Year : 2020 Month : September Volume : 7 Issue : 38 Page : 2101-2104.
Tinju James1, Femina Jose2, Jerry Joseph3
1Department of Physiology, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India.
2Medical student, Department of Physiology, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India.
3Department of Ophthalmology, Ahalia Foundation Eye Hospital, Pattambi, Kerala, India.
Dr. Tinju James,
Department of Physiology,
Amala Institute of Medical Sciences,
Amala Nagar, Thrissur-680 555,
Email : firstname.lastname@example.org
Diabetes Mellitus (DM) is one of the major public health problems across the world contributing to significant morbidity and mortality.(1) It is like an epidemic rapidly emerging in the developing countries and the current global number of diabetic patients estimated is 382 million which is likely to rise over the subsequent years. Moreover, there are many people who are unaware of the fact that they have diabetes.(2) A genetic predisposition has been explained for this illness and the studies have shown that environmental factors do influence in its genetic expression.(3) ABO is the major human blood group system and there is marked variation in the incidence of ABO groups in different races, socioeconomic groups and ethnic groups in different parts of the world.(4) Though human population have the same type of blood group systems, the frequency of blood group types are different across population. Susceptibility to certain diseases could be explained by the presence of blood group antigens.(5) Diseases like gastric ulcer, duodenal ulcer,(6) abdominal aortic aneurysm, vascular diseases, cancer etc were associated with ABO blood group system.(7 - 9) Limited studies are conducted regarding the correlation of blood groups and diabetes mellitus in South Indian population. The aim of the present study was to find out the association of ABO blood group system with type 2 diabetes mellitus.
This study was carried out among the patients visited various departments of a tertiary care hospital, Central Kerala. 513 patients, already diagnosed with type 2 diabetes mellitus were enrolled in the study after getting informed consent. Blood grouping and Rh typing was noted from the previous record of doing the blood grouping and Rh typing.
The mean age of the study population was represented as mean ± SD. Data were tabulated as frequencies and percentages for categorical data.
A total of 513 subjects with type 2 diabetics in the age group 40-80 years were enrolled in the study. The mean age of the study population was 58.75 ± 11.30 years. 61 % of the study population was males and 39% were females and is represented in the Figure 1. The prevalence of diabetes was found to be more in blood group O followed by B, A and AB. This study also noted an increased prevalence of Rh positive blood group than Rh negative blood group in this population and is demonstrated in Figure 2. The frequency distribution of different blood group types across the entire study population is demonstrated in the Figure 3. On comparing males and females, there was no significant difference in the blood group type associated with type 2 diabetes mellitus (p >0.05) and is represented in Figure 4.
Males and Females in the Study Population
Percentage Distribution of Rh Positive and Rh-Negative Blood Types of the Entire Study Group
Figure 3. Frequency Distribution of Different Blood Group Types across the Entire Study Population
Figure 4. Frequency Distribution of Blood Group Types across Males and Females of Study Population
The present study aimed to look for the prevalence of ABO and Rh blood group system among type 2 diabetics. The prevalence seemed to be different in different population. This study showed that individuals with blood group O and B were more likely to have type 2 diabetes mellitus in this population. This could be due to the increased prevalence of the blood group O and B among this population.(10) Least association was noted among blood group AB in this population. This is similar to the studies done by Zhang et al(11) among Chinese population and Buckwalter et al,(12) which showed a reduced association of blood group AB with diabetes mellitus.
According to the studies done by Bener et al and Henry et al,(13) blood group B was significantly more common in diabetic patients as compared with healthy population. But the results of the present study were contrary to the studies done by Aggarwal et al(14) as well as Sidhu et al(15) among Indian population, Waseem et al(16) among Pakistan population and Karagoz et al(17) among Turkish population and in all these studies, they demonstrated a high percentage of blood group AB in diabetics. Study done by Bibawi and Khatwa(18) showed an increased frequency of blood groups A and AB in patients with diabetes and Okon et al.(19) in their study done on from Nigeria had noted a strong association of blood group A with diabetes. The reason for the conflicting results related to the association between ABO blood groups and DM could be explained by the racial as well as geographical variations affecting the genetic expression of diabetes. There was no significant difference of gender on type 2 diabetes mellitus (chi square = 0.515, p >0.05). This is similar to studies among other population which didn’t note any significant difference of gender on diabetics as well as controls, except for a study done in Algeria(20) which showed a significantly greater proportion of blood groups O and AB among diabetic men compared with healthy controls.
The exact mechanism regarding the association of blood groups with is not explained till now. Recent genomic studies have shown that antigens of “ABO” blood group increase the inflammatory state of the body in general. Single nucleotide polymorphisms at the “ABO” locus are associated with increase of tumour necrosis factor (TNF)-alpha and soluble intercellular adhesion molecule, which are identified as serum markers of inflammation.(21,22) Systemic inflammation is considered to be one of major cause of insulin resistance, which ultimately playing a role in developing type 2 diabetes.(23)
Maximum prevalence of type 2 diabetes mellitus was noted with O blood group followed by B and least prevalence was noted with blood group B. 92% of the study population was Rh positive. Further studies should be done in a larger population along with genomic studies to establish the same and to look for any association of gender on type 2 diabetes mellitus.
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James T, Jose F, Joseph J. A study to assess the prevalence of ABO and RH blood groups among subjects with type 2 diabetes mellitus. J Evid Based Med Healthc 2020; 7(38), 2101-2104. DOI: 10.18410/jebmh/2020/436