Ann Lab Med.  2018 Nov;38(6):503-511. 10.3343/alm.2018.38.6.503.

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

Affiliations
  • 1Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea. cellonah@hanmail.net
  • 2MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea.

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.

Keyword

Complete blood count; Reference intervals; Secondary data; Pediatric; Geriatric; Age; Sex; Korean

MeSH Terms

Adolescent
Adult*
Blood Cell Count*
Blood Cells
Blood Platelets
Eosinophils
Female
Humans
Korea*
Leukocytes
Lymphocyte Count
Male
Monocytes
Neutrophils
Platelet Count
Puberty
Sex Characteristics

Figure

  • Fig. 1 Scatter plot distributions of the hematologic parameters. (A) Hemoglobin. (B) Red blood cell count. (C) White blood cell count. (D) Platelet count.

  • Fig. 2 Box plots of the red blood cell parameters according to age and sex. (A) Hematocrit. (B) Hemoglobin. (C) Red blood cell count. (D) Mean corpuscular volume. (E) Mean corpuscular hemoglobin. (F) Mean corpuscular hemoglobin concentration. (G) Red blood cell distribution width. Box limits and horizontal lines within boxes represent interquartile ranges and the median, respectively. The upper and lower whiskers indicate the 97.5th and 2.5th percentiles, respectively. The difference in median values between sexes in each age group was determined using the Wilcoxon rank sum test: *P<0.05; **P<0.005. The median values among age groups for each sex differed significantly (P<0.001, Kruskal-Wallis test).

  • Fig. 3 Box plots of the white blood cell and the platelet parameters according to age and sex. (A) White blood cell count. (B) Neutrophil count. (C) Lymphocyte count. (D) Monocyte count. (E) Eosinophil count. (F) Basophil count. (G) Platelet count. (H) Platelet distribution width. (I) Mean platelet volume. (J) Plateletcrit. Box limits and horizontal lines within boxes represent interquartile ranges and the median, respectively. The upper and lower whiskers indicate the 97.5th and 2.5th percentiles, respectively. The difference in median values between sexes in each age group was determined using the Wilcoxon rank sum test: *P<0.05; **P<0.005. The median values among age groups for each sex differed significantly (P<0.001, Kruskal-Wallis test).


Cited by  1 articles

Establishment of Pediatric Reference Intervals for Routine Laboratory Tests in Korean Population: A Retrospective Multicenter Analysis
Ji Yeon Sung, Jong Do Seo, Dae-Hyun Ko, Min-Jeong Park, Sang Mee Hwang, Sohee Oh, Sail Chun, Moon-Woo Seong, Junghan Song, Sang Hoon Song, Sung Sup Park
Ann Lab Med. 2021;41(2):155-170.    doi: 10.3343/alm.2021.41.2.155.


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