Laboratory reference ranges



Laboratory reference ranges


S.W. Walker



Notes on the international system of units (SI units)


Système International (SI) units are a specific subset of the metre–kilogram–second system of units and were agreed upon as the everyday currency for commercial and scientific work in 1960, following a series of international conferences organised by the International Bureau of Weights and Measures. SI units have been adopted widely in clinical laboratories but non-SI units are still used in many countries. For that reason, values in both units are given for common measurements throughout this textbook and commonly used non-SI units are shown in this chapter. However, the SI unit system is recommended.








Laboratory reference ranges in adults


Reference ranges are largely those used in the Departments of Clinical Biochemistry and Haematology, Lothian Health University Hospitals Division, Edinburgh, UK. Values are shown in both SI units and, where appropriate, non-SI units. Many reference ranges vary between laboratories, depending on the assay method used and on other factors; this is especially the case for enzyme assays. The origin of reference ranges and the interpretation of ‘abnormal’ results are discussed on pages 4–6. No details are given here of the collection requirements, which may be critical to obtaining a meaningful result. Unless otherwise stated, reference ranges shown apply to adults; values in children may be different.


Many analytes can be measured in either serum (the supernatant of clotted blood) or plasma (the supernatant of anticoagulated blood). A specific requirement for one or the other may depend on a kit manufacturer’s recommendations. In other instances, the distinction is critical (e.g. plasma is required for measurement of fibrinogen, since it is largely absent from serum; serum is required for electrophoresis to detect paraproteins because fibrinogen migrates as a discrete band in the zone of interest).



image 29.1   Urea and electrolytes in venous blood





image 29.2   Analytes in arterial blood

































  Reference range
Analysis SI units Non-SI units
Bicarbonate 21–29 mmol/L 21–29 meq/L
Hydrogen ion 37–45 nmol/L pH 7.35–7.43
PaCO2 4.5–6.0 kPa 34–45 mmHg
PaO2 12–15 kPa 90–113 mmHg
Oxygen saturation > 97%  


image




image 29.3   Hormones in venous blood

























































































































































  Reference range
Hormone SI units Non-SI units
Adrenocorticotrophic hormone
(ACTH) (plasma)		 1.5–11.2 pmol/L (0700–1000 hrs) 7–51 ng/L
Aldosterone    
Supine (at least 30 mins) 30–440 pmol/L 1.09–15.9 ng/dL
Erect (at least 1 hr) 110–860 pmol/L 3.97–31.0 ng/dL
Cortisol Dynamic tests are required – see Ch. 20
Follicle-stimulating hormone (FSH)
Male 1.0–10.0 U/L 0.2–2.2 ng/mL
Female 3.0–10.0 U/L (early follicular) 0.7–2.2 ng/mL
> 30 U/L (post-menopausal) > 6.7 ng/mL
Gastrin (plasma, fasting) < 120 ng/L < 120 pg/mL
Growth hormone (GH) Dynamic tests are usually required – see Ch. 20
< 0.5 µg/L excludes acromegaly (if IGF1 in reference range)
> 6 µg/L excludes GH deficiency		 –
Insulin Highly variable and interpretable only in relation to plasma glucose and body habitus
Luteinising hormone (LH)    
Male 1.0–9.0 U/L 0.11–1.0 µg/L
Female 2.0–9.0 U/L (early follicular) 0.2–1.0 µg/L
> 20 U/L (post-menopausal) > 2.2 µg/L
17β-Oestradiol    
Male < 160 pmol/L < 43 pg/mL
Female: early follicular 75–140 pmol/L 20–38 pg/mL
post-menopausal < 150 pmol/L < 41 pg/mL
Parathyroid hormone (PTH) 1.6–7.5 pmol/L 16–75 pg/mL
Progesterone (in luteal phase in women)    
Consistent with ovulation > 30 nmol/L > 9.3 ng/mL
Probable ovulatory cycle 15–30 nmol/L 4.7–9.3 ng/mL
Anovulatory cycle < 10 nmol/L < 3 ng/mL
Prolactin (PRL) 25–630 mU/L –
Renin concentration    
Supine (at least 30 mins) 5–40 mU/L –
Sitting (at least 15 mins) 5–45 mU/L –
Erect (at least 1 hr) 16–63 mU/L –
Testosterone    
Male 10–30 nmol/L 2.9–8.6 ng/mL
Female 0.3–1.9 nmol/L 0.1–0.9 ng/mL
Thyroid-stimulating hormone (TSH) 0.2–4.5 mU/L –
Thyroxine (free), (free T4) 9–21 pmol/L 700–1632 pg/dL
Triiodothyronine (free), (free T3) 2.6–6.2 pmol/L 160–400 pg/dL

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Apr 9, 2017 | Posted by in GENERAL SURGERY | Comments Off on Laboratory reference ranges

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