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Common Hematological Reference Indices Among Healthy Reproductive Age Indian Women-Data Subset from Nationwide Study

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Abstract

Despite the negative implications on women’s health, pregnancy, and fetal outcomes, population-based studies on hematological indices among reproductive age women in India have received inadequate attention. This study aimed to generate normative ranges for various hematological parameters among these women. After ethics approval, apparently healthy (n = 5884) women (aged 18–40 years) were recruited from six eco-geographic zones of India. After various exclusions (n = 5412), including women having anemia, data of clinically, and biochemically healthy women (n = 472) was analysed to generate centiles (2.5 and 97.5th) and correlations. The mean age and mean BMI of women was 29.3 ± 6.5 years and 23.25 ± 3.26 kg/m2 with BP of 112.26 ± 8.9/74.04 ± 6.7 mmHg. The reference intervals for hemoglobin (12–15.1 gm/dl), RBC (3.68–5.55 millions/μl), WBC (4.1–11.26*109/L), platelet count (1.32–4.42*105/μl), and erythrocyte sedimentation rate (4.35–41.65 mm/hr) were different from currently used reference values (p < 0.05). However, these haematological indices did not vary among various age categories, geographical zones, ethnicities and rural or urban origins. Pearson’s correlation revealed a statistically significant association between ESR, WBC, monocytes, and platelets with homeostasis model assessment of insulin resistance (HOMA-IR). Women with HOMA-IR > 2 displayed a statistically significant differences in parameters like MCV, ESR, eosinophil and platelet counts as compared to the women with HOMA-IR < 2. This study provides a pioneering reference data of hematological indices among women of reproductive age in India. Despite the small sample size results can be extrapolated to the national population given the representative sampling of various geographical zones. This may pave way for future comprehensive large-scale studies on the subject.

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Upon rational request, and subject to review, the corresponding author may provide the data that support the findings of this study.

References

  1. Remme M, Vassall A, Fernando G, Bloom DE (2020) Investing in the health of girls and women: a best buy for sustainable development. BMJ 369:1175

    Article  Google Scholar 

  2. Lee S, Guillet R, Cooper EM, Westerman M, Orlando M, Kent T, Pressman E, O’Brien KO (2016) Prevalence of anemia and associations between neonatal iron status, hepcidin, and maternal iron status among neonates born to pregnant adolescents. Pediatr Res 79(1):42–48

    Article  CAS  PubMed  Google Scholar 

  3. Nah EH, Cho S, Park H, Kim S, Cho HI (2022) Associations of complete blood count parameters with pancreatic beta-cell function and insulin resistance in prediabetes and type 2 diabetes mellitus. J Clin Lab Anal 36(4):e24454

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Mekonnen Z, Amuamuta A, Mulu W, Yimer M, Zenebe Y, Adem Y, Abera B, Gebeyehu W, Gebregziabher Y (2017) Clinical chemistry reference intervals of healthy adult populations in Gojjam Zones of Amhara National Regional State, Northwest Ethiopia. PLoS ONE 12(9):e0184665

    Article  PubMed  PubMed Central  Google Scholar 

  5. Al-Mawali A, Pinto AD, Al-Busaidi R, Al-Lawati RH, Morsi M (2018) Comprehensive haematological indices reference intervals for a healthy Omani population: first comprehensive study in Gulf Cooperation Council (GCC) and Middle Eastern countries based on age, gender and ABO blood group comparison. PLoS ONE 13(4):e0194497

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bakr S, AlFattani A, Al-Nounou R, Bakshi N, Khogeer H, Alharbi M, Almousa N, Alomaim W, Aguilos A, Almashary M (2022) Hematologic reference intervals for healthy adult Saudis in Riyadh. Ann Saudi Med 42(3):191–203

    Article  PubMed  PubMed Central  Google Scholar 

  7. Karita E, Ketter N, Price MA, Kayitenkore K, Kaleebu P, Nanvubya A, Anzala O, Jaoko W, Mutua G, Ruzagira E (2009) CLSI-derived hematology and biochemistry reference intervals for healthy adults in eastern and southern Africa. PLoS ONE 4(2):e4401

    Article  PubMed  PubMed Central  Google Scholar 

  8. Sairam S, Domalapalli S, Muthu S, Swaminathan J, Ramesh VA, Sekhar L, Pandeya P, Balasubramaniam U (2014) Hematological and biochemical parameters in apparently healthy Indian population: defining reference intervals. Ind J Clin Biochem 29(3):290–297

    Article  Google Scholar 

  9. Subhashree A, Parameaswari P, Shanthi B, Revathy C, Parijatham B (2012) The reference intervals for the haematological parameters in healthy adult population of chennai, southern India. JCDR 6(10):1675

    Google Scholar 

  10. Yadav D, Mishra S, Gupta M, John P, Sharma P (2013) Establishment of reference interval for liver specific biochemical parameters in apparently healthy north Indian population. Ind J Clin Biochem 28(1):30–37

    Article  CAS  Google Scholar 

  11. Das M, Saikia M (2009) Stimation of reference interval of lipid profile in Assamese population. Ind J Clin Biochem 24(2):190–193

    Article  CAS  Google Scholar 

  12. Durgawale P, Patil S, Shukla P, Sontakke A, Kakade S, Yadav S (2009) Evaluation of reference intervals of serum lipid profile from healthy population in western Maharashtra. Ind J Clin Biochem 24(1):30–35

    Article  CAS  Google Scholar 

  13. Biino G, Santimone I, Minelli C, Sorice R, Frongia B, Traglia M, Ulivi S, Di Castelnuovo A, Gögele M, Nutile T (2013) Age-and sex-related variations in platelet count in Italy: a proposal of reference ranges based on 40987 subjects’ data. PLoS ONE 8(1):e54289

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Qiao R, Yang S, Yao B, Wang H, Zhang J, Shang H (2014) Complete blood count reference intervals and age-and sex-related trends of North China Han population. CCLM 52(7):1025–1032

    Article  CAS  PubMed  Google Scholar 

  15. Guideline A, Edition T (2008) CLSI document C28-A3. Wayne: CLSI

  16. Sundaram M, Mohanakrishnan J, Murugavel K, Shankar E, Solomon S, Srinivas C, Solomon S, Pulimi S, Piwowar-Manning E, Dawson S (2008) Ethnic variation in certain hematological and biochemical reference intervals in a south Indian healthy adult population. Eur J Intern Med 19(1):46–50

    Article  CAS  PubMed  Google Scholar 

  17. OmarineNlinwe N, Larissa Kumenyuy Y, Precious Funwi C (2021) Establishment of hematological reference values among healthy adults in Bamenda, North West Region of Cameroon. Anemia 2021:1–7

    Article  Google Scholar 

  18. Sultan N, Sharma SK (2019) Prevalence of low platelet count and identification of associating determinants and genetic polymorphism in healthy individuals of upper Assam, India. Ind J Hematol Blood Transfusion 35(2):332–338

    Article  Google Scholar 

  19. Geelani S, Jeelani T, Altaf S, Qadri M, Altaf A, Bashir N, Manzoor F, Bhat S, Rasool J, Jeelani S (2017) Assessment of platelet count in normal kashmiri population. Int j contemp med 4:5–8

    Google Scholar 

  20. Javed R, Basu S (2017) Should we reconsider platelet content criteria for single donor platelets in West Bengal, India? Asian J Transfus Sci 11(1):69–70

    Article  PubMed  PubMed Central  Google Scholar 

  21. Ambayya A, Su AT, Osman NH, Nik-Samsudin NR, Khalid K, Chang KM, Sathar J, Rajasuriar JS, Yegappan S (2014) Haematological reference intervals in a multiethnic population. PLoS ONE 9(3):e91968

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wu X, Zhao M, Pan B, Zhang J, Peng M, Wang L, Hao X, Huang X, Mu R, Guo W (2015) Complete blood count reference intervals for healthy Han Chinese adults. PLoS ONE 10(3):e0119669

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gebreweld A, Bekele D, Tsegaye A (2018) Hematological profile of pregnant women at St Paul’s Hospital Millennium Medical College, Addis Ababa Ethiopia. BMC Hematol 18(1):15. https://doi.org/10.1186/s12878-018-0111-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Anand S, Yusuf S (2011) A global tsunami of cardiovascular risk. Lancet 377:502–505

    Article  Google Scholar 

  25. Barazzoni R, GortanCappellari G, Semolic A, Chendi E, Ius M, Situlin R, Zanetti M, Vinci P, Guarnieri G (2014) The association between hematological parameters and insulin resistance is modified by body mass index–results from the North-East Italy MoMa population study. PLoS ONE 9(7):e101590

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lee CTC, Harris SB, Retnakaran R, Gerstein HC, Perkins BA, Zinman B, Hanley AJ (2014) White blood cell subtypes, insulin resistance and β-cell dysfunction in high-risk individuals–the PROMISE cohort. Clin Endocrinol 81(4):536–541

    Article  CAS  Google Scholar 

  27. Mubarek NM, Adam I, Eltayeb R, Rayis DA, Hamdan HZ (2021) Association between insulin resistance and haematological parameters in pregnant women: a cross-sectional study. World Acad Sci J 3(4):1–5

    Article  Google Scholar 

  28. Park J-M, Lee J-W, Shim J-Y, Lee Y-J (2018) Relationship between platelet count and insulin resistance in Korean adolescents: a nationwide population-based study. Metab Syndr Relat Disord 16(9):470–476

    Article  CAS  PubMed  Google Scholar 

  29. Varol E, Akcay S, Ozaydin M, Erdogan D, Dogan A, Altinbas A (2010) Mean platelet volume is associated with insulin resistance in non-obese, non-diabetic patients with coronary artery disease. Cardiol J 56(2):154–158. https://doi.org/10.1016/j.jjcc.2010.03.005

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Indian Council of Medical Research, Govt. of India for financial support vide file No: 5/7/1337/2015-RBMH. The authors also thank the Multi-disciplinary Research Unit, SKIMS, Srinagar funded by the Department of Health Research, Govt. of India, for providing necessary research facilities for carrying out this study.

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Author notes

  1. Mohd Ashraf Ganie, Subhankar Chowdhury, Vanita Suri, Beena Joshi, Prasanta Kumar Bhattacharya, Sarita Agrawal, Neena Malhotra, Rakesh Sahay, Puthiyaveettil Khadar Jabbar, Roya Rozati, Rohina Bashir, Reshma Roshan, Imtiyaz Wani, Haroon Rashid, Gaivee Meshram and Shouvik Choudhury have contributed equally.

Authors and Affiliations

  1. Department of Endocrinology, and Clinical Research, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India

    Mohd Ashraf Ganie, Rohina Bashir, Reshma Roshan, Imtiyaz Wani & Haroon Rashid

  2. Department of Haematology and Clinical Research, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India

    Reshma Roshan

  3. Department of Endocrinology and Metabolism, Institute of Postgraduate Medical Education & Research, Kolkata, India

    Subhankar Chowdhury & Shouvik Choudhury

  4. Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Vanita Suri

  5. Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India

    Beena Joshi

  6. Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India

    Prasanta Kumar Bhattacharya

  7. Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raipur, India

    Sarita Agrawal & Gaivee Meshram

  8. Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India

    Neena Malhotra

  9. Department of Endocrinology, Osmania Medical College, Hyderabad, India

    Rakesh Sahay

  10. Department of Endocrinology, Government Medical College, Thiruvananthapuram, India

    Puthiyaveettil Khadar Jabbar

  11. Department of Obstetrics and Gynaecology, Maternal Health and Research Trust, Hyderabad, India

    Roya Rozati

  12. Reproductive Biology and Maternal Health, Child Health, Indian Council of Medical Research, New Delhi, India

    Amlin Shukla & Taruna Arora

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  1. Mohd Ashraf Ganie
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Correspondence to Mohd Ashraf Ganie.

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Ganie, M.A., Chowdhury, S., Suri, V. et al. Common Hematological Reference Indices Among Healthy Reproductive Age Indian Women-Data Subset from Nationwide Study. Indian J Hematol Blood Transfus (2023). https://doi.org/10.1007/s12288-023-01714-6

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