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Zinc protoporphyrin/haem ratio and plasma ferritin in preterm infants
I J Griffin1, M M Reid, K P B McCormick
1Neonatal Nutrition Research Group, Royal Victoria Infirmary, University of Newcastle, Newcastle Upon Tyne, UK. igriffin@bcm.tmc.edu
Insights
The zinc protoporphyrin/haem (ZPP/H) ratio initially increases then decreases in preterm infants, showing potential as an iron status indicator later in infancy. This contrasts with typical iron store changes.
Area of Science:
- Pediatrics
- Nutritional Science
- Biochemistry
Background:
- Iron deficiency is a concern in preterm infants.
- Assessing iron status in infants requires reliable biomarkers.
- The zinc protoporphyrin/haem (ZPP/H) ratio is a potential indicator of iron status.
Purpose of the Study:
- To evaluate the utility of the zinc protoporphyrin/haem (ZPP/H) ratio for assessing iron status in healthy, growing, preterm infants.
- To compare ZPP/H ratio changes with iron stores and plasma ferritin levels during the first year of life.
Main Methods:
- The ZPP/H ratio was measured in 109 preterm infants from hospital discharge to 1 year of age.
- A total of 637 ZPP/H determinations were performed.
- Correlations with other iron status measures were assessed.
Main Results:
- ZPP/H ratios were initially high and declined steadily, contrary to expected iron store changes.
- Higher ZPP/H ratios generally corresponded to lower plasma ferritin levels.
- ZPP/H correlated with iron status measures between 6 and 9 months, unlike serum ferritin.
Conclusions:
- Developmental changes in ZPP/H may confound its use as an iron status marker in early infancy.
- The ZPP/H ratio may be a more effective measure of iron status than serum ferritin in the latter half of the first year of life for preterm infants.
Objective:
To study the utility of the zinc protoporphyrin/haem (ZPP/H) ratio as a measure of iron status in healthy, growing, preterm infants.
Method:
ZPP/H was measured in 109 well, preterm infants from the time of hospital discharge until 1 year of age (637 determinations).
Results:
ZPP/H was initially high, but steadily declined. This was opposite to what was expected from the known changes in iron stores during the first year of life and the observed changes in plasma ferritin. Subjects with higher ZPP/H ratios tended to have lower ferritins, but changes in ZPP/H in a given subject were poorly reflected by changes in plasma ferritin. Between 6 and 9 months of age, ZPP/H correlated with other measures of iron status, but serum ferritin concentration did not.
Conclusion:
Use of the ZPP/H ratio as a measure of iron status during the first year of life appears to be confounded by the developmental changes in ZPP/H, but in the later half of this period it may be a better measure of iron status than serum ferritin.