Establishment of Reference Intervals for Blood Cell Analysis of Adult Tibetan Farmers and Herdsmen Over 4100 Meters Above Sea Level in Tibet Based on a Health Survey.

Background: High altitude has substantial influence on reference intervals (RIs) for blood cell analysis. However, the currently used RIs for blood cell analysis in China have not been investigated in people from high-altitude areas, which may potentially cause confusion regarding disease diagnosis and treatment of Tibetan farmers and herdsmen from high-altitude areas. Therefore, it is necessary to establish blood cell analysis RIs that are suitable for people in high-altitude areas. Methods: In total, 1145 healthy Tibetan farmers and herdsmen were recruited who have lived at an altitude from 4100 to 5280 m in Kangma, Tibet, for a long time. The C28-A3 guideline from the Clinical and Laboratory Standards Institute was used to establish the RIs for hemoglobin (HGB) concentrations and red blood cell (RBC), white blood cell (WBC), and platelet (PLT) counts from the blood results of Tibetan participants. Results: There were significant gender differences in blood cell RIs for Tibetan farmers and herdsmen who lived above 4100 m above sea level in Kangma, Tibet. Compared with currently used RIs in China, RIs for HGB concentrations and RBCs in Kangma were significantly higher, whereas WBCs were similar and PLT count was lower. Conclusions: The currently used RIs in China may not be applicable to adult Tibetan farmers and herdsmen above 4100 m in Tibet. The newly obtained RIs can supplement the currently used RIs.