Browse > Article
http://dx.doi.org/10.3343/alm.2018.38.6.503

Complete Blood Count Reference Intervals and Patterns of Changes Across Pediatric, Adult, and Geriatric Ages in Korea  

Nah, Eun-Hee (Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion)
Kim, Suyoung (Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion)
Cho, Seon (Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion)
Cho, Han-Ik (MEDIcheck LAB, Korea Association of Health Promotion)
Publication Information
Annals of Laboratory Medicine / v.38, no.6, 2018 , pp. 503-511 More about this Journal
Abstract
Background: Sampling a healthy reference population to generate reference intervals (RIs) for complete blood count (CBC) parameters is not common for pediatric and geriatric ages. We established age- and sex-specific RIs for CBC parameters across pediatric, adult, and geriatric ages using secondary data, evaluating patterns of changes in CBC parameters. Methods: The reference population comprised 804,623 health examinees (66,611 aged 3-17 years; 564,280 aged 18-59 years; 173,732 aged 60-99 years), and, we excluded 22,766 examinees after outlier testing. The CBC parameters (red blood cell [RBC], white blood cell [WBC], and platelet parameters) from 781,857 examinees were studied. We determined statistically significant partitions of age and sex, and calculated RIs according to the CLSI C28-A3 guidelines. Results: RBC parameters increased with age until adulthood and decreased with age in males, but increased before puberty and then decreased with age in females. WBC and platelet counts were the highest in early childhood and decreased with age. Sex differences in each age group were noted: WBC count was higher in males than in females during adulthood, but platelet count was higher in females than in males from puberty onwards (P <0.001). Neutrophil count was the lowest in early childhood and increased with age. Lymphocyte count decreased with age after peaking in early childhood. Eosinophil count was the highest in childhood and higher in males than in females. Monocyte count was higher in males than in females (P <0.001). Conclusions: We provide comprehensive age- and sex-specific RIs for CBC parameters, which show dynamic changes with both age and sex.
Keywords
Complete blood count; Reference intervals; Secondary data; Pediatric; Geriatric; Age; Sex; Korean;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Friedberg RC, Souers R, Wagar EA, Stankovic AK, Valenstein PN. The origin of reference intervals. Arch Pathol Lab Med 2007;131:348-57.
2 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.   DOI
3 Adeli K, Raizman JE, Chen Y, Higgins V, Nieuwesteeg M, Abdelhaleem M, et al. Complex biological profile of hematologic markers across pediatric, adult, and geriatric ages: establishment of robust pediatric and adult reference intervals on the basis of the Canadian Health Measures Survey. Clin Chem 2015;61:1075-86.   DOI
4 Ambayya A, Su AT, Osman NH, Nik-Samsudin NR, Khalid K, Chang KM, et al. Haematological reference intervals in a multiethnic population. PLoS One 2014;9:e91968.   DOI
5 Lee HR, Shin S, Yoon JH, Roh EY, Chang JY. Reference intervals of hematology and clinical chemistry analytes for 1-year-old Korean children. Ann Lab Med 2016;36:481-8.   DOI
6 Horowitz GL, Atlaie S, Boyd JC. Defining, establishing, and verifying reference intervals in the clinical laboratory; approved guideline. C28-A3c. Wayne, PA: Clinical and Laboratory Standards Institute. 2010.
7 Cho SM, Lee SG, Kim HS, Kim JH. Establishing pediatric reference intervals for 13 biochemical analytes derived from normal subjects in a pediatric endocrinology clinic in Korea. Clin Biochem 2014;47:268-71.   DOI
8 Bachman E, Travison TG, Basaria S, Davda MN, Guo W, Li M, et al. Testosterone induces erythrocytosis via increased erythropoietin and suppressed hepcidin: evidence for a new erythropoietin/hemoglobin set point. J Gerontol A Biol Sci Med Sci 2014;69:725-35.   DOI
9 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.   DOI
10 Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. Prevalence of iron deficiency in the United States. JAMA 1997;277:973-6.   DOI
11 Roshan TM, Rosline H, Ahmed SA, Rapiaah M, Wan Zaidah A, Khattak MN. Hematological reference values of healthy Malaysian population. Int J Lab Hematol 2009;31:505-12.   DOI
12 Food and Agricultural Organization of the United Nations, WHO. World declaration and plan of action for nutrition: International Conference on Nutrition. http://www.who.int/nutrition/publications/policies/icn_worlddeclaration_planofaction1992/en/ (Updated on Dec 1992).
13 WHO. Iron deficiency anaemia: assessment, prevention and control: a guide for programme managers. http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/WHO_NHD_01.3/en/ (Updated on Aug 2001).
14 Ershler WB. Biological interactions of aging and anemia: a focus on cytokines. J Am Geriatr Soc 2003;51(S3):S18-21.   DOI
15 Balducci L. Epidemiology of anemia in the elderly: information on diagnostic evaluation. J Am Geriatr Soc 2003;51(S3):S2-9.   DOI
16 Verthelyi D. Sex hormones as immunomodulators in health and disease. Int Immunopharmacol 2001;1:983-93.   DOI
17 Ishiguro A, Nakahata T, Matsubara K, Hayashi Y, Kato T, Suzuki Y, et al. Age-related changes in thrombopoietin in children: reference interval for serum thrombopoietin levels. Br J Haematol 1999;106:884-8.   DOI
18 Daly ME. Determinants of platelet count in humans. Haematologica 2011; 96:10-3.   DOI
19 Kadikoylu G, Yavasoglu I, Bolaman Z, Senturk T. Platelet parameters in women with iron deficiency anemia. J Natl Med Assoc 2006;98:398-402.
20 Beguin Y. Erythropoietin and platelet production. Haematologica 1999; 84:541-7.
21 Giles C. The platelet count and mean platelet volume. Br J Haematol 1981;48:31-7.
22 Buckley MF, James JW, Brown DE, Whyte GS, Dean MG, Chesterman CN, et al. A novel approach to the assessment of variations in the human platelet count. Thromb Haemost 2000;83:480-4.   DOI