Reference intervals for indices derived from the complete blood count in the Longitudinal Study of Adult Health (ELSA-Brasil).
5 affiliations
- 1Universidade Federal de São João del-Rei, Campus Centro Oeste, Brazil.
- 2Universidade Federal de São João del-Rei, Campus Centro Oeste, Brazil. Electronic address: [email protected].
- 3Department of Preventive Medicine, School of Medicine, Universidade Federal de Minas Gerais (UFMG) and Hospital das Clínicas/EBSERH, Belo Horizonte, Brazil.
- 4Department of Clinical Pathology, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
- 5Universidade Federal de São João del-Rei, Campus Centro Oeste, Brazil. Electronic address: [email protected].
Abstract
Introduction
Hematological biomarkers from routine tests are attractive for their accessibility and clinical applicability, particularly indices derived from the complete blood count. Establishing reference intervals is essential for accurate interpretation, requiring healthy populations and standardized methods following Clinical and Laboratory Standards Institute guidelines.Objective
To establish reference intervals for complete blood count-derived indices in healthy adults.Methods
This cross-sectional study analyzed baseline data from 2230 participants aged 35-74 years in the Brazilian Longitudinal Study of Adult Health. Individuals with inflammatory conditions or hematological extremes (<1st and >99th percentiles) were excluded. Evaluated cellular parameters comprised five inflammatory ratios (neutrophil-to-lymphocyte, platelet-to-lymphocyte, lymphocyte-to-monocyte, monocyte-to-lymphocyte, and derived neutrophil-to-lymphocyte) and three composite indices (systemic inflammatory response, aggregate index of systemic inflammation, and systemic immune-inflammation). Reference intervals corresponded to the 2.5th-97.5th percentiles. Group differences by sex and age were evaluated using Mann-Whitney and Harris-Boyd tests.Results
Males constituted 54.3% of the sample, and 92.0% of the participants were aged 35-59 years. Neither sex nor age required data stratification. The established reference intervals were: neutrophil-to-lymphocyte ratio (0.95-3.28), platelet-to-lymphocyte ratio (77.25-213.27), lymphocyte-to-monocyte ratio (2.27-7.17), monocyte-to-lymphocyte ratio (0.14-0.44), derived neutrophil-to-lymphocyte ratio (0.72-2.33), systemic inflammatory response index (0.33-1.89), aggregate index of systemic inflammation (69.85-460.01), and systemic immune-inflammation index (201.64-830.02).Conclusion
These reference intervals provide a basis for clinical and epidemiological studies on subclinical inflammation and chronic disease risk.
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BibTeX
@article{almeida2026reference,
title = {{Reference intervals for indices derived from the complete blood count in the Longitudinal Study of Adult Health (ELSA-Brasil).}},
author = {Nívea Aparecida de Almeida and Roberta Carvalho Figueiredo and Sandhi Maria Barreto and Letícia Gonçalves Resende Ferreira and Chams Bicalho Maluf and Pedro Guatimosim Vidigal and Danyelle Romana Alves Rios},
journal = {Hematology, transfusion and cell therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.108552},
url = {https://europepmc.org/article/MED/42880187},
note = {CC BY},
}
RIS
TY - JOUR
TI - Reference intervals for indices derived from the complete blood count in the Longitudinal Study of Adult Health (ELSA-Brasil).
AU - Nívea Aparecida de Almeida
AU - Roberta Carvalho Figueiredo
AU - Sandhi Maria Barreto
AU - Letícia Gonçalves Resende Ferreira
AU - Chams Bicalho Maluf
AU - Pedro Guatimosim Vidigal
AU - Danyelle Romana Alves Rios
PY - 2026
DA - 2026/10/15
JO - Hematology, transfusion and cell therapy
DO - 10.1016/j.htct.2026.108552
UR - https://europepmc.org/article/MED/42880187
AB - Introduction Hematological biomarkers from routine tests are attractive for their accessibility and clinical applicability, particularly indices derived from the complete blood count. Establishing reference intervals is essential for accurate interpretation, requiring healthy populations and standardized methods following Clinical and Laboratory Standards Institute guidelines.Objective To establish reference intervals for complete blood count-derived indices in healthy adults.Methods This cross-sectional study analyzed baseline data from 2230 participants aged 35-74 years in the Brazilian Longitudinal Study of Adult Health. Individuals with inflammatory conditions or hematological extremes (<1st and >99th percentiles) were excluded. Evaluated cellular parameters comprised five inflammatory ratios (neutrophil-to-lymphocyte, platelet-to-lymphocyte, lymphocyte-to-monocyte, monocyte-to-lymphocyte, and derived neutrophil-to-lymphocyte) and three composite indices (systemic inflammatory response, aggregate index of systemic inflammation, and systemic immune-inflammation). Reference intervals corresponded to the 2.5th-97.5th percentiles. Group differences by sex and age were evaluated using Mann-Whitney and Harris-Boyd tests.Results Males constituted 54.3% of the sample, and 92.0% of the participants were aged 35-59 years. Neither sex nor age required data stratification. The established reference intervals were: neutrophil-to-lymphocyte ratio (0.95-3.28), platelet-to-lymphocyte ratio (77.25-213.27), lymphocyte-to-monocyte ratio (2.27-7.17), monocyte-to-lymphocyte ratio (0.14-0.44), derived neutrophil-to-lymphocyte ratio (0.72-2.33), systemic inflammatory response index (0.33-1.89), aggregate index of systemic inflammation (69.85-460.01), and systemic immune-inflammation index (201.64-830.02).Conclusion These reference intervals provide a basis for clinical and epidemiological studies on subclinical inflammation and chronic disease risk.
SN - 2531-1379
SN - 2531-1387
ER -