Range and determinants of white blood cell count in a large survey of Israelis without inflammation

Arie Steinvil, Shlomo Berliner, Yair Herishanu, Yael Paran, Dan Justo, Michael Cohen, Itzhak Shapira, Ori Rogowski

Research output: Contribution to journalArticlepeer-review


Background: The white blood cell count and its differential are established inflammation-sensitive biomarkers with a proven prognostic value in the field of atherothrombosis. However, the WBCC count range and determinants have not been explored in the absence of a significant inflammatory response. Objective: To analyze the WBCC range and determinants in a large Israeli sample of individuals, excluding patients with a significant inflammatory response. Methods: WBCC and differential count reference ranges were determined in a large sample of apparently healthy participants with high sensitivity C-reactive protein concentrations below 10 mg/L. Linear regression models were used to identify the determinants of the WBCC. The central 95% areas under the distribution curves were established for each gender. Results: The study population comprised 8247 individuals (5391 males and 2856 females). The main laboratory and clinical variables found to affect the WBCC were gender, hemoglobin level, smoking status, triglycerides, and body mass index (all P < 0.001). Similar results were obtained for the differential count. The reference ranges for men and women were 3.6-9.9 and 3.4-10.0×103/μl, respectively. The reference ranges for currently smoking men and women were 3.6-11.5 and 3.6-11.2×103/μl, respectively, and were significantly higher compared with those of the never smokers and past smokers. Conclusions: We have demonstrated new limits of normal values for the WBCC in apparently healthy individuals who lack a significant "background" acute-phase response in a large Israeli sample. Our data might be useful for the risk stratification of apparently healthy individuals in the field of atherothrombosis.

Original languageEnglish
Pages (from-to)363-366
Number of pages4
JournalIsrael Medical Association Journal
Issue number6
StatePublished - 2009


  • C-reactive protein
  • Reference values
  • White blood cell count


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