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Establishing Reference Intervals for Complete Blood Cell Count in Healthy Korean Elderly Individuals
J Lab Med Qual Assur 2018;40:27-37
Published online March 31, 2018
© 2018 Korean Association of External Quality Assessment Service.

Eun Jin Lee, Miyoung Kim, Eunyup Lee, Kibum Jeon, Jiwon Lee, Han-Sung Kim, Hee Jung Kang, and Young Kyung Lee

Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
Correspondence to: Miyoung Kim
Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea
Tel: +82-31-380-1795
Fax: +82-31-380-1798
E-mail: rabbit790622@gmail.com
Received November 30, 2017; Revised January 15, 2018; Accepted February 1, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: Different age groups may have different reference intervals. However, the currently used reference interval for complete blood count (CBC) in clinical laboratories is based on results from healthy adults between 20 and 50 years of age. In this study, we aimed to establish reference intervals for 16 CBC parameters in Korean healthy elderly individuals.
Methods: A total of 3,359 healthy adults were selected from 4,253 adults (aged 돟20 years) who underwent regular health check-ups, based on a medical examination by interview. The reference intervals for CBC in two groups (aged 竊60 and 돟60 years), and the partitioning of reference intervals between the two age groups were established.
Results: Most CBC parameters showed no significant differences in reference intervals between the two age groups. Among the men, platelet distribution width (PDW) was the only parameter that required a separate reference interval between the two age groups. Among the women, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and eosinophil % required separate reference intervals between the two age groups.
Conclusions: The reference intervals for most CBC parameters were not significantly different between the two age groups. Except for PDW in men and MCV, MCHC, RDW, and eosinophil % in women, reference intervals for CBC parameters in individuals younger than 60 years of age could also be applied to those that are 60 years of age or older.
Keywords : Complete blood cell count, Elderlies, Reference interval
References
  1. Clinical and Laboratory Standards Institute. Defining, establishing, and verifying reference intervals in the clinical laboratory: approved guideline: EP28-A3c. 3rd ed. Wayne (PA): Clinical and Laboratory Standards Institute, 2010.
  2. National Health Insurance Service, Health Insurance Review and Assessment Service. 2016 Korea health insurance statistics. http://www.nhis.or.kr/menu/retriveMenuSet.xx?menuId=F3323 (Accessed November 18, 2017).
  3. Wu X, Zhao M, Pan B, Zhang J, Peng M, Wang L, et al. Complete blood count reference intervals for healthy Han Chinese adults. PLoS One 2015;10:e0119669.
    Pubmed KoreaMed CrossRef
  4. Park SH, Park CJ, Lee BR, Kim MJ, Han MY, Cho YU, et al. Establishment of age- and gender-specific reference ranges for 36 routine and 57 cell population data items in a new automated blood cell analyzer, Sysmex XN-2000. Ann Lab Med 2016;36:244-9.
    Pubmed KoreaMed CrossRef
  5. Turan S, Topcu B, Gokce I, Guran T, Atay Z, Omar A, et al. Serum alkaline phosphatase levels in healthy children and evaluation of alkaline phosphatase z-scores in different types of rickets. J Clin Res Pediatr Endocrinol 2011;3:7-11.
    Pubmed KoreaMed CrossRef
  6. Colantonio DA, Kyriakopoulou L, Chan MK, Daly CH, Brinc D, Venner AA, et al. Closing the gaps in pediatric laboratory reference intervals: a CALIPER database of 40 biochemical markers in a healthy and multiethnic population of children. Clin Chem 2012;58:854-68.
    Pubmed CrossRef
  7. Ridefelt P, Hellberg D, Aldrimer M, Gustafsson J. Estimating reliable paediatric reference intervals in clinical chemistry and haematology. Acta Paediatr 2014;103:10-5.
    Pubmed CrossRef
  8. 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.
    Pubmed KoreaMed CrossRef
  9. Zierk J, Arzideh F, Rechenauer T, Haeckel R, Rascher W, Metzler M, et al. Age- and sex-specific dynamics in 22 hematologic and biochemical analytes from birth to adolescence. Clin Chem 2015;61:964-73.
    Pubmed CrossRef
  10. Solberg HE. Approved recommendations (1987) on the theory of reference values: part 5. statistical treatment of collected reference values: determination of reference limits. J Clin Chem Clin Biochem 1987;25:645-56.
    CrossRef
  11. Reed AH, Henry RJ, Mason WB. Influence of statistical method used on the resulting estimate of normal range. Clin Chem 1971;17:275-84.
    Pubmed
  12. Harris EK, Boyd JC. On dividing reference data into subgroups to produce separate reference ranges. Clin Chem 1990;36:265-70.
    Pubmed
  13. Korean Statistical Information Service. http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=362609 (Accessed November 18, 2017).
  14. Gamaldo AA, Ferrucci L, Rifkind JM, Zonderman AB. Age-related changes in mean corpuscular volume in adult whites and African Americans. J Am Geriatr Soc 2011;59:1763-4.
    Pubmed KoreaMed CrossRef
  15. Danon D, Bologna NB, Gavendo S. Memory performance of young and old subjects related to their erythrocyte characteristics. Exp Gerontol 1992;27:275-85.
    CrossRef
  16. Yip R, Johnson C, Dallman PR. Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. Am J Clin Nutr 1984;39:427-36.
    Pubmed CrossRef
  17. Woo J, Arumanayagam M, Ho SC, Swaminathan R. Hematological indices and the prevalence of anemia in an elderly Chinese population. Pathology 1989;21:31-4.
    Pubmed CrossRef
  18. Tsang CW, Lazarus R, Smith W, Mitchell P, Koutts J, Burnett L. Hematological indices in an older population sample: derivation of healthy reference values. Clin Chem 1998;44:96-101.
    Pubmed