Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 151, Issue 2, Pages 128-142Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ajcp/aqy116
Keywords
Hemoglobin; Hematocrit; MCHC; Mean cell volume; RDW
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Funding
- US Army Medical Research and Materiel Command (USAMRMC)
- Department of Defense Center Alliance for Nutrition and Dietary Supplement Research
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Objectives To develop age- and sex-specific RBC reference intervals using the National Health and Nutrition Examination Survey (NHANES) 1999 to 2012, a large nationally representative, population-based, cross-sectional database (n = 44,328). Methods Comprehensive medical data were used to define a healthy population. Reference intervals for RBC count, hemoglobin, hematocrit, mean cell hemoglobin, mean cell hemoglobin concentration, mean cell volume, and red cell distribution width were computed using piecewise regression, an evidence-based statistical procedure that identifies breakpoints. Results The derived reference intervals were sex specific, unlike many current standards, and more precise for individuals of different ages, especially for children, adolescents, and elderly individuals, as additional breakpoints were detected for these groups. Suggested reference values for hematocrit and hemoglobin of older adult males were substantially lower than current values. Conclusions The reference intervals provided here, based on a large, nationally representative healthy population, contribute to the ongoing transition to precision medicine.
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