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

Abstract

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.