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Ozarda Y, Ichihara K, Bakan E, Polat H, Ozturk N, Baygutalp NK, Taneli F, Guvenc Y, Ormen M, Erbayraktar Z, Aksoy N, Sezen H, Demir M, Eskandari G, Polat G, Mete N, Yuksel H, Vatansev H, Gun F, Akin O, Ceylan O, Noyan T, Gozlukaya O, Aliyazicioglu Y, Kahraman S, Dirican M, Tuncer GO, Kimura S, Eker P. A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood. Biochem Med (Zagreb) 2017; 27:350-377. [PMID: 28694726 PMCID: PMC5493180 DOI: 10.11613/bm.2017.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/08/2017] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION A nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). MATERIALS AND METHODS K2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. RESULTS Analyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers' results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. CONCLUSIONS With the novel use of a freshly prepared blood panel, manufacturer-specific RIs' were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude.
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Affiliation(s)
- Yesim Ozarda
- Department of Medical Biochemistry, Uludag University School of Medicine, Bursa, Turkey
| | - Kiyoshi Ichihara
- Department of Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Ebubekir Bakan
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Harun Polat
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Nurinnisa Ozturk
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Nurcan K Baygutalp
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Fatma Taneli
- Department of Medical Biochemistry, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Yesim Guvenc
- Department of Medical Biochemistry, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Murat Ormen
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Zubeyde Erbayraktar
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Nurten Aksoy
- Department of Medical Biochemistry, Harran University School of Medicine, Urfa, Turkey
| | - Hatice Sezen
- Department of Medical Biochemistry, Harran University School of Medicine, Urfa, Turkey
| | - Meltem Demir
- Department of Medical Biochemistry, Medicalpark Hospital, Antalya, Turkey
| | - Gulcin Eskandari
- Department of Medical Biochemistry, Mersin University School of Medicine, Mersin, Turkey
| | - Gurbuz Polat
- Department of Medical Biochemistry, Mersin University School of Medicine, Mersin, Turkey
| | - Nuriye Mete
- Department of Medical Biochemistry, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Hatice Yuksel
- Department of Medical Biochemistry, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Husamettin Vatansev
- Department of Medical Biochemistry, Selçuk University School of Medicine, Konya, Turkey
| | - Fatma Gun
- Department of Medical Biochemistry, Selçuk University School of Medicine, Konya, Turkey
| | - Okhan Akin
- Department of Medical Biochemistry, Keçiören Teaching and Research Hospital, Ankara, Turkey
| | - Ozlem Ceylan
- Department of Medical Biochemistry, Keçiören Teaching and Research Hospital, Ankara, Turkey
| | - Tevfik Noyan
- Department of Medical Biochemistry, Ordu University School of Medicine, Ordu, Turkey
| | - Ozgul Gozlukaya
- Department of Medical Biochemistry, Ordu University School of Medicine, Ordu, Turkey
| | - Yuksel Aliyazicioglu
- Department of Medical Biochemistry, Karadeniz Teknik University School of Medicine, Trabzon, Turkey
| | - Sevim Kahraman
- Department of Medical Biochemistry, Karadeniz Teknik University School of Medicine, Trabzon, Turkey
| | - Melahat Dirican
- Department of Medical Biochemistry, Uludag University School of Medicine, Bursa, Turkey
| | - Gul Ozlem Tuncer
- Department of Medical Biochemistry, Uludag University School of Medicine, Bursa, Turkey
| | - Shogo Kimura
- Department of Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Pinar Eker
- Department of Medical Biochemistry, Kuzey Laboratories, Fatih Sultan Mehmet Hospital, Istanbul
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