title: Range and determinants of white blood cell count in a large survey of Israelis without inflammation.
abstract: BACKGROUND
  The white blood cell count and its differential are established inflammation-sensitive biomarkers with a proven prognostic value in the field of atherothrombosis. However, the WBCC count range and determinants havenot been explored in the absence of a significant inflammatory response.
  
  
  OBJECTIVE
  To analyze the WBCC range and determinants in a large Israeli sample of individuals, excluding patients with a significant inflammatory response.
  
  
  METHODS
  WBCC and differential count reference ranges were determined in a large sample of apparently heal participants with high sensitivity C-reactive protein concentrations below 10 mg/L. Linear regression models were used to identify the determinants of the WBCC. The central 95% areas under the distribution curves were established for each gender.
  
  
  RESULTS
  The study population comprised 8247 individuals (5391 males and 2856 females). The main laboratory and clinical variables found to affect the WBCC were gender, hemoglobin level, smoking status, triglycerides, and body mass index (all P < 0.001). Similar results were obtained for the differential count. The reference ranges for men and women were 3.6-9.9 and 3.4-10.0 x10(3) microl, respectively.The reference ranges for currently smoking men and women were 3.6-11.5 and 3.6-11.2 x10(3) microl, respectively, and were significantly higher compared with those of the never smokers and past smokers.
  
  
  CONCLUSIONS
  We have demonstrated new limits of normal values for the WBCC in apparently healthy individuals who lack a significant "background" acute-phase response in a large Israeli sample. Our data might be useful for the risk stratification of apparently healthy individuals in the field of atherothrombosis.
authors.affiliation: Department of Internal Medicine D, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: Yair
authors.initials: Y
authors.lastname: Herishanu
authors.forename: Yael
authors.initials: Y
authors.lastname: Paran
authors.forename: Dan
authors.initials: D
authors.lastname: Justo
authors.forename: Michael
authors.initials: M
authors.lastname: Cohen
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis*; D003625:Data Collection; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D007557:Israel; D007958:Leukocyte Count; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein