Evaluation of Biological Variation of Different Clinical Laboratory Analytes in the Blood of Healthy Subjects

Background Biological variation (BV) as a prognostic marker implies that each individual has a “subject mean” or central tendency, control level, or “set point” concentration for maintaining homeostasis regulation, which is influenced by factors such as genes, diet, exercise, and age. Uses for information on BV include determining the value of population-based reference intervals, assessing the importance of variation in serial findings, and establishing criteria for judging correct analysis. Aims We focused on the assessment of BV parameters for these elements as within-subject BV (CVW), between subject BV (CVG), the index of individuality (II), and the reference change value (RCV) of important biochemical analytes in the Bangladeshi adult population. Methodology This is a cross-sectional analytical study of a representative sample in the population of Bangladesh to determine BV in clinical laboratory analytes. For the study, 758 people were requested to take part; among those 730 (ages 18-65) apparently, healthy adults were blood donors, hospital staff, laboratory personnel, or any individuals who presented themselves for health screening at a tertiary hospital in Dhaka, Bangladesh. Results The CVW for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate were calculated as 5.10 %, 4.64%, 10.72%, 5.71%, 0.69%, 4.35%, 0.75%, 3.69%, 4.57%, and 4.72%, respectively. The CVG for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate was 10.70%, 21.46%, 31.47%, 23.52%, 1.95%, 9.74%, 2.56%, 4.64%, 9.96 %, and 17.45%, respectively. The index of individuality (II) for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate were 0.48, 0.22, 0.34, 0.24, 0.35, 0.45, 0.29, 0.79, 0.46, and 0.27, respectively. The RCV for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate was 14.75%, 14.10%, 30.58%, 16.13%, 2.82%, 12.58%, 3.54%, 10.62%, 13.62 %, and 15.80%, respectively. Conclusions Nine serum biochemistry analytes (blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, magnesium, and phosphate) had low individuality, indicating that subject-based reference intervals are appropriate, only one analyte (calcium) had high individuality and, therefore, population-based reference intervals are more appropriate.