChildChild, PreschoolEnzyme InhibitorsFemaleFerritinsHematologic TestsHemeHeme Oxygenase (Decyclizing)HumansInfantIronMaleProtoporphyrinsRegression AnalysisSensitivity and SpecificitySex FactorsTransferrin

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10469820

Citation

Rettmer, R L., et al. "Zinc Protoporphyrin/heme Ratio for Diagnosis of Preanemic Iron Deficiency." Pediatrics, vol. 104, no. 3, 1999, pp. e37.
Rettmer RL, Carlson TH, Origenes ML, et al. Zinc protoporphyrin/heme ratio for diagnosis of preanemic iron deficiency. Pediatrics. 1999;104(3):e37.
Rettmer, R. L., Carlson, T. H., Origenes, M. L., Jack, R. M., & Labb, R. F. (1999). Zinc protoporphyrin/heme ratio for diagnosis of preanemic iron deficiency. Pediatrics, 104(3), e37.
Rettmer RL, et al. Zinc Protoporphyrin/heme Ratio for Diagnosis of Preanemic Iron Deficiency. Pediatrics. 1999;104(3):e37. PubMed PMID: 10469820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Zinc protoporphyrin/heme ratio for diagnosis of preanemic iron deficiency. AU - Rettmer,R L, AU - Carlson,T H, AU - Origenes,M L, AU - Jack,R M, AU - Labb,R F, PY - 1999/9/2/pubmed PY - 1999/9/2/medline PY - 1999/9/2/entrez SP - e37 EP - e37 JF - Pediatrics JO - Pediatrics VL - 104 IS - 3 N2 - OBJECTIVE: Iron deficiency anemia is known to impair cognitive and psychomotor development. The zinc protoporphyrin/heme (ZPP/H) ratio is a simple, accurate, and sensitive laboratory screening test that detects early iron depletion before the onset of anemia. The objective of this work was to evaluate this test in a primary pediatric practice setting. METHODS: The iron status of a cohort of 361 children was screened during routine examinations at a community pediatric practice. Whole blood hemoglobin concentration, hematocrit ratio, serum transferrin saturation, ferritin concentration, and the ZPP/H ratio were measured. The ZPP/H ratio then was evaluated as a single indicator of iron status by comparing it with other tests for detecting the onset of iron deficiency and for monitoring recovery after iron supplementation. RESULTS: Significant age- and sex-related differences in the ZPP/H ratio were found. In this cohort, serum ferritin concentration and the ZPP/H ratio independently identified the same fraction of iron-deficient patients (3%-4%), and both tests were more specific than was either hemoglobin or hematocrit. A concordance of three iron status parameters changed the prediction of iron deficiency to </=1%. Children <3 years of age and adolescent girls had significantly higher ZPP/H results. CONCLUSION: The prevalence of iron deficiency anemia in the typical healthy American pediatric population is low, but iron deficiency without anemia remains relatively common at some stages of development. Increase in the ZPP/H ratio is demonstrated to be a sensitive, specific, and cost-effective test for identifying preanemic iron deficiency in a community pediatric practice. anemia, nutrition, development. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/10469820/Zinc_protoporphyrin/heme_ratio_for_diagnosis_of_preanemic_iron_deficiency_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=10469820 DB - PRIME DP - Unbound Medicine ER -