Monocyte distribution width reference intervals in healthy Chinese adults: a study revealing the impact of anticoagulant choice

Monocyte distribution width (MDW) is a promising biomarker for early sepsis detection, but its use in Asian populations has been limited due to the lack of region-specific reference intervals (RIs). This study aimed to establish the first MDW RI for healthy Chinese adults using EDTA-K₂ anticoagulant, strictly following CLSI EP28-A3C guidelines. A total of 262 samples from healthy Chinese blood donors were analyzed using a Beckman Coulter DxH 900 analyzer. Statistical methods included Shapiro-Wilk tests for normality, t-tests, ANOVA for group differences, and Spearman correlation analysis, with RIs calculated using parametric, non-parametric, and robust methods. The parametric RI limits were determined to be 14.48 (90% CI 14.16-14.80) and 21.56 (90% CI 21.24-21.88), closely aligning with results from the robust method (14.41-21.55) and non-parametric method (14.70-21.52). Our findings are consistent with Spanish data obtained using EDTA-K₂ anticoagulant but differ from Italian data that used EDTA-K₃, highlighting the potential impact of anticoagulant type on MDW values. This RI is unaffected by gender or age, providing a critical diagnostic tool for early sepsis detection in Chinese clinical practice and emphasizing the need for further studies to investigate anticoagulant influences for global standardization.