Sex-divided reference intervals for mean platelet volume, platelet large cell ratio and plateletcrit using the Sysmex XN-10 automated haematology analyzer in a UK population

Ali, Usman; Gibbs, Roz; Knight, Gavin; Tsitsikas, Dimitris

doi:10.1016/j.htct.2018.09.005

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Hematology, Transfusion and Cell Therapy

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Original Articles • Hematol., Transfus. Cell Ther. 41 (2) • Apr-Jun 2019 • https://doi.org/10.1016/j.htct.2018.09.005 copy

Sex-divided reference intervals for mean platelet volume, platelet large cell ratio and plateletcrit using the Sysmex XN-10 automated haematology analyzer in a UK population

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background:

This study aimed to define the sex-divided reference intervals for platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR) and plateletcrit (PCT)) on the Sysmex XN-10.

Methods:

A total of 2376 samples were assayed for full blood count on the Sysmex XN-10 haematology analyzer. After removing the outliers, reference intervals were calculated using the mean ± 2SD. The P value 0.05 was adopted to denote statistical significance.

Results:

There was a statistical significance (α = 0.05) between sex-divided reference intervals for MPV (p = 0.007), P-LCR (p = 0.015) and PCT (p < 0.001), thus separate reference intervals were calculated for these indices, with orientation to the sex-divisions as follows: MPV, 9.1-13.0 fL [males] and 9.2-12.8 fL [females]; P-LCR, 17.6-47.0% [males] and 17.8-47.8% [females]; and PCT, 0.16-0.35% [males] and 0.18-0.37% [females]. No significance was found between sex-divided reference intervals for the PDW (p = 0.838), therefore a reference interval for total individuals was calculated for this platelet measurement as 9.3-17.3 fL.

Conclusion:

This study showed comparable reference intervals, using the Sysmex XN-10, with the previous literature. It determined the need to define sex-specific reference intervals for the MPV, P-LCR and PCT, but not for the PDW. These reference intervals will allow for low and high values to be facilitated in order to do further research and guide platelet disorder management.

Keywords:
Reference values; Blood platelet; Mean platelet volume; Blood cell count; Hematologic tests

	Pekelharing²²22 Pekelharing JM, Hauss O, De Jonge R, Lokhoff J, Sodikromo J, Spaans M, et al. Haematology reference intervals for established and novel parameters in healthy adults. Sysmex Diagn Perspect. 2010;1:1-11.		Subhashree²³23 Subhashree AR, Parameaswari PJ, Shanthi B, Revathy C, Parijatham BO. The reference intervals for the haematological parameters in healthy adult population of Chennai Southern India. J Clin Diagn Res. 2012;6(10):1675-80.		Sachdev²⁴24 Sachdev R, Tiwari AK, Goel S, Raina V, Sethi M. Establishing biological reference intervals for novel platelet parameters (immature platelet fraction, high immature platelet fraction, platelet distribution width, platelet large cell ratio, platelet-X, plateletcrit, and platelet distribution width) and their correlations among each other. Indian J Pathol Microbiol. 2014;57(2):231-5.	Abass²⁵25 Abass AE, Ismail I, Ali E, Mohammed R, Mohammed S, et al. Reference value of platelets count and indices in Sudanese using Sysmex KX-21. Int J Healthcare Sci. 2015;3:120-5.		Maluf²⁶26 Maluf CB, Barreto SM, Vidigal PG. Standardization and reference intervals of platelet volume indices: Insight from the Brazilian longitudinal study of adult health (ELSA-BRASIL). Platelets. 2015;26:413-20.	Boshnak²⁷27 Boshnak NH. Reference intervals for platelet indices using Sysmex XT-1800i in Egyptian population. Int J Med Health Res. 2017;3:4-11.		Current study
Year of publication	2010		2012		2014	2015		2015	2017		2017
Analytic platform	XE-5000		KX-21		XE-2100	KX-21		XE-2100D	XT1800i		XN-10
Sex-division	M	F	M	F	T	M	F	T	M	F	M	F
Sample size	133	176	252	248	945	150	150	580	184	196	791	1565
MPV [fL]	9.3-12.1	9.1-11.9	7.9-13.7	8.0-13.28	8.6-15.5	8.4-11.4	8.0-11.6	8.9-11.8	9.5-11.8	9.3-12.2	9.1-13.0	9.2-12.8
PDW [fL]	10.1-16.1	9.9-15.4	9.0-16.56	8.0-13.28	8.3-25.0	8.7-15.7^a a Although reported separately, the PDW did not show a significant difference between males and females in Abass et al.25	7.8-16.7^a a Although reported separately, the PDW did not show a significant difference between males and females in Abass et al.25	9.6-15.3	10.4-15.9	10.0-16.9	9.3-17.0	9.3-17.3
P-LCR [%]	18.5-42.3	17.5-42.3			11.9-66.9	12.7-36.1	10.9-38.8	15.6-39.5	21.6-39.0	20.0-42.3	17.6-47.0	17.8-47.8
PCT [%]	0.17-0.32	0.18-0.39			0.15-0.62	0.14-0.24	0.13-0.33		0.18-0.34	0.18-0.41	0.16-0.35	0.18-0.37

Variable	Sex	Mean	SD	P value	RI for total individuals
MPV [fL]	M	10.9	0.891	0.007
	F	11.0	0.913
PDW [fL]	M	13.3	2.018	0.838	9.3-17.3
	F	13.3	2.004
P-LCR [%]	M	32.5	7.435	0.015
	F	33.3	7.728
PCT [%]	M	0.26	0.046	<
	F	0.28	0.049	0.001

Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) R. Dr. Diogo de Faria, 775 cj 133, 04037-002, São Paulo / SP - Brasil - São Paulo - SP - Brazil
E-mail: htct@abhh.org.br

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[1] *Corresponding author at: Department of Hematology, Homerton University Hospital NHS Foundation Trust, Homerton Row, London E9 6SR, UK. E-mail address: usmanali1@nhs.net (U. Ali).