Ann Lab Med 2018; 38(6): 503-511  https://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
Eun-Hee Nah, M.D.1, Suyoung Kim, M.S.1, Seon Cho, M.S.1, and Han-Ik Cho, M.D.2
1Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea; 2MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea
Corresponding author: Eun-Hee Nah
https://orcid.org/0000-0003-0637-4364
Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, 350 Hwagok-ro, Gangseo-gu, Seoul 07653, Korea
Tel: +82-2-2600-0107
Fax: +82-2-2690-4915
E-mail: cellonah@hanmail.net
Received: July 10, 2017; Revised: April 5, 2018; Accepted: June 27, 2018; Published online: November 1, 2018.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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



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