背景:在初级保健中,卫生专业人员使用血液检查来调查非特异性陈述,以告知转诊决定。西方国家常用血液检测的参考范围主要是在白人人群中开发的,因此,当应用于非白人人群时,可能会有不同的表现。了解健康/普通人群的血液检查结果中的种族差异可以帮助解决癌症转诊诊断和结果的种族不平等。
目的:本系统综述探讨了健康/普通人群中选定血液检测结果分布的种族差异的证据,为未来旨在解决癌症诊断不平等的研究提供信息。
方法:我们搜索了PubMed和EMBASE,以确定报告血红蛋白测量值的研究,MCV,钙,白蛋白,血小板计数,和CRP在至少两个不同种族的未患病成年人中。两名审稿人独立筛选研究,使用适应的纽卡斯尔-渥太华量表完成数据提取和质量评估。参与者被分层为白色,黑色,亚洲人,混合,和其他团体。对数据进行叙述性合成,并在可能的情况下进行荟萃分析。
结果:共纳入47篇论文。黑人男性和女性的血红蛋白平均值较低,MCV,和白蛋白,和较高的CRP平均值相对于他们的白色同行。此外,黑人男性的平均血红蛋白低于亚洲男性,与白人女性相比,亚洲女性的平均CRP值较低。
结论:有证据表明血红蛋白的平均值存在种族差异,MCV,CRP,和白蛋白在健康/一般人群中。需要进一步的研究来探索这些差异的原因。系统审查注册:CRD42021274580。
BACKGROUND: In primary care, health professionals use blood tests to investigate nonspecific presentations to inform referral decisions. Reference ranges for the commonly used blood tests in western countries were developed in predominately White populations, and so may perform differently when applied to non-White populations. Knowledge of ethnic variation in blood test results in healthy/general populations could help address ethnic inequalities in cancer referral for diagnosis and outcomes.
OBJECTIVE: This systematic
review explored evidence of ethnic differences in the distribution of selected blood test results among healthy/general populations to inform future research aimed at addressing inequalities in cancer diagnosis.
METHODS: We searched PubMed and EMBASE to identify studies reporting measures of haemoglobin, MCV, calcium, albumin, platelet count, and CRP in nondiseased adults from at least 2 different ethnic groups. Two reviewers independently screened studies, completed data extraction and quality assessment using an adapted Newcastle-Ottawa scale. Participants were stratified into White, Black, Asian, Mixed, and Other groups. Data were synthesised narratively and meta-analyses were conducted where possible.
RESULTS: A total of 47 papers were included. Black men and women have lower average values of haemoglobin, MCV, and albumin, and higher average values of CRP relative to their White counterparts. Additionally, Black men have lower average haemoglobin than Asian men, whereas Asian women have lower average CRP values when compared with White women.
CONCLUSIONS: There is evidence of ethnic differences in average values of haemoglobin, MCV, CRP, and albumin in healthy/general populations. Further research is needed to explore the reasons for these differences. Systematic
review registration: CRD42021274580.