Prevalence of neutropenia in the US population: age, sex, smoking status, and ethnic differences
MM Hsieh, JE Everhart, DD Byrd-Holt… - Annals of internal …, 2007 - acpjournals.org
MM Hsieh, JE Everhart, DD Byrd-Holt, JF Tisdale, GP Rodgers
Annals of internal medicine, 2007•acpjournals.orgBackground: Benign reductions in neutrophil counts may be more common at certain ages
and in certain ethnic groups and may be affected by sex and smoking status. Objective: To
determine differences in neutrophil counts in the US population according to ethnicity, age,
sex, and smoking status. Design: Population-based, cross-sectional study. Setting: Various
locations in the United States. Participants: 25 222 participants in the 1999 to 2004 National
Health and Nutrition Examination Survey who were 1 year of age or older. Measurements …
and in certain ethnic groups and may be affected by sex and smoking status. Objective: To
determine differences in neutrophil counts in the US population according to ethnicity, age,
sex, and smoking status. Design: Population-based, cross-sectional study. Setting: Various
locations in the United States. Participants: 25 222 participants in the 1999 to 2004 National
Health and Nutrition Examination Survey who were 1 year of age or older. Measurements …
Background
Benign reductions in neutrophil counts may be more common at certain ages and in certain ethnic groups and may be affected by sex and smoking status.
Objective
To determine differences in neutrophil counts in the U.S. population according to ethnicity, age, sex, and smoking status.
Design
Population-based, cross-sectional study.
Setting
Various locations in the United States.
Participants
25 222 participants in the 1999 to 2004 National Health and Nutrition Examination Survey who were 1 year of age or older.
Measurements
Complete blood counts and comparison of means and the proportion of participants with neutropenia.
Results
Relative to white participants, black participants had lower leukocyte counts (mean difference, 0.89 × 109 cells/L; P < 0.001), lower neutrophil counts (0.83 × 109 cells/L; P < 0.001), and similar lymphocyte counts (0.022 × 109 cells/L; P = 0.36), whereas Mexican-American participants had slightly higher mean leukocyte counts (0.16 × 109 cells/L; P = 0.014), higher neutrophil counts (0.11 × 109 cells/L; P = 0.026), and higher lymphocyte counts (0.095 × 109 cells/L; P < 0.001). The prevalence of neutropenia (neutrophil count <1.5 × 109 cells/L) was 4.5% among black participants, 0.79% among white participants, and 0.38% among Mexican-American participants. The prevalence of neutropenia was higher among males and children younger than 5 years of age. Neutrophil counts less than 1.0 × 109 cells/L were observed in fewer than 1% of the overall sample (0.57% in black participants, 0.11% in white participants, and 0.08% in Mexican-American participants). Smoking was associated with higher leukocyte and neutrophil counts but had a smaller effect among black and Mexican-American participants than among white participants.
Limitation
Because estimates are based on single measures, fluctuations over time could not be determined.
Conclusions
In the United States, neutrophil counts are lower in black persons than in white persons and neutropenia is more prevalent in black persons. Neutrophil counts are slightly higher in Mexican-American persons than in white persons, and neutropenia is uncommon in both groups. The clinical implications of these findings are unclear, but they suggest that when determining the need for a diagnostic evaluation for neutropenia, clinicians should consider the patient's age, sex, ethnicity, and smoking status.
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