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Reference intervals for erythrocyte parameters and hemoglobin electrophoresis parameters for young children in
Chaofan Zhou1, Sheng He1, Dun Liu2
1Genetic and Metabolic Central Laboratory, Birth Defects Prevention and Control Institute, Reproductive Health and Birth Defects Prevention, Guangxi Clinical Research Center for Pediatric Diseases, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China.
Insights
Establishing pediatric reference intervals (RIs) for erythrocyte parameters aids in diagnosing hematological diseases, including thalassemia screening in Southern China. This study provides crucial RIs for children aged 1 day to 6 years.
Area of Science:
- Pediatric Hematology
- Clinical Laboratory Science
- Medical Diagnostics
Background:
- Erythrocyte parameter analysis is vital for diagnosing hematological diseases and screening for thalassemia in Southern China.
- Limited data exists on reference intervals (RIs) for healthy pediatric populations in Guangxi and other relevant regions.
- Accurate RIs are essential for effective diagnosis and treatment monitoring.
Purpose of the Study:
- To establish age-specific reference intervals (RIs) for erythrocyte parameters in healthy Southern Chinese children (1 day to <6 years).
- To evaluate the necessity of sex and age partitioning for these parameters.
- To optimize thalassemia screening using hemoglobin electrophoresis parameters and established RIs.
Main Methods:
- Calculated 95% RIs for erythrocyte parameters in 853 healthy preschoolers following CLSI C28-A3C guidelines.
- Utilized ANOVA to calculate Standard Deviation Ratio (SDR) for assessing age and sex variations.
- Employed ROC curves with 3814 thalassemia carriers to determine optimal cut-off values for hemoglobin electrophoresis parameters.
Main Results:
- Age partitioning was necessary for all erythrocyte parameters except Red Blood Cell (RBC), indicated by SDRage > 0.4.
- Sex partitioning was not required for any erythrocyte parameters, as SDRsex < 0.4.
- Optimal cut-off values for Hemoglobin A2 (Hb A2) were determined for different subgroups, aiding thalassemia screening.
Conclusions:
- Established RIs significantly improved diagnostic efficiency for pediatric hematological diseases, particularly thalassemia, in Guangxi.
- The findings provide reliable hematological references for clinical diagnosis, treatment monitoring, and health screening in children.
- This study addresses a critical gap in pediatric hematological reference data for the region.
Background:
Erythrocyte parameter analysis is the important means for diagnosis and treatment of hematological diseases, which are essential for screening of thalassemia in southern China combined with hemoglobin electrophoresis analysis. But little is known regarding the reference intervals (RIs) in healthy pediatrics in these two areas.
Methods:
95% RIs of erythrocyte parameters were calculated from 853 healthy preschoolers, aged from 1 days to <6 years, according to the C28-A3C guidelines of the Institute of Clinical and Laboratory Standards. To express the magnitude of sex and age variation, standard deviation ratio (SDR) was calculated using ANOVA. Concurrently, we selected 3814 thalassemia carriers as carriers group and drew receiver operating characteristic (ROC) curves to establish the optimal cut-off values of hemoglobin electrophoresis parameters, which were used as the upper/lower limits of RIs to efficiently screen thalassemia.
Results:
All parameters except red blood cell (RBC) required age partitioning, confirmed by SDRage above .4. There was no need for sex partitioning on all parameters, confirmed by SDRsex below .4. The optimal cut-off value of Hemoglobin A2 (Hb A2) in the four subgroups was <7.8% (Hb A), 2.3%-3.2%, 2.5%-3.6% and 2.6%-3.6%, respectively.
Conclusion:
In this study, the establishment of RIs improved the diagnostic efficiency of hematological disease (especially thalassaemia) for children in Guangxi. It provides reliable hematological references for the identification and diagnosis, treatment monitoring, and health screening of children's clinical diseases.
