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Licensed Unlicensed Requires Authentication Published by De Gruyter February 5, 2014

Complete blood count reference intervals and age- and sex-related trends of North China Han population

  • Rui Qiao , Shuo Yang , Bei Yao , Hongya Wang , Jie Zhang EMAIL logo and Hong Shang EMAIL logo

Abstract

Background: Defining common reference intervals (RIs) are encouraging. The aim of this study is to establish RIs for complete blood count (CBC) in a Chinese Han population and probe their age- and sex-related CBC trends. Additionally, we will compare the CBC RIs of Han with those of other races.

Methods: In total 1259 Han individuals (584 male and 675 female) were recruited in North China. CBC was processed on Sysmex XE-2100, Coulter LH750 and Mindray BC5800 whose traceability was well verified. The non-parametric 2.5th–97.5th percentiles RIs were calculated.

Results: The RIs for CBC parameters did not show apparent analyzer-specificity, apart from mean cellular volume (MCV), mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW). Red blood cell (RBC), hemoglobin (HBG), hematocrit (HCT), mean cellular hemoglobin (MCH), and mean cellular hemoglobin concentration (MGHC) are higher in males; and their male mean values tend to drop after 40 years; conversely, the female mean values tend to rise. Platelet (PLT) is higher in females and tends to drop after 40 years in both sexes. White blood cell (WBC) and absolute count of neutrophils (NE) and monocytes (MO) are higher in males, but there is no apparent change with age. Lymphocytes (LY) absolute count declines with age in males, but the same change in females is not obvious. RIs for HBG and HCT are similar among Han, Nordic, US European and US Mexican populations and are lower in US Africans. WBC RIs for Han and US African populations are lower than that for US Europeans and US Mexicans.

Conclusions: RIs for major blood cell parameters are not method-dependent; variations obviously exist in age, sex and race. Consequently, common RIs for most CBC parameters appear inapplicable.


Corresponding authors: Dr. Jie Zhang, Department of Laboratory Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, P.R. China, E-mail: ; and Dr. Hong Shang, Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang 110001, P.R. China, E-mail:

Acknowledgments

This study was supported by the National Key Technology R&D Program (2012BAI37B01) and the Ministry of Health P.R. China Project of “The establishment of clinical laboratory key assays reference intervals for Chinese”.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Research support played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

References

1. CLSI. Defining establishing and verifying reference intervals in the clinical laboratory; approved guideline, 3rd ed. CLSI document C28-A3c. Horowitz GL. Wayne, PA: Clinical and Laboratory Standards Institute, 2010.Search in Google Scholar

2. Ceriotti F. Common reference intervals: the IFCC position. Clin Biochem 2009;42:297.10.1016/j.clinbiochem.2008.09.017Search in Google Scholar PubMed

3. Nordic Reference Interval Project. Hematology data. Available from: http://pweb.furst.no/norip/. Accessed July 21, 2012.Search in Google Scholar

4. Cheng CK, Chan J, Cembrowski GS, van Assendelft OW. Complete blood count reference interval diagrams derived from NHANES III: stratification by age, sex, and race. Lab Hematol 2004;10:42–53.10.1532/LH96.04010Search in Google Scholar

5. CLSI. Validation, verification, and quality assurance of automated hematology analyzers; approved standard, 2nd ed. CLSI document H26-A2. Rabinovitch A. Wayne, PA: Clinical and Laboratory Standards Institute, 2007.Search in Google Scholar

6. ICSH HGB Expert Panel. Recommendations for reference method for haemoglobinometry in human blood and specifications for international haemiglobincyanide standard. J Clin Pathol 1996;49:271–4.10.1136/jcp.49.4.271Search in Google Scholar PubMed PubMed Central

7. ICSH Cytometry Panel. Recommendation for reference method for packed cell volume. Laboratory Hematology 2001;7:148–70.Search in Google Scholar

8. ICSH. Reference method for the enumeration of erythrocytes and leukocytes. Clin Lab Haematol 1994;16:13–138.Search in Google Scholar

9. ICSH Cytometry Panel. Platelet counting by RBC/platelet ratio method. Am J Clin Pathol 2001;115:460–4.10.1309/W612-MYEP-FA7U-8UYASearch in Google Scholar

10. Solberg HE. The IFCC recommendation on estimation of reference intervals. The RefVal program. Clin Chem Lab Med 2004;42:710–4.10.1515/CCLM.2004.121Search in Google Scholar PubMed

11. Buttarello M, Plebani M. Automated blood cell count. State of the Art. Am J Clin Pathol 2008;130:104–16.10.1309/EK3C7CTDKNVPXVTNSearch in Google Scholar PubMed

12. Ceriotti F, Hinzmann R, Panteghini M. Reference intervals: the way forward. Ann Clin Biochem 2009;46:8–17.10.1258/acb.2008.008170Search in Google Scholar PubMed

13. Van den Bossche J, Devreese K, Malfait R, Van de Vyvere M, Wauters A, Neeis H, et al. Reference intervals for a complete blood count determined on different automated haematology analysers: Abx Pentra 120 Retic, Coulter Gen-S, Sysmex SE 9500, Abbott Cell Dyn 4000 and Bayer Advia 120. Clin Chem Lab Med 2002;40:69–73.Search in Google Scholar

14. Brummitt DR, Barker HF. The determination of a reference range for new platelet parameters produced by the Bayer ADVIA120 full blood count analyser. Clin Lab Haematol 2000;22:103–7.10.1046/j.1365-2257.2000.00285.xSearch in Google Scholar PubMed

15. Wakeman L, Al-Ismail S, Benton A, Beddall A, Gibbs A, Hartnell S, et al. Robust, routine haematology reference ranges for healthy adults. Int J Lab Hematol 2007;29:279–83.10.1111/j.1365-2257.2006.00883.xSearch in Google Scholar PubMed

16. Ye Y, Wang Y, Shen Z. National guide to clinical laboratory procedures, 3rd ed. Nanjing: Southeast University Press, 2006:160.Search in Google Scholar

17. Ferrucci L, Maggio M, Bandinelli S, Basaria S, Lauretani F, Ble A, et al. Low testosterone levels and the risk of anemia in older men and women. Arch Intern Med 2006;166:1380–8.10.1001/archinte.166.13.1380Search in Google Scholar PubMed PubMed Central

18. Ferrucci L, Guralnik JM, Woodman RC, Bandinelli S, Lauretani F, Corsi AM, et al. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med 2005;118:1288.10.1016/j.amjmed.2005.06.039Search in Google Scholar PubMed

19. Shelton JB, Rajfer J. Androgen deficiency in aging and metabolically challenged men. Urol Clin North Am 2012;39:63–75.10.1016/j.ucl.2011.09.007Search in Google Scholar PubMed

20. Montagnana M, Cervellin G, Meschi T, Lippi G. The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Clin Chem Lab Med 2011;50:635–41.Search in Google Scholar

21. Lim EM, Cembrowski G, Cembrowski M, Clarke G. Race-specific WBC and neutrophil count reference intervals. Int J Lab Hematol 2010;32:590–7.10.1111/j.1751-553X.2010.01223.xSearch in Google Scholar PubMed

Received: 2013-7-27
Accepted: 2014-1-3
Published Online: 2014-2-5
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

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