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Within-day biological variation and hour-to-hour reference change values for hematological parameters

  • Judith M. Hilderink , Lieke J.J. Klinkenberg , Kristin M. Aakre , Norbert C.J. de Wit , Yvonne M.C. Henskens , Noreen van der Linden , Otto Bekers , Roger J.M.W. Rennenberg , Richard P. Koopmans and Steven J.R. Meex EMAIL logo
Published/Copyright: December 21, 2016
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 7

Abstract

Background:

Middle- and long-term biological variation data for hematological parameters have been reported in the literature. Within-day 24-h variability profiles for hematological parameters are currently lacking. However, comprehensive hour-to-hour variability data are critical to detect diurnal cyclical rhythms, and to take into account the ‘time of sample collection’ as a possible determinant of natural fluctuation. In this study, we assessed 24-h variation profiles for 20 hematological parameters.

Methods:

Blood samples were collected under standardized conditions from 24 subjects every hour for 24 h. At each measurement, 20 hematological parameters were determined in duplicate. Analytical variation (CVA), within-subject biological variation (CVI), between-subject biological variation (CVG), index of individuality (II), and reference change values (RCVs) were calculated. For the parameters with a diurnal rhythm, hour-to-hour RCVs were determined.

Results:

All parameters showed higher CVG than CVI. Highest CVG was found for eosinophils (46.6%; 95% CI, 34.9%–70.1%) and the lowest value was mean corpuscular hemoglobin concentration (MCHC) (3.2%; 95% CI, 2.4%–4.8%). CVI varied from 0.4% (95% CI, 0.32%–0.42%) to 20.9% (95% CI, 19.4%–22.6%) for red cell distribution width (RDW) and eosinophils, respectively. Six hematological parameters showed a diurnal rhythm.

Conclusions:

We present complete 24-h variability profiles for 20 hematological parameters. Hour-to-hour reference changes values may help to better discriminate between random fluctuations and true changes in parameters with rhythmic diurnal oscillations.

Keywords: biological variation; diurnal rhythm; hematology; reference change value

Acknowledgments

The skillful technical assistance of the laboratory research analyst V. W. Kleijnen is gratefully acknowledged.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This study was supported by an Academic Incentive Grant from Maastricht University Medical Center to S.J.R.M.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplemental Material:

The online version of this article (DOI: https://doi.org/10.1515/cclm-2016-0716) offers supplementary material, available to authorized users.

Received: 2016-8-10
Accepted: 2016-11-1
Published Online: 2016-12-21
Published in Print: 2017-6-27

©2017 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2016-0716
Keywords for this article
biological variation; diurnal rhythm; hematology; reference change value

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Opportunities and drawbacks of nonstandard body fluid analysis
  4. How I first met Dr. Morton K. Schwartz
  5. Reviews
  6. Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids
  7. Quality control materials for pharmacogenomic testing in the clinic
  8. Modulating thrombotic diathesis in hereditary thrombophilia and antiphospholipid antibody syndrome: a role for circulating microparticles?
  9. Opinion Papers
  10. Advances in laboratory diagnosis of hereditary spherocytosis
  11. Analytical performance specifications for external quality assessment – definitions and descriptions
  12. Genetics and Molecular Diagnostics
  13. Differences between quantification of genotype 3 hepatitis C virus RNA by Versions 1.0 and 2.0 of the COBAS AmpliPrep/COBAS TaqMan HCV Test
  14. General Clinical Chemistry and Laboratory Medicine
  15. Estimating the intra- and inter-individual imprecision of manual pipetting
  16. Effect of multiple freeze-thaw cycles on selected biochemical serum components
  17. The effect of storage temperature fluctuations on the stability of biochemical analytes in blood serum
  18. Comparison of ex vivo stability of copeptin and vasopressin
  19. Physiologic changes of urinary proteome by caffeine and excessive water intake
  20. Assessment of autoantibodies to interferon-ω in patients with autoimmune polyendocrine syndrome type 1: using a new immunoprecipitation assay
  21. Reference Values and Biological Variations
  22. Within-day biological variation and hour-to-hour reference change values for hematological parameters
  23. Relationship between anti-Müllerian hormone and antral follicle count across the menstrual cycle using the Beckman Coulter Access assay in comparison with Gen II manual assay
  24. Cardiovascular Diseases
  25. Low-grade inflammation and tryptophan-kynurenine pathway activation are associated with adverse cardiac remodeling in primary hyperparathyroidism: the EPATH trial
  26. Infectious Diseases
  27. Comparison between procalcitonin and C-reactive protein in predicting bacteremias and confounding factors: a case-control study
  28. Monitoring of procalcitonin but not interleukin-6 is useful for the early prediction of anastomotic leakage after colorectal surgery
  29. Activation of the tryptophan/serotonin pathway is associated with severity and predicts outcomes in pneumonia: results of a long-term cohort study
  30. Letters to the Editor
  31. Incidental findings of monoclonal proteins from carbohydrate-deficient transferrin analysis using capillary electrophoresis
  32. IgD-λ myeloma with extensive free light-chain excretion: a diagnostic pitfall in the identification of monoclonal gammopathies
  33. 25-Hydroxyvitamin D threshold values should be age-specific
  34. Effect of dabigatran treatment at therapeutic levels on point-of-care international normalized ratio (INR)
  35. Alkaline phosphatase activity – pH impact on the measurement result
  36. Cyst hydatid and cancer: the myth continues
  37. Role of activated platelets in severe acne scarring and adaptive immunity activation
  38. Towards a random-access LC-MS/MS model for busulfan analysis
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