scholarly journals Reference intervals for hemoglobin and mean corpuscular volume in an ethnically diverse community sample of Canadian children 2 to 36 months

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jemila S. Hamid ◽  
Eshetu G. Atenafu ◽  
Cornelia M. Borkhoff ◽  
Catherine S. Birken ◽  
Jonathon L. Maguire ◽  
...  

Abstract Objective To establish reference intervals for hemoglobin and mean corpuscular volume (MCV) in an ethnically diverse community sample of Canadian children 36 months and younger. Methods We collected blood samples from young children at scheduled primary care health supervision visits at 2 weeks, 2, 4, 6, 9, 12, 15, 18, 24, and 36 months of age. Samples were analyzed on the Sysmex XN-9000 Hematology Analyzer. We followed the Clinical and Laboratory Standards Institute guidelines in our analysis. Data were partitioned by sex and also combined. We considered large age partitions (3 and 6 months) as well as monthly partitions. Reference intervals (lower and upper limits) and 90% confidence intervals were calculated. Results Data from 2106 children were included. The age range was 2 weeks to 36 months, 46% were female, 48% were European and 23% were of mixed ethnicity. For hemoglobin, from 2 to 36 months of age, we found a wide reference interval and the 90% confidence intervals indicated little difference across age groups or according to sex. For MCV, from 2 to 7 months of age there was considerable decrease in the reference interval, which was lowest during the second year of life, followed by a slight increase in the last months of the third year of life. Conclusion These findings suggest adoption of a single hemoglobin reference interval for children 2–36 months of age. Further studies in children under 4 months of age are needed. Trial registration TARGet Kids! cohort is registered at ClinicalTrials.gov. www.clinicaltrials.gov. Identifier: NCT01869530.

1998 ◽  
Vol 44 (10) ◽  
pp. 2120-2125 ◽  
Author(s):  
Anders Helander ◽  
Erling Vabö ◽  
Klas Levin ◽  
Stefan Borg

Abstract Blood samples for determination of the biochemical alcohol markers carbohydrate-deficient transferrin (CDT) in serum, γ-glutamyltransferase (GGT) in serum, and erythrocyte mean corpuscular volume (MCV) were collected once every 1–2 weeks over ∼5 months from 10 female and 4 male teetotalers. Mean values for serum CDT (using the CDTectTM assay) ranged from 9.9 to 29.4 units/L (median, 14.2 units/L), and the highest results were obtained in the women. The mean values for serum GGT ranged from 0.15 to 0.49 μkat/L (median, 0.30 μkat/L, or 18 U/L) except for one woman with a very high mean of 3.07 μkat/L. For MCV, the mean values ranged from 79.5 to 91.5 fL. Two women showed several CDT results above the upper reference limit (mean values, 27.6 and 29.4 units/L, respectively); however, their GGT and MCV values fell within the reference intervals. One of these women exhibited an increased total transferrin concentration (mean value, 5.38 g/L), which was possibly related to the use of oral contraceptives and/or a low serum iron concentration. When the CDTect value was expressed relative to total transferrin, a ratio within the reference interval was observed for this woman but not for the other woman with increased CDTect values. The present study demonstrates a considerable variation between individuals in CDT, GGT, and MCV without drinking any alcohol. The results also show that these baseline values are fairly constant over time within the same individual.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Alina Concepción Alvarez ◽  
Ivette Camayd Viera ◽  
Lisy Vento Buigues ◽  
Yanet Fernández Martínez ◽  
Eraida Hernández ◽  
...  

AbstractObjectivesHomocysteine (Hcy) is a nonessential amino acid, produced by the demethylation of methionine. High Hcy levels, or hyperhomocysteinemia, have been associated with genetic and multifactorial diseases. Hcy reference values may vary between different populations, as Hcy levels are affected by factors such as sex, age, diet, smoking, and coffee consumption. The estimation reference interval (RI) allows to establish the normal values of this marker in population. At present, these levels are unknown in Cuba. The aim of this work is to estimate the Hcy reference intervals in Cuban children and adults.MethodsTotal Hcy concentration was quantified by high performance liquid chromatography (HPLC) in plasma. Hcy levels were evaluated in samples from 507 healthy individuals (260 children, 247 adults).ResultsRIs were estimated by nonparametric methods. We found significant differences between both age groups, but we did not find significant differences between sexes, within these groups. The established ranges were 2.56–14.55 µM and 3.63–17.19 µM for children and adults, respectively. Also, we observed a weak association between Hcy levels and age in both sex groups.ConclusionsThis is the first study that assesses Hcy reference values in Cuban population. Our results will allow the introduction of Hcy as a biochemical marker in laboratory testing.


2018 ◽  
Vol 6 ◽  
pp. 205031211880762 ◽  
Author(s):  
Lealem Gedefaw Bimerew ◽  
Tesfaye Demie ◽  
Kaleab Eskinder ◽  
Aklilu Getachew ◽  
Shiferaw Bekele ◽  
...  

Background: Clinical laboratory reference intervals are an important tool to identify abnormal laboratory test results. The generating of hematological parameters reference intervals for local population is very crucial to improve quality of health care, which otherwise may lead to unnecessary expenditure or denying care for the needy. There are no well-established reference intervals for hematological parameters in southwest Ethiopia. Objective: To generate hematological parameters reference intervals for apparently healthy individuals in southwest Ethiopia. Methods: A community-based cross-sectional study was conducted involving 883 individuals from March to May 2017. Four milliliter of blood sample was collected and transported to Jimma University Medical Center Laboratory for hematological analysis and screening tests. A hematological parameters were measured by Sysmex XS-500i hematology analyzer (Sysmex Corporation Kobe, Japan). The data were analyzed by SPSS version 20 statistical software. The non-parametric independent Kruskal–Wallis test and Wilcoxon rank-sum test (Mann–Whitney U test) were used to compare the parameters between age groups and genders. The 97.5 percentile and 2.5 percentile were the upper and lower reference limit for the population. Results: The reference interval of red blood cell, white blood cell, and platelet count in children were 4.99 × 1012/L (4.26–5.99 × 1012/L), 7.04 × 109/L (4.00–11.67 × 109/L), and 324.00 × 109/L (188.00–463.50 × 109/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in adults was 5.19 × 1012/L (4.08–6.33 × 1012/L), 6.35 × 109/L (3.28–11.22 × 109/L), and 282.00 × 109/L (172.50–415.25 × 109/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in geriatrics were 5.02 × 1012/L (4.21–5.87 × 1012/L), 6.21 × 109/L (3.33–10.03 × 109/L), and 265.50 × 109/L (165.53–418.80 × 109/L), respectively. Most of the hematological parameters showed significant differences across all age groups. Conclusion: Most of the hematological parameters in this study showed differences from similar studies done in the country. This study provided population-specific hematological reference interval for southwest Ethiopians. Reference intervals should also be established in the other regions of the country.


2018 ◽  
Vol 33 (4) ◽  
pp. 487-491 ◽  
Author(s):  
Bing Zhao ◽  
Miaomiao Zhang ◽  
Feng Lin ◽  
Jing Xie ◽  
Yan Liang ◽  
...  

Objective: The aim of this study is to establish the reference interval for serum pro-gastrin-releasing peptide (proGRP) determined by electrochemiluminescence immunoassay (ECLIA) in healthy Chinese Han ethnic adults. Methods: After screening, 9932 healthy Chinese Han adults (age range 18–95 years) were enrolled in this study, including 6220 men and 3712 women. Serum proGRP levels were measured by ECLIA. The reference interval was defined by non-parametric 95th percentile interval. Results: Serum proGRP levels conformed to a non-Gussian distribution. The reference interval for healthy Chinese Han adults calculated by the non-parametric method was 0–73.90 ng/mL in this study. Since serum proGRP levels were significantly correlated with age (r=0.226, P<0.001), the participants were divided into six age groups: 18–39, 40–49, 50–59, 60–69, 70–79, and ⩾80 years. No significant difference for serum proGRP levels was found between the sexes at each of six age groups. The reference intervals were gradually increased with age (65.35 ng/mL, 68.65 ng/mL, 74.10 ng/mL, 77.65 ng/mL, 84.57 ng/mL, and 98.03 ng/mL in 18–39, 40–49, 50–59, 60–69, 70–79, and ⩾80 years, respectively). Conclusions: We established the reference interval for serum proGRP, which was determined by ECLIA in the healthy Chinese Han population. Furthermore, our study suggests that it is necessary to establish the age-specific reference intervals for serum proGRP.


Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4708-4708
Author(s):  
Young Kyung Lee ◽  
Eun Jin Lee ◽  
Miyoung Kim ◽  
Eunyup Lee ◽  
Kibum Jeon ◽  
...  

Abstract Background: The use of laboratory reference intervals based on younger populations is of questionable validity in older populations. We established reference intervals for 16 complete blood count (CBC) parameters in healthy elderly Koreans aged ≥60 years and compared them to those of individuals aged 20-59 years. Methods: Among 64,532 individuals (39,609 men and 24,923 women) aged ≥20 years who underwent medical check-ups, 8,151 healthy subjects (12.6%, 5,270 men and 2,881 women, including 675 and 511, respectively, who were ≥60 years of age) were enrolled based on stringent criteria including laboratory, imaging, and endoscopy results; previous medical history; and medication history. CBC parameters were measured using an Advia2120i instrument. The difference between 2 age groups in subjects of each sex was compared using the Mann-Whitney U-test. P-values <0.05 were considered statistically significant. The reference intervals for measured CBC parameters were established according to a nonparametric method based on the CLSI EP28A-3C in each subgroup. The 90% confidence intervals for the upper and lower limits of each reference interval were calculated; the Reed method was used to remove extreme outliers. The Harris and Boyd method was used to determine the necessity of separating the reference intervals for different age groups within each sex group. To identify reference intervals in different age groups in individuals aged 60 years and over, such individuals of each sex were subdivided into 5 age subgroups with 5-year age interval: since the sizes of 4 of these subgroups were not sufficiently large, we used the Robust method. Results: A statistical difference in the medians of the following parameters were observed between the <60- and ≥60-year age groups: RBC, Hb, hematocrit (Hct), basophils, and platelets in men aged <60 years were higher than those in men aged ≥60 years; furthermore, MCV, MCH, and RDW in men aged ≥60 years were higher than those in men aged <60 years. Neutrophils in women aged <60 years were higher than in those aged ≥60 years. Hb, Hct, MCV, MCH, MCHC, lymphocytes, and basophils in women aged ≥60 years were higher than in those aged <60 years. Separate reference intervals were required only for RDW and MCH in women ≥60 from those < 60 years of age. Men aged ≥60 years versus those <60 years did not require separate reference intervals for any of the 16 measured parameters. In subjects aged ≥60 years, RBC, Hb, Hct, MCV, MCH, MCHC, RDW, WBC, neutrophils, monocytes, eosinophils, MPV, and PDW were higher in men than in women, while the opposite was true for lymphocytes and platelets. Partitioning of reference intervals by sex was required for RBC, Hb, Hct, MCH, monocytes, and eosinophils. In men, median values and the lower limits of the reference intervals for RBC, Hb, and Hct tended to decrease with advancing age. The upper and lower limits of reference intervals for WBC, neutrophils, lymphocytes, and MPV also showed increasing and decreasing tendencies, respectively, widening the reference intervals as the subjects aged (except in the 70-74-year-old group for men). Among women, the lower limits of the reference intervals for RBC, Hb, and Hct showed a tendency to decrease with increasing age for those >70 years of age; however, the median values did not show such a tendency. The reference interval for PDW narrowed as women aged. Separate reference intervals were required among men for MCH and eosinophils in the 70-74-year group, and for basophils in the 65-69-year group. Among women, separate reference intervals were required for MCV in the 65-69-year group; for MCH in the 60-64, 65-69, and ≥75-years groups; and for RDW in all the 4 elderly age subgroups. Conclusion: Healthy elderly Koreans can use the same reference intervals as younger populations. Thus, abnormal CBC results may not necessarily be attributable to physiologic changes but possible underlying diseases that should be investigated. Disclosures No relevant conflicts of interest to declare.


2010 ◽  
Vol 19 (10) ◽  
pp. 1529-1540 ◽  
Author(s):  
Norah E. Mulvaney-Day ◽  
Marcela Horvitz-Lennon ◽  
Chih-nan Chen ◽  
Mara Laderman ◽  
Margarita Alegría

1994 ◽  
Vol 40 (12) ◽  
pp. 2209-2215 ◽  
Author(s):  
T Kouri ◽  
V Kairisto ◽  
A Virtanen ◽  
E Uusipaikka ◽  
A Rajamäki ◽  
...  

Abstract We utilized the databases of a hospital information system to select for determination of reference values various individual hospitalized patients on the basis of their diagnoses at discharge. The nonparametric 2.5-97.5% "health-related" reference intervals were calculated for hemoglobin concentration, mean corpuscular volume (MCV), and erythrocyte count for both sexes. After excluding patients with diseases possibly affecting erythrocyte variables, we obtained a final group of 1786 women and 1450 men, ages 20-65 years, who were studied in age groups of 20-30, 30-45, 45-55, and 55-65 years. The upper reference limits of the MCV results obtained from hospitalized patients were higher than those produced conventionally from healthy individuals, as would be intuitively suggested by clinical experience. This method, based on selection by diagnosis, could be applicable to various analytes measured in hospital laboratories, provided sufficient data are available as databases.


2019 ◽  
Vol 40 (2) ◽  
pp. 99-111 ◽  

Reference intervals are relied upon by clinicians when interpreting their patients’ test results. Therefore, laboratorians directly contribute to patient care when they report accurate reference intervals. The traditional approach to establishing reference intervals is to perform a study on healthy volunteers. However, the practical aspects of the staff time and cost required to perform these studies make this approach difficult for clinical laboratories to routinely use. Indirect methods for deriving reference intervals, which utilise patient results stored in the laboratory’s database, provide an alternative approach that is quick and inexpensive to perform. Additionally, because large amounts of patient data can be used, the approach can provide more detailed reference interval information when multiple partitions are required, such as with different age-groups. However, if the indirect approach is to be used to derive accurate reference intervals, several considerations need to be addressed. The laboratorian must assess whether the assay and patient population were stable over the study period, whether data ‘clean-up’ steps should be used prior to data analysis and, often, how the distribution of values from healthy individuals should be modelled. The assumptions and potential pitfalls of the particular indirect technique chosen for data analysis also need to be considered. A comprehensive understanding of all aspects of the indirect approach to establishing reference intervals allows the laboratorian to harness the power of the data stored in their laboratory database and ensure the reference intervals they report are accurate.


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