Hematological Reference Intervals for Healthy Iranian Blood Donors

  • Mahboubeh Rasouli Department of Biostatics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
  • Mojgan Pourmokhtar Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
  • Shaghayegh Sarkardeh Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
Keywords: Reference values, Blood donors, Iran, Gender, Age


Background: Development of locally-derived hematological reference intervals is necessary for improving the quality of health care and clinical trials. However hematological reference intervals are affected by several variables including age, gender and environmental factors. Therefore this study was conducted to determine the gender and age-specific hematological reference intervals of healthy Iranian blood donors.Materials and Methods: Selected hematological indices of 394 healthy blood donor volunteers, donating blood at Tehran Blood Transfusion Center were analyzed. Hematological reference intervals, stratified by age and gender were compared. The results of current study were also compared with those of US population.Results: There were significant gender-related differences for mean values of hematological indices, with males having higher mean values of RBC, HCG, HCT and MCV than females. While the mean of PLT and MCH were higher in women. Age-related differences for mean values of RBC and MCH were also significant. The comparison of reference intervals, stratified by both gender and age showed that RBC, HGB and HCT values were higher in males than females in all age groups. But MCH values of females in all age groups and WBC and PLT counts in females older than 30 years were higher compared to the males in the same age group. The results of this study showed some similarity with US population, with narrower intervals.Conclusion: This study suggests that gender and age-specific, locally derived hematological reference intervals should be referred to, before interpretation of any laboratory test result.

Author Biography

Mahboubeh Rasouli, Department of Biostatics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran


Chang YH, Yang SH, Wang TF, et al. Complete blood count reference values of cord blood in Taiwan and their influence by gender and delivery route on them. Pediatr Neonatol. 2011; 52(3):155-60.

Roshan TM, Rosline H, Ahmed SA, et al. Hematological reference values of healthy Malaysian population. Int J Lab Hematol. 2009; 31(5): 505-12.

Gräsbeck R. The evolution of the reference value concept. Clin Chem Lab Med. 2004; 42(7):692–7.

Kueviakoe IM, Segbena A, Jouault H, et al. Hematological reference values for healthy adults in Togo. ISRN Hematol. 2011; 2011: 736062.

Eller LA, Eller MA, Ouma B, et al. Reference intervals in healthy adult Ugandan blood donors and their impact on conducting international vaccine trials. PLoS One 2008; 3(12):e3919.

Zeh C, Amornkul PN, Inzaule S, et al. Population-based biochemistry, immunologic and hematological reference values for adolescents and young adults in a rural population in Western Kenya. PLoS One. 2011; 6(6):e21040.

El-Hazmi MAF, Warsy AS. Normal reference values for the hematological parameters, red cell indices, HbA2 and Hb F from early childhood through adolescence in Saudis. Ann Saudi Med 2001; 2: 165–9.

Buchanan AM, Muro FJ, Gratz J, et al. Establishment of haemato¬logical and immunological reference values for healthy Tanzanian children in Kilimanjaro Region. Trop Med Int Health. 2010; 15(9):1011–21.

Horn PS, Pesce AJ. Effect of ethnicity on reference intervals. Clin Chem. 2002; 48(10):1802–4.

Lugada ES., Mermin J, Kaharuza F, et al. Population-based hematologic and immunologic reference values for a healthy Ugandan population. Clin Diagn LabImmunol. 2004; 11(1): 29–34.

Koram K, Addae M, Ocran J, et al. Population based reference in¬tervals for common blood haematological and biochem¬ical parameters in the Akuapem north district. Ghana Med J. 2007; 41(4):160-6.

Kibaya RS, Bautista CT, Sawe FK, et al. Reference Ranges for the Clinical Laboratory Derived from a Rural Population in Kericho, Kenya. PLoS One. 2008; 3 (10):e3327.

Saathoff E, Schneider P, Kleinfeldt V, et al. Laboratory reference values for healthy adults from southern Tanzania. Trop Med Int Health. 2008; 13(5):612-25.

Shaper AG, Lewis P. Genetic neutropenia in people of African origin. Lancet. 1971; 2(7732):1021-3.

Adetifa IM, Hill PC, Jeffries DJ, et al. Haematological values from a Gambian cohort–possible reference range for a West African population. Int J Lab Hematol. 2009; 31(6): 615–22.

Rakoto AO, Ratsitoralina M, Pfister P, et al. Estimation of normal hemogram values in Madagascar. Arch Inst Pasteur Madag. 2000; 66(1-2): 68-71.

Menard D, Mandeng MJ, Tothy MB, et al. Immunohematological reference ranges for adults from the Central African Republic. Clin Diagn Lab Immunol. 2003; 10(3):443–5.

Tsegaye A, Messele T, Tilahun T, et al. Immunohematological Reference Ranges for Adult Ethiopians. Clin Diagn Lab Immunol 1999, 6(3):410-4.

Bain BJ. Ethnic and sex differences in the total and differential white cell count and platelet count. J Clin Pathol.1996; 49(8):664–6.

Adibi P, Faghih Imani E, Talaei M, et al. Population-based platelet reference values for an Iranian population. Int J Lab Hematol. 2007; 29(3):195–9.

Gordon AS, Mirand EA, Wenig J, et al. Androgen actions on erythropoiesis. Ann N Y Acad Sci. 1968; 149(1): 318–35.

Krabbe S, Christensen T, Worm J, et al. Relationship between haemoglobin and serum testosterone in normal children and adolescents and in boys with delayed puberty. Acta Paediatr Scand. 1978; 67(5):655–8.

Biino G, Santimone I, Minelli C, et al. Age- And Sex-Related Variations in Platelet Count in Italy: A Proposal of Reference Ranges Based on 40987 Subjects' Data. PLoS One. 2013; 8(1): e54289.

Clinical and Laboratory Standards Institute. How to define and determine reference intervals in the clinical laboratory: approved guideline. Second Edition” CLSI document C28-A2. Wayne, PA: 2000; 13-22.

Shokouhi Shoormasti R, Azimdoost A, Saghafi S, et al. Normal range determination of lymphocytes subsets in normal adults in Iran. Iran J Allergy Asthma Immunol. 2011; 10(4):295-8.

How to Cite
Rasouli M, Pourmokhtar M, Sarkardeh S. Hematological Reference Intervals for Healthy Iranian Blood Donors. ijhoscr. 11(4):305-12.