title: The effect of thalassemia on erythrocyte reference intervals in a representative Han Chinese adult population.
abstract: BACKGROUND
  The data from apparently healthy individuals with thalassemia has been demonstrated to have an effect on the reference intervals for the erythrocyte indices in areas with a high incidence of thalassemia.
  
  
  METHODS
  Six clinical centers screened apparently healthy individuals using a questionnaire and a physical examination. Then, the qualified reference individuals were selected by hematological indices and a genotypic thalassemia diagnosis. Statistical comparisons were conducted for the erythrocyte reference intervals in the Chinese population with and without thalassemia. The constituent ratios and the mean (SD) of erythrocyte indices according to the thalassemia genotype were calculated. The relationship between the MCV values and the thalassemia genotype was also estimated.
  
  
  RESULTS
  4,636 reference individuals were included using hematological indices and genotypic thalassemia screening. The results of the erythrocyte reference intervals for individuals in Guangzhou with thalassemia demonstrated that the RBC, MCV, and MCH values significantly differed by gender compared with other regions (p < 0.01). In contrast, for individuals without thalassemia, the results tended to be similar and clinically acceptable. In addition, the results of the erythrocyte indices revealed significant differences among α-thalassemia patients, β-thalassemia patients, and the control group.
  
  
  CONCLUSIONS
  Apparently healthy individuals with thalassemia in the high prevalence zone of thalassemia could not be excluded by the questionnaire, physical examination or laboratory indices (Fe < 6 μmol/L, Hb < 90 g/L). The screening of genotypic thalassemia based on the MCV or MCH values to exclude unqualified individuals is the most effective way to obtain accurate and reliable reference intervals for the erythrocyte indices.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Xu
authors.forename: Xiao-Ke
authors.initials: XK
authors.lastname: Hao
authors.forename: Run-Qing
authors.initials: RQ
authors.lastname: Mu
authors.forename: Bai-Shen
authors.initials: BS
authors.lastname: Pan
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Ming-Ting
authors.initials: MT
authors.lastname: Peng
authors.forename: Lan-Lan
authors.initials: LL
authors.lastname: Wang
authors.forename: Xian-Zhang
authors.initials: XZ
authors.lastname: Huang
authors.forename: Yue-Yun
authors.initials: YY
authors.lastname: Ma
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.forename: Rui
authors.initials: R
authors.lastname: Qiao
authors.forename: Wen-Xiang
authors.initials: WX
authors.lastname: Chen
authors.forename: Hong
authors.initials: H
authors.lastname: Jiang
authors.forename: Hong
authors.initials: H
authors.lastname: Shang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D019411:Clinical Laboratory Techniques / Q000592:standards; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000166:cytology*; D005260:Female; D005838:Genotype; D005843:Geography; D064368:Healthy Volunteers; D006405:Hematology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D017422:Sequence Analysis, DNA; D011795:Surveys and Questionnaires; D013789:Thalassemia / Q000097:blood* / Q000208:ethnology*; D055815:Young Adult