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Gupta AK, Kunnumbrath A, Tayal SG, Mehan A, Sahay R, Kumar U, Jeladharan R, Anthony ML, Singh N, Chandra H, Chowdhury N. Short-term biological variation of differential count in healthy subjects in a South Asian population. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:654-658. [PMID: 33016776 DOI: 10.1080/00365513.2020.1827290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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.
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Affiliation(s)
- Arvind Kumar Gupta
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Arathi Kunnumbrath
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Sakshi Garg Tayal
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Anoushika Mehan
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Rishabh Sahay
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Utpal Kumar
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Reshma Jeladharan
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Michael Leonard Anthony
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Neha Singh
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Harish Chandra
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Nilotpal Chowdhury
- Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
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Li C, Peng M, Wu J, Du Z, Lu H, Zhou W. Long-term biological variation estimates of 13 hematological parameters in healthy Chinese subjects. Clin Chem Lab Med 2020; 58:1282-1290. [PMID: 32069228 DOI: 10.1515/cclm-2019-1141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/16/2019] [Indexed: 01/13/2023]
Abstract
Background The complete blood count (CBC) is a basic test routinely ordered by physicians as a part of initial diagnostic work-up on their patients. To ensure safe clinical application of the CBC, reliable biological variation (BV) data are needed to establish analytical performance specifications. Our aim was to define the BV of CBC parameters using a rigorous protocol that is compliant with the Biological Variation Data Critical Appraisal Checklist (BIVAC) provided by the European Federation of Clinical Chemistry and Laboratory Medicine. Methods Blood samples drawn from 41 healthy Chinese subjects (22 females and 19 males; 23-59 years of age) once monthly for 6 consecutive months were analyzed using an ABX Pentra 80 instrument. The instrument was precisely calibrated. All samples were analyzed in duplicate for 13 CBC parameters. The data were assessed for outliers, normality, and variance homogeneity prior to nested ANOVA. Gender-stratified within-subject (CVI) and between-subject (CVG) BV estimates were calculated. Results The number of remaining data for each subject was 442-484 after removing outliers. No significant differences existed between female/male CVI estimates. Except for leukocytes, neutrophils, and lymphocytes, the mean values of 10 parameters differed significantly between genders, rendering partitioning of CVG data between genders. No significant differences were detected between most BV estimates and recently published estimates representing a Europid population. Conclusions Most BV estimates in BIVAC-compliant studies are similar. The turnover time of blood cells and age distribution of participants should be considered in a CBC BV study. Our study will contribute to global BV estimates and future studies.
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Affiliation(s)
- Chenbin Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Mingting Peng
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Ji Wu
- National Center for Clinical Laboratories, Beijing, P.R. China
| | - Zhongli Du
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Hong Lu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Wenbin Zhou
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
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Critchley WR, Reid A, Morris J, Naish JH, Stone JP, Ball AL, Major T, Clark D, Waldron N, Fortune C, Lagan J, Lewis GA, Ainslie M, Schelbert EB, Davis DM, Schmitt M, Fildes JE, Miller CA. The effect of 1.5 T cardiac magnetic resonance on human circulating leucocytes. Eur Heart J 2019; 39:305-312. [PMID: 29165554 DOI: 10.1093/eurheartj/ehx646] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 10/20/2017] [Indexed: 12/25/2022] Open
Abstract
Aims Investigators have proposed that cardiovascular magnetic resonance (CMR) should have restrictions similar to those of ionizing imaging techniques. We aimed to investigate the acute effect of 1.5 T CMR on leucocyte DNA integrity, cell counts, and function in vitro, and in a large cohort of patients in vivo. Methods and results In vitro study: peripheral blood mononuclear cells (PBMCs) were isolated from healthy volunteers, and histone H2AX phosphorylation (γ-H2AX) expression, leucocyte counts, and functional parameters were quantified using flow cytometry under the following conditions: (i) immediately following PBMC isolation, (ii) after standing on the benchside as a temperature and time control, (iii) after a standard CMR scan. In vivo study: blood samples were taken from 64 consecutive consenting patients immediately before and after a standard clinical scan. Samples were analysed for γ-H2AX expression and leucocyte counts. CMR was not associated with a significant change in γ-H2AX expression in vitro or in vivo, although there were significant inter-patient variations. In vitro cell integrity and function did not change with CMR. There was a significant reduction in circulating T cells in vivo following CMR. Conclusion 1.5 T CMR was not associated with DNA damage in vitro or in vivo. Histone H2AX phosphorylation expression varied markedly between individuals; therefore, small studies using γ-H2AX as a marker of DNA damage should be interpreted with caution. Cardiovascular magnetic resonance was not associated with loss of leucocyte viability or function in vitro. Cardiovascular magnetic resonance was associated with a statistically significant reduction in viable leucocytes in vivo.
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Affiliation(s)
- William R Critchley
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity and Respiratory Research, School of Biology, Medicine and Health, Manchester Academic Health Science Centre, Room 2.12 Core Technology Facility, Grafton Street, University of Manchester, M13 9NT Manchester, UK.,The Transplant Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Anna Reid
- North West Heart Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK.,Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, 3rd Floor-Core Technology Facility, 46 Grafton Street, M13 9PL Manchester UK
| | - Julie Morris
- Department of Medical Statistics, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Josephine H Naish
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, 3rd Floor-Core Technology Facility, 46 Grafton Street, M13 9PL Manchester UK
| | - John P Stone
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity and Respiratory Research, School of Biology, Medicine and Health, Manchester Academic Health Science Centre, Room 2.12 Core Technology Facility, Grafton Street, University of Manchester, M13 9NT Manchester, UK.,The Transplant Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Alexandra L Ball
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity and Respiratory Research, School of Biology, Medicine and Health, Manchester Academic Health Science Centre, Room 2.12 Core Technology Facility, Grafton Street, University of Manchester, M13 9NT Manchester, UK.,The Transplant Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Triin Major
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity and Respiratory Research, School of Biology, Medicine and Health, Manchester Academic Health Science Centre, Room 2.12 Core Technology Facility, Grafton Street, University of Manchester, M13 9NT Manchester, UK.,The Transplant Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - David Clark
- Wythenshawe Alliance Medical Cardiac MRI Unit, Wythenshawe Hospital, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Nick Waldron
- North West Heart Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Christien Fortune
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, 3rd Floor-Core Technology Facility, 46 Grafton Street, M13 9PL Manchester UK
| | - Jakub Lagan
- North West Heart Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK.,Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, 3rd Floor-Core Technology Facility, 46 Grafton Street, M13 9PL Manchester UK
| | - Gavin A Lewis
- North West Heart Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK.,Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, 3rd Floor-Core Technology Facility, 46 Grafton Street, M13 9PL Manchester UK
| | - Mark Ainslie
- North West Heart Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Erik B Schelbert
- Department of Medicine, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, USA.,Cardiovascular Magnetic Resonance Center, UPMC, 200 Lothrop St., Pittsburgh, PA 15213, USA
| | - Daniel M Davis
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity and Respiratory Research, School of Biology, Medicine and Health, Manchester Academic Health Science Centre, Room 2.12 Core Technology Facility, Grafton Street, University of Manchester, M13 9NT Manchester, UK
| | - Matthias Schmitt
- North West Heart Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - James E Fildes
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity and Respiratory Research, School of Biology, Medicine and Health, Manchester Academic Health Science Centre, Room 2.12 Core Technology Facility, Grafton Street, University of Manchester, M13 9NT Manchester, UK.,The Transplant Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK
| | - Christopher A Miller
- North West Heart Centre, Manchester University Hospitals NHS Foundation Trust, Southmoor Road, Wythenshawe, M23 9LT Manchester, UK.,Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, 3rd Floor-Core Technology Facility, 46 Grafton Street, M13 9PL Manchester UK.,Wellcome Centre for Cell-Matrix Research, Division of Cell-Matrix Biology and Regenerative Medicine, School of Biology, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, M13 9PT Manchester, UK
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