Evaluation of Erythrocyte Zinc Protoporphyrin/Heme Ratio for Iron-Deficiency Anemia in Pregnant Women

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Tchai, Bum Suk; Kwon, Seok Woon; Han, Jung Ho
Issue Date
Seoul National University College of Medicine
Seoul J Med 1993;34(3):173-180
Erythrocyte zinc protoporphyrin(ZPP)ZPP/heme ratioSerum ferritinIron deficiencyPregnancy
To evaluate the diagnostic values for detecting iron depletion and for
predicting anemia, the erythrocyte zinc protoporphyrin(ZPP) and ZPP/heme ratio
were measured using a hematofluorometer and compared with the serum ferritin
and blood hemoglobin levels in 136 randomly selected pregnant Korean women.
A significant decline in mean hemoglobin and serum ferritin levels and an
increase in ZPP/heme ratio level were observed as pregnancy advanced. During
the third trimester, 41.7 % of pregnant women were found to have hemoglobin
concentrations below 11 g/100ml. 61.0 %, 58.5 % and 48.8 % of the third
trimester group demonstrated an abnormal ZPP/heme ratio, serum ferritin and
ZPP levels, respectively. The ZPP/heme ratio showed good negative logarithmic
correlation with the serum ferritin (r = -0.51). The diagnostic sensitivity and positive
predictive value of ZPP/heme ratio for evaluating iron depletion and the risk
of anemia compared favorably to those of serum ferritin. It was concluded that
the operational simplicity and low cost of erythrocyte ZPP/heme ratio measurement
in addition to good diagnostic efficiency offer a procedure for the primary
screening test of iron depletion in pregnancy or other risk groups.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 34 No.3 (1993)
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