Hematologic reference intervals for healthy adult Saudis in Riyadh

Abstract

BACKGROUND: Laboratory hematological tests are widely used in clinical practice to assess health and disease conditions. Reference ranges provided by laboratory reports are considered the most authoritative medical tools to assist in the decision-making phase. International standards institutes recommend that reference ranges be established for each region. OBJECTIVES: Provide reference values of routine hematological parameters in Saudi adults according to age and gender. DESIGN: Cross-sectional SETTING: Central province of Saudi Arabia. PATIENTS AND METHODS: Apparently healthy Saudi adults were subjected to laboratory testing of routine hematological parameters (full blood count, hemostatic profile, and serum hematinics), after completing a detailed health medical questionnaire. MAIN OUTCOME MEASURES: Hematological reference values based on the local population. SAMPLE SIZE AND CHARACTERISTICS: 637 after screening 827 potentially healthy Saudi adults with ages ranging from 15 to 65 years. RESULTS: The reference values of routine hematological parameters for the full population and by gender are presented with 90% CI as the lower and upper limits. Reference ranges mostly differed from universal established ranges shown in textbooks. CONCLUSION: The reference ranges of routine hematologic parameters for accurate assessment and appropriate management will help improve the routine clinical care of the adult Saudi population. LIMITATIONS: Difficulty in assessing health status of participants, who could have subclinical illnesses not reflected in the evaluated blood measurement. Lack of ability to eliminate individuals who might be carriers for haemoglobinopathies. Studies with larger sample sizes from different areas of the country are required to achieve a more accurate representation of the whole Saudi population. CONFLICT OF INTEREST: None.

Establishment of reference intervals for hematological parameters of adult population in the western region of Saudi Arabia

“…In comparison with other RIs studies, we obtained higher UL of Hb (18.0 g/dL) in males and PLT in females (443 ×10 6 /μL) compared to other Arab countries (Oman, Iraq, Qatar, Morocco, Sudan) for Hb and PLT [ 13 , 40 , 51 – 53 ]. Moreover, S3 Fig shows that our UL of Hb in males and PLT in females are mostly higher than those of four previously published studies on Saudi population (17.9 g/dL, 303×10 9 /μL; [ 21 ] 17.2 g/dL, 334×10 9 /μL [ 54 ]; 17.5g/dL, 337×10 6 /μL [ 19 ]; 18.0g/dL, 367×10 6 /μL [ 50 ]) respectively. The reason for the higher-side shift of RVs for hemoglobin and PLT compared in this study could be due to our use of improved statistical approaches including: 1) the parametric method which is robust to extreme values prevalent in skewed distributions unlike nonparametric method [ 31 ], and, 2) the LAVE procedure which is effective in reducing the influence of highly prevalent subclinical conditions such as anemia with and without iron deficiency.…”

“…They found that the calculated RIs for WBC, hemoglobin, platelet, MCV, and neutrophils were vastly lower than those currently used in our clinical laboratories [ 18 ]. Three other studies were also carried out in Saudi Arabia, attempting to establish hematological RIs [ 19 – 21 ]. However, these studies were performed without rigorous attempt to exclude individuals with latent diseases, especially iron deficiency states, and without application of up-to-date statistical methods for data analysis and determination of RIs.…”

Investigation of hematologic findings related to brucellosis in Anatolian region

“…This is thought to be related to the effect of hormones on erythropoiesis and menstrual blood loss. 26 In the current study, anemia was the most common hematologic finding in all brucellosis subgroups. The mean hemoglobin was lower especially in the acute brucellosis stage.…”