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<p>Erythrocyte sedimentation rate (ESR) is a widely used inflammatory marker, but reference intervals vary significantly across populations and are influenced by temperature conditions. The International Committee for Standardization in Hematology (ICSH) recommends temperature correction, yet population-specific reference values for Indian populations remain limited. This study analyzed ESR values in 1,446 healthy individuals from Central India, measuring ESR at room temperature and 18&#xa0;°C. Reference intervals were established using percentile methods, and agreement between the measurement conditions was evaluated with Bland–Altman analysis and linear regression. Among 1,393 participants (1,051 males, 342 females; mean age 44.8 ± 20.4 years), room temperature ESR was significantly higher than 18&#xa0;°C ESR (11.9 ± 9.7 vs. 9.6 ± 8.7&#xa0;mm/h, <i>p</i> &lt; 0.001). Bland-Altman analysis revealed systematic bias (2.37&#xa0;mm/h) and substantially reduced proportional bias (<i>r</i> = 0.4554), with limits of agreement (-1.73 to 6.46&#xa0;mm/h), confirming better method agreement. Females showed greater bias than males. Population-specific reference intervals (mean ± 1 SD) were 2.3–21.6&#xa0;mm/h (room temperature) and 0.9–18.3&#xa0;mm/h (18&#xa0;°C) for all subjects. Temperature affects ESR values in the Central Indian population. The established reference intervals are notably variable than conventional Western standards, emphasizing the need for population-specific reference values.</p>

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Assessment of ESR by Manual Westergren at Room Temperature and Automated ESR Analyzer at 18 °C in a Hospital-Based Central Indian Cohort: Establishment of Reference Ranges

  • 期刊论文

  • 发表日期：

    2026年4月8日

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  • Kartavya Kumar Verma,
  • Himanshu Upadhyay

摘要

Erythrocyte sedimentation rate (ESR) is a widely used inflammatory marker, but reference intervals vary significantly across populations and are influenced by temperature conditions. The International Committee for Standardization in Hematology (ICSH) recommends temperature correction, yet population-specific reference values for Indian populations remain limited. This study analyzed ESR values in 1,446 healthy individuals from Central India, measuring ESR at room temperature and 18 °C. Reference intervals were established using percentile methods, and agreement between the measurement conditions was evaluated with Bland–Altman analysis and linear regression. Among 1,393 participants (1,051 males, 342 females; mean age 44.8 ± 20.4 years), room temperature ESR was significantly higher than 18 °C ESR (11.9 ± 9.7 vs. 9.6 ± 8.7 mm/h, p < 0.001). Bland-Altman analysis revealed systematic bias (2.37 mm/h) and substantially reduced proportional bias (r = 0.4554), with limits of agreement (-1.73 to 6.46 mm/h), confirming better method agreement. Females showed greater bias than males. Population-specific reference intervals (mean ± 1 SD) were 2.3–21.6 mm/h (room temperature) and 0.9–18.3 mm/h (18 °C) for all subjects. Temperature affects ESR values in the Central Indian population. The established reference intervals are notably variable than conventional Western standards, emphasizing the need for population-specific reference values.