Developmental changes in erythrocyte protoporphyrin: roles of iron deficiency and lead toxicity

Iron deficiency and lead toxicity both result in increased erythrocyte protoporphyrin. The purpose of this study was to determine the differences in EP concentration, according to age and sex, obtained in the 2nd National Health and Nutrition Examination Survey of the United States and to determine the extent to which EP differences might be related to iron deficiency or lead toxicity. The highest EP concentrations were found in infants and children. Among adults, women had higher EP values than men. Lead toxicity (blood lead greater than 30 micrograms/dl) and low serum iron concentration/total iron binding capacity (Fe/TIBC less than 16%), often in combination, were associated with elevated EP values in infants and children. In women, elevated EP concentration were related primarily to low Fe/TIBC values, whereas in men there was only a weak association with elevated blood lead concentration. Age/sex differences in EP values diminished markedly when the influences of lead toxicity and iron deficiency were excluded by the above criteria.