title: Haematological reference intervals in a multiethnic population.
abstract: BACKGROUND
  Similar to other populations, full blood count reference (FBC) intervals in Malaysia are generally derived from non-Malaysian subjects. However, numerous studies have shown significant differences between and within populations supporting the need for population specific intervals.
  
  
  METHODS
  Two thousand seven hundred twenty five apparently healthy adults comprising all ages, both genders and three principal races were recruited through voluntary participation. FBC was performed on two analysers, Sysmex XE-5000 and Unicel DxH 800, in addition to blood smears and haemoglobin analysis. Serum ferritin, soluble transferrin receptor and C-reactive protein assays were performed in selected subjects. All parameters of qualified subjects were tested for normality followed by determination of reference intervals, measures of central tendency and dispersion along with point estimates for each subgroup.
  
  
  RESULTS
  Complete data was available in 2440 subjects of whom 56% (907 women and 469 men) were included in reference interval calculation. Compared to other populations there were significant differences for haemoglobin, red blood cell count, platelet count and haematocrit in Malaysians. There were differences between men and women, and between younger and older men; unlike in other populations, haemoglobin was similar in younger and older women. However ethnicity and smoking had little impact. 70% of anemia in premenopausal women, 24% in postmenopausal women and 20% of males is attributable to iron deficiency. There was excellent correlation between Sysmex XE-5000 and Unicel DxH 800.
  
  
  CONCLUSIONS
  Our data confirms the importance of population specific haematological parameters and supports the need for local guidelines rather than adoption of generalised reference intervals and cut-offs.
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Angeli
authors.initials: A
authors.lastname: Ambayya
authors.affiliation: Department of Community Medicine and Public Health, Universiti Malaysia Sarawak, Kuching, Sarawak, Malaysia.
authors.forename: Anselm Ting
authors.initials: AT
authors.lastname: Su
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Nadila Haryani
authors.initials: NH
authors.lastname: Osman
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Nik Rosnita
authors.initials: NR
authors.lastname: Nik-Samsudin
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Khadijah
authors.initials: K
authors.lastname: Khalid
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Kian Meng
authors.initials: KM
authors.lastname: Chang
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Jameela
authors.initials: J
authors.lastname: Sathar
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Jay Suriar
authors.initials: JS
authors.lastname: Rajasuriar
authors.affiliation: Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia.
authors.forename: Subramanian
authors.initials: S
authors.lastname: Yegappan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000208:ethnology; D044466:Asian People; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005293:Ferritins / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood* / Q000208:ethnology; D017697:Premenopause / Q000097:blood* / Q000208:ethnology; D011990:Receptors, Transferrin / Q000097:blood; D012016:Reference Values; D012737:Sex Factors; D044465:White People
chemical_list: D006454:Hemoglobins; D011990:Receptors, Transferrin; D002097:C-Reactive Protein; D005293:Ferritins