Short-term biological variation of differential count in healthy subjects in a South Asian population

Abstract

Estimates of Within-Subject and between subject biological variation for the white blood cell differential count (DC) have not been reported in South Asia. Therefore, we attempted to measure the short-term biological variation estimates for DC. The study was conducted on 28 healthy volunteers (15 males and 13 females). Blood from the volunteers was collected in the morning in K3-EDTA vials and analyzed in triplicate on the Sysmex XN-1000 analyzer, for six consecutive days. The Within subject, between subject and analytical coefficient of variation of the DC was calculated from the results by nested repeated measures ANOVA after outlier exclusion. The Reference change values (RCV) were also calculated. The within-subject variation for eosinophil Count and between subject variation for basophils in our study from South Asia was greater than the published European and American studies. Males and females showed similar biological variation for DC. The within-subject variation of other parameters (Neutrophils, Lymphocytes, Monocytes and Basophils) were similar or showed only mild differences to the published studies. The markedly different within-subject variation for Eosinophil counts suggest that the RCV for DC in South Asians need to be different from the published data in order to have clinical relevance. The Within-subject variation values of the other parameters seem transportable from the published European and American studies, but the small differences found mean that further regional estimates need to be reported for robust evidence of the same.

Keywords:

• Biological variation
• individual
• within-subject variation
• biological variation
• population
• between-subject variation
• leukocyte count differential
• lymphocyte count
• eosinophils
• neutrophils
• reference change value

Acknowledgment

Thanks to Mr Manish Mehta (Lab technician) and Mr Sarvesh (Lab technician) for their technical support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is funded by an institutional intramural funding project [IM/RC117/2017/05].