Biochemical reference values for blood

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Biochemical reference values for blood (B = whole blood; P = plasma; S = serum)

Table 1.1 Everyday tests

Determination

Sample

Reference range

Alcohol

 legal limit (UK)

B or P

<17.4 mmol/l

Albumin

P

35–50 g/l

 in pregnancy

P

25–38 g/l

Ammonia

B

<40 μmol/l

α-Amylase

P

25–180 somogyi units/dl

Anion gap (Na+ + K+) − (HCO3 + Cl)

P

12–16 mmol/l

Bilirubin

P

3–17 μmol/l

Bicarbonate (see also Table 1.2)

P

22–28 mmol/l

Calcium

 ionized

P

1.0–1.25 mmol/l

 total

P

2.12–2.65 mmol/l

 total in pregnancy

P

1.95–2.35 mmol/l

Chloride

P

95–105 mmol/l

Cholesterol (see also Table 1.7)

P

3.9–7.8 mmol/l

Copper

P

12–26 μmol/l

Creatinine

P

70–150 μmol/l

 in pregnancy

P

24–68 μmol/l

Digoxin

 children

P

2.0–3.0 nmol/l

 adults

P

1.0–2.0 nmol/l

Glucose (fasting)

P

3.0–5.0 mmol/l

Glycated haemoglobin (HbA1C)

B

5–8%

Iron

 male

S

14–31 μmol/l

 female

S

11–30 μmol/l

 total iron-binding capacity (TIBC)

S

45–75 μmol/l

Lactate

 venous

B

0.5–2.2 mmol/l

 arterial

B

0.5–1.6 mmol/l

Magnesium

P

0.75–1.05 mmol/l

Osmolality

P

278–305 mosm/kg

Phosphate (inorganic)

P

0.8–1.45 mmol/l

Potassium

P

3.5–5.0 mmol/l

Protein (total)

P

60–80 g/l

Sodium

P

135–145 mmol/l

Urea

P

2.5–6.7 mmol/l

 in pregnancy

P

2.0–4.2 mmol/l

Urea nitrogen (BUN)

P

1.16–3.12 mmol/l

Uric acid

 male

P

210–480 μmol/l

 female

P

150–390 μmol/l

 in pregnancy

P

100–270 μmol/l

Zinc

P

6–25 μmol/l

Table 1.2 Blood gases

Measurement

Reference range

Arterial CO2 (Paco2)

4.7–6.0 kPa

Mixed venous CO2 (Pvco2)

5.5–6.8 kPa

Arterial oxygen (Pao2)

12.0–14.5 kPa

Mixed venous oxygen (Pvo2)

4.0–6.0 kPa

Newborn arterial oxygen

5.3–8.0 kPa

H+ ion activity

36–44 nmol/l

Arterial pH

7.35–7.45 pH units

Bicarbonate

 arterial – whole blood

19–24 mmol/l

 venous – plasma

22–28 mmol/l

 cord blood

14–22 mmol/l

Base excess

± 2 mmol/l

Carboxyhaemoglobin

 non-smoker

<2%

 smoker

3–15%

 toxic at:

>15%

 coma at:

>50%

Table 1.3 Diagnostic enzymes

Enzyme

Sample

Reference range

Acid phosphatase

 total

S

1–5 U/l

 prostatic

S

0–1 U/l

Alkaline phosphatase

P

80–250 U/l

Alanine aminotransferase (ALT)

P

5–35 U/l

α-Amylase

P

25–180 somogyi units/dl

Angiotensin-converting enzyme (ACE)

S

21–54 U/l

Aspartate aminotransferase (AST)

P

15–42 U/l

Creatine kinase (CK)

 male

P

24–195 U/l

 female

P

24–170 U/l

Gamma-glutamyl transferase (GGT)

 male

P

11–51 U/l

 female

P

7–35 U/l

Lactate dehydrogenase (total)

P

240–525 U/l

Table 1.4 Hormones

Hormone

Sample

Reference range

Adrenaline (epinephrine)

P

0.03–1.31 nmol/l

ACTH

P

3.3–15.4 pmol/l

Aldosterone

 recumbent

P

100–450 pmol/l

 midday

P

2-fold increase of recumbent level

Angiotensin II

P

5–35 pmol/l

Antidiuretic hormone (ADH)

P

0.9–4.6 pmol/l

Calcitonin

 male

P

<100 nmol/l

 female

P

<30 nmol/l

Cortisol

 00.00 h

P

80–280 nmol/l

 09.00 h

P

280–700 nmol/l

Follicle-stimulating hormone (FSH)

  follicular phase

P or S

0.5–5.0 U/l

  ovulatory peak

P or S

8–15 U/l

  luteal phase

P or S

2–8 U/l

  postmenopause

P or S

> 30 U/l

  male

P or S

0.5–5.0 U/l

Gastrin

 male + female (>60 yr)

P

<50 pmol/l

 female (16–60 yr)

P

<38 pmol/l

Glucagon

P

<50 pmol/l

Growth hormone

P

<20 mU/l

Human chorionic gonadotrophin

S

<5 U/l

Insulin (fasting)

P

<15 mU/l

Insulin C-peptide (fasting)

P

<0.4 nmol/l (undetectable in hypoglycaemia)

Insulin-like growth factor-1 (IGF- 1)

P

0.52–3.4 kU/l

Luteinizing hormone

 premenopausal

P or S

6–13 U/l

 follicular phase

P or S

3–12 U/l

 ovulatory peak

P or S

20–80 U/l

 luteal phase

P or S

3–16 U/l

 postmenopause

P or S

>30 U/l

 male

P or S

3–8 U/l

Noradrenaline

P

0.47–4.14 mmol/l

17-β-oestradiol

 follicular phase

P

75–260 pmol/l

 mid-cycle

P

370–1470 pmol/l

 luteal phase

P

180–1100 pmol/l

 male

P

<220 pmol/l

Parathyroid hormone (intact)

P

0.9–5.4 pmol/l

Pancreatic polypeptide

P

<200 pmol/l

Progesterone

 male

P

<5 nmol/l

 female postovulation

P

15–77 nmol/l

 follicular (newborn)

P

<3 nmol/l

17-Hydroxyprogesterone

P

7–16 nmol/l

Prolactin

 male

P

<450 U/l

 female

P

<600 U/l

Renin activity

P

 recumbent

1.1–2.7 pmol/ml per hr

 erect after 30 min

3.0–4.3 pmol/ml per hr

Somatostatin

P

30–166 pmol/l

Testosterone

 male

P or S

9–42 nmol/l

 female

P or S

1–2.5 nmol/l

Thyroid-stimulating hormone

P

0.5–5.5 mU/l

Thyroid-binding globulin

P

13–28 mg/l

Tri-iodothyronine (T3)

P

1–3 nmol/l

 Free T3

P

3.3–8.2 pmol/l

Thyroxine (T4)

P

70–140 nmol/l

 Free T4

P

9–25 pmol/l

Vasoactive intestinal peptide (VIP)

P

<30 pmol/l

Table 1.5 Proteins and immunoproteins

Protein/immunoprotein

Sample

Reference range

Albumin

P

35–50 g/l

α1-Antitrypsin

S

107–209 mg/l

Complement

 C3

65–190 mg/dl

 C4

15–50 mg/dl

Caeruloplasmin

S

16–60 mg/dl

C1 esterase inhibitor

S

15–35 mg/dl

C-reactive protein (CRP)

S

<10 mg/l

Ferritin

S

14–200 μg/l

Fibrinogen

P

2–4 g/l

d-dimer

S

<500 μg/l

Haptoglobins

S

0.6–2.6 g/l

Immunoglobulins

 IgG

S

6.0–13.0 g/l

 IgA

S

0.8–3.0 g/l

 IgM

S

0.4–2.5 g/l

 IgE

S

<120 kU/l

β2-Microglobulin

S

<3 mg/l

Thyroid microsomal antibodies

 male

S

<1/400

 female (<44 yr)

S

<1/400

 female (>44 yr)

S

<1/6400

Total protein

P

60–80 g/l

β1-Transferrin

S

1.2–2.0 g/l

Table 1.6 Paediatric reference values

Determination

Sample

Reference range

Alkaline phosphatase

P

 <1 year

30–250 IU/l

 1–14 years

150–570 IU/l

 >14 years

80–250 IU/l

Ammonia

P

 newborn

64–107 μmol/l

 0–2 weeks

56–92 μmol/l

 >1 month

21–50 μmol/l

Aspartate aminotransferase

P

 1–3 years

20–60 IU/l

 4–6 years

15–50 IU/l

Bicarbonate

P

 infants

18–22 mmol/l

 older children

20–26 mmol/l

Bilirubin

P

 first week of life

100–200 μmol/l (total)

 after first week of life

2–14 μmol/l (total)

 and throughout childhood

0–0.4 μmol/l (direct)

Calcium

P

 1–3 weeks

1.9–2.85 mmol/l

 3 weeks and above

2.12–2.65 mmol/l

β-Carotene

S

 <1 year (upper limit falls with age up to 3½ years)

1.3–6.3 μmol/l

 3½ years onwards

1.9–2.8 μmol/l

Creatinine

P

 cord blood

57–100 μmol/l

 2 weeks–6 years

33–61 μmol/l

 6 years–10 years

39–70 μmol/l

 >12 years

49–81 μmol/l

Creatinine clearance

P

 3–13 years

94–142 ml/min per 1.73m2

Creatine kinase (CK)

P

 neonates

75–400 U/l

 infants 3–12 months

10–145 U/l

 children 1–15 years

15–130 U/l

Glucose (fasting)

S

 cord

2.5–5.3 mmol/l

 premature/low birth wt

1.1–3.3 mmol/l

 neonates

1.67–3.3 mmol/l

 1 day

2.2–3.3 mmol/l

 1–7 days

2.8–4.6 mmol/l

 >7 days

3.3–5.5 mmol/l

Total protein

P

 1st month

51 g/l (mean)

 1st year

61 g/l (mean)

 1–6 years

61–78 g/l

 7–16 years

66–82 g/l

Immunoglobulins

 IgG

S

  cord

5.2–18.0 g/l

  0–2 weeks

5.0–17.0 g/l

  2–6 weeks

3.9–13.0 g/l

  6–12 weeks

2.1–7.7 g/l

  3–6 months

2.4–8.8 g/l

  6–9 months

3.0–9.0 g/l

  9–12 months

3.0–10.9 g/l

  1–2 years

3.1–13.8 g/l

  2–3 years

3.7–15.8 g/l

  3–6 years

4.9–16.1 g/l

  6–9 years

5.4–16.1 g/l

  9–12 years

5.4–16.1 g/l

  12–15 years

5.4–16.1 g/l

 IgA

S

  cord

0.00–0.02 g/l

  0–2 weeks

0.01–0.08 g/l

  2–6 weeks

0.02–0.15 g/l

  6–12 weeks

0.05–0.4 g/l

  3–6 months

0.1–0.5 g/l

  6–9 months

0.15–0.7 g/l

  9–12 months

0.20–0.7 g/l

  1–2 years

0.3–1.2 g/l

  2–3 years

0.3–1.3 g/l

  3–6 years

0.4–2.0 g/l

  6–9 years

0.5–2.4 g/l

  9–12 years

0.8–2.8 g/l

  12–15 years

0.8–2.8 g/l

IgM

S

  cord

0.02–0.2 g/l

  0–2 weeks

0.05–0.2 g/l

  2–6 weeks

0.08–0.4 g/l

  6–12 weeks

0.15–0.7 g/l

  3–6 months

0.20–1.0 g/l

  6–9 months

0.40–1.6 g/l

  9–12 months

0.60–2.1 g/l

  1–2 years

0.50–2.2 g/l

  2–3 years

0.50–2.2 g/l

  3–6 years

0.50–2.0 g/l

  6–9 years

0.50–1.8 g/l

  9–12 years

0.50–1.9 g/l

  12–15 years

0.50–1.9 g/l

Lactate

P (venous)

0.5–2.2 mmol/l

P (arterial)

0.5–1.6 mmol/l

B

0.5–1.7 mmol/l

Phosphate (inorganic)

P

 newborn

1.20–2.78 mmol/l

 young children

1.29–1.78 mmol/l

 girls 15 years

0.9–1.38 mmol/l

 boys 17 years

0.83–1.49 mmol/l

Potassium

P

 newborn

up to 6.6 mmol/l

 >1 month–6 years

4.1–5.6 mmol/l

 boys 7–16 years

3.3–4.7 mmol/l

 girls 7–16 years

3.4–4.5 mmol/l

Sweat sodium

10–40 mmol/l

Sweat chloride

0–50 mmol/l

Thyroid-stimulating hormone (TSH) (outside neonatal period)

S

0.5–5.0 mU/l

Uric acid

P

 childhood

0.06–0.24 mmol/l

 boys 16 years

0.23–0.46 mmol/l

 girls 16 years

0.19–0.36 mmol/l

Table 1.7 Lipids and lipoproteins

Lipid/lipoprotein

Sample

Reference range

Cholesterol

P

3.9–7.8 mmol/l

 ideal upper limit

5.2 mmol/l

 acceptable upper limit

6.5 mmol/l

Triglyceride (fasting)

P

0.55–1.90 mmol/l

Nonesterified (free) fatty acids (NEFA)

S

  male

0.19–0.78 mmol/l

  female

0.06–0.9 mmol/l

Lipoproteins (as cholesterol)

 low-density (LDL)

S

1.55–4.4 mmol/l

  ideal upper limit

3.4 mmol/l

  acceptable upper limit

4.2 mmol/l

 high density (HDL)

S

0.8–2.0 mmol/l

  ideal (male)

>0.9 mmol/l

  ideal (female)

>1.2 mmol/l

Total cholesterol/HDL

S

  ideal

<5 ratio

Table 1.8 Vitamins

Vitamin

Sample

Reference range

Vitamin A

 retinol

S

  male

1.06–3.35 μmol/l

  female

0.84–2.95 μmol/l

 β-carotene

S

  male

0.01–6.52 μmol/l

  female

0.019–2.93 μmol/l

Vitamin B

 Thiamin (B1)

P

>40 nmol/l

 Riboflavin (B2)

S

100–630 nmol/l

 Pyridoxine (B6)

P (EDTA)

20–120 nmol/l

 Vitamin B12

S

138–780 nmol/l

Folate

S

12–33 μmol/l

 red blood cell folate

B

500–1300 μmol/l

Vitamin D metabolites

 25-(OH) D

S

17–125 nmol/l

 1,25-(OH)2 D3

S

50–120 pmol/l

Vitamin E (α- tocopherol)

S

11.5–35 μmol/l