Establishing serum zinc reference intervals with two different photometric assays and evaluating their impact on zinc deficiency prevalence
The results obtained for zinc levels by different laboratory measurement procedures vary because zinc is not yet a harmonized test. Firstly, we aimed to determine reference intervals for serum zinc that had been measured by two different kits on two different clinical chemistry analyzers, employing various statistical methodologies, and secondly to make a comparison between zinc deficiency prevalences according to the determined reference intervals and the manufacturer’s reference intervals.
Methods
The results of the serum zinc levels that were measured by spectrophotometric method, using Improgen® and Archem® zinc kits across a range of time intervals, were obtained retrospectively. The indirect reference intervals for zinc were determined using the Bhattacharya, RefineR and ReflimR methods for both assays. The prevalence of zinc deficiency was evaluated according to the two different kit manufacturers’ recommendations and our established reference intervals.
Results
The reference intervals determined by all three methods were found to be lower than those recommended by the manufacturers with the exception of Archem® kit in children. Although the determined reference intervals and lower reference limits were different, the prevalence of zinc deficiency has decreased substantially after the implementation of established reference intervals for both kits and has reached almost same level (20.0–4.6 % and 8.5–4.7 %).
Conclusions
The establishment of appropriate and accurate zinc reference intervals is of paramount importance in order to avoid the overdiagnosis of zinc deficiency, the unnecessary laboratory testing and the administration of supplements to individuals without underlying deficiencies.
Keywords: zinc; zinc deficiency; reference interval; reference limit; cut-off
Vurgun, Eren and Aktas, Ayse. “Establishing serum zinc reference intervals with two different photometric assays and evaluating their impact on zinc deficiency prevalence” Journal of Laboratory Medicine, vol. 49, no. 5, 2025, pp. 199-205. https://doi.org/10.1515/labmed-2025-0124
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