title: High prevalence of subclinical iron deficiency in whole blood donors not deferred for low hemoglobin.
abstract: BACKGROUND
  Blood donors that meet the hemoglobin (Hb) criteria for donation may have undetected subclinical iron deficiency. The aim of this study was to assess the prevalence of subclinical iron deficiency in whole blood donors with Hb levels above cutoff levels for donation by measuring zinc protoporphyrin (ZPP) levels. In addition, prevalence rates based on other iron variables were assessed for comparison.
  
  
  METHODS
  The study population comprised 5280 Dutch whole blood donors, who passed the Hb criteria for donation. During donor screening, Hb levels were measured in capillary samples (finger prick), and venous blood samples were taken for measurements of ZPP and other iron variables. These variables included ferritin, transferrin saturation, soluble transferrin receptor (sTfR), hepcidin, red blood cell mean corpuscular volume (MCV), and mean cell Hb (MCH).
  
  
  RESULTS
  With a ZPP cutoff level of at least 100 μmol/mol heme, subclinical iron deficiency was present in 6.9% of male donors and in 9.8% of female donors. Based on other iron variables, iron deficiency was also observed. Prevalence rates ranged from 4.8% (based on transferrin saturation) to 27.4% (based on hepcidin concentration) in men and from 5.6% (based on sTfR concentration) to 24.7% (based on hepcidin concentration) in women.
  
  
  CONCLUSIONS
  Results from this study showed that subclinical iron deficiency is prevalent among blood donors that meet the Hb criteria for blood donation, based on ZPP levels and on other iron variables. This finding needs attention because these donors are at increased risk of developing iron deficiency affecting Hb formation and other cellular processes.
authors.affiliation: Department of Donor Studies, Sanquin Research, Nijmegen, The Netherlands. m.baart@sanquin.nl
authors.forename: A Mireille
authors.initials: AM
authors.lastname: Baart
authors.forename: Paulus A H
authors.initials: PA
authors.lastname: van Noord
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Vergouwe
authors.forename: Karel G M
authors.initials: KG
authors.lastname: Moons
authors.forename: Dorine W
authors.initials: DW
authors.lastname: Swinkels
authors.forename: Erwin T
authors.initials: ET
authors.lastname: Wiegerinck
authors.forename: Wim L A M
authors.initials: WL
authors.lastname: de Kort
authors.forename: Femke
authors.initials: F
authors.lastname: Atsma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D001782:Blood Donors; D046148:Donor Selection; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011524:Protoporphyrins / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D011524:Protoporphyrins; C017803:zinc protoporphyrin