Establishment of Reference Intervals for Hemoglobin Levels Among Healthy Adult Males and Females in Derna, Libya

Abstract

Hemoglobin concentration is one of the most important hematological parameters used in clinical practice for the diagnosis and monitoring of anemia and other hematological disorders. However, the reference intervals currently used in Libya are largely derived from non-Libyan populations and may not accurately reflect the physiological characteristics of the local population. Therefore, the present study aimed to establish population-specific reference intervals for hemoglobin concentration among healthy adults in Derna city, Libya. A cross-sectional study was conducted between November and December 2024 involving 129 apparently healthy adults, including 67 males and 62 females, randomly recruited from different districts of Derna city. Venous blood samples were collected in EDTA tubes and analyzed using an automated hematology analyzer. Statistical analysis was performed using nonparametric methods following assessment of data distribution. The findings demonstrated significant sex-related differences in hemoglobin concentration, with males exhibiting higher values than females (p < 0.05). The established reference intervals for hemoglobin were 11.1–16.0 g/dL for males and 10.2–13.5 g/dL for females. Furthermore, the hemoglobin values demonstrated a skewed distribution and did not follow normality according to the Anderson–Darling test. The present findings emphasize the importance of establishing locally derived hematological reference intervals rather than relying exclusively on international reference standards. The implementation of population-specific hemoglobin reference values may improve laboratory interpretation, enhance diagnostic accuracy, and support better clinical management of hematological disorders within the Libyan population.