Reference Intervals of Red Blood Cell Parameters in Healthy Adults of the Chinese Population in High-Altitude Areas.

Abstract

Background: Typically, red blood cell (RBC)-based parameters and platelet count vary with age and gender. Moreover, these variations may happen due to geographical origin and ethnicity. Nevertheless, the reference intervals (RIs) in healthy Tibetan adult populations are limited. This study aimed to determine the RIs for RBC parameters and platelet count (PLT) in Tibetans living at various high altitudes.

Methods: Initially, a total of 1,104 subjects were randomly recruited from Ali, Shigatse/Lhasa, and Nyingchi of Ti-bet. Further, RBC count, hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and PLT were measured using an automated hematocytometer (Sysmex XN-2100). Then, multiple linear regression and variance component analyses were employed to assess the effect of gender, age, and altitude on RBC parameters and PLT count. Finally, RIs were established using non-parametric methods and compared with those currently used in China.

Results: The notified blood parameters (RBC, HGB, HCT, MCV, MCH, and MCHC) were significantly higher in males than in females, while PLT count was higher in females than males. Notably, some parameters, including RBC, HGB, and MCHC values, increased with increasing altitude, while MCHC and PLT parameters increased with age. The RIs for RBC parameters and PLT were finally determined according to gender and altitude in healthy Tibetan adults.

Conclusions: In summary, the specific RIs for RBC parameters and PLT among Tibetans were significantly different, emphasizing the need to consider gender and geographical origin in the clinical use of IRs of hemogram parameters.