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Relationship between ABO blood groups and cardiovascular disease in type 1 diabetes according to diabetic nephropathy status.

ABSTRACT: BACKGROUND:ABO blood groups have previously been associated with cardiovascular disease (CVD) in the general population. This study aimed to investigate the potential relationship between ABO blood groups and CVD in individuals with type 1 diabetes according to diabetic nephropathy (DN) status. METHODS:Adults with type 1 diabetes (4531 individuals) from the FinnDiane Study were evaluated. DN was determined by two out of three measurements of urinary albumin excretion rate. Albuminuria was defined as an excretion rate above 20 µg/min. CVD events were identified by linking the data with the Finnish Care Register for Health Care and the Finnish Cause of Death Register. Follow-up ranged from the baseline visit until a CVD event, death or the end of 2017. The impact of ABO blood groups on CVD risk was estimated by multivariable Cox-regression analyses adjusted for traditional risk factors. RESULTS:At baseline, the median age was 38.5 (IQR 29.2-47.9) years, 47.5% were female and median duration of diabetes was 20.9 (11.4-30.7) years. There were 893 incident ischemic heart disease (IHD) events, 301 ischemic strokes (IS), and 415 peripheral artery disease (PAD) events during a median follow up of 16.5 (IQR 12.8-18.6) years. The A blood group showed the highest risk of IHD versus the O blood group, when microalbuminuria was present. Comparing the population with microalbuminuria with those with normoalbuminuria, only the A blood group elevated the risk of IHD. This increased risk was neither explained by the FUT2 secretor phenotype nor by the A-genotype distribution. The risk of IS or PAD was no different among the ABO blood groups regardless of diabetic nephropathy stage. CONCLUSION:The A blood group is a risk factor for IHD in individuals with type 1 diabetes and microalbuminuria.

SUBMITTER: Parente EB

PROVIDER: S-EPMC7238526 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Relationship between ABO blood groups and cardiovascular disease in type 1 diabetes according to diabetic nephropathy status.

Parente Erika B EB Harjutsalo Valma V Lehto Markku M Forsblom Carol C Sandholm Niina N Groop Per-Henrik PH

Cardiovascular diabetology 20200519 1

<h4>Background</h4>ABO blood groups have previously been associated with cardiovascular disease (CVD) in the general population. This study aimed to investigate the potential relationship between ABO blood groups and CVD in individuals with type 1 diabetes according to diabetic nephropathy (DN) status.<h4>Methods</h4>Adults with type 1 diabetes (4531 individuals) from the FinnDiane Study were evaluated. DN was determined by two out of three measurements of urinary albumin excretion rate. Albumin ...[more]

PMID: 32429911

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Project description:BackgroundSince the discovery of the ABO blood group system by Karl Landsteiner in 1901, several reports have suggested an important involvement of the ABO blood group system in the susceptibility to thrombosis. Assessing that non-O blood groups in particular A blood group confer a higher risk of venous and arterial thrombosis than group O.Epidemiologic data are typically not available for all racial and ethnics groups.The purpose of this pilot study was to identify a link between ABO blood group and ischemic disease (ID) in Africans, and to analyze whether A blood group individuals were at higher risk of ischemic disease or not.MethodsA total of 299 medical records of patients over a three-year period admitted to the cardiology and internal medicine department of military hospital of Ouakam in Senegal were reviewed. We studied data on age, gender, past history of hypertension, diabetes, smoking, sedentarism, obesity, hyperlipidemia, use of estrogen-progestin contraceptives and blood group distribution.In each blood group type, we evaluated the prevalence of ischemic and non-ischemic cardiovascular disease. The medical records were then stratified into two categories to evaluate incidence of ischemic disease: Group 1: Patients carrying blood-group A and Group 2: Patients carrying blood group non-A (O, AB and B).ResultsOf the 299 patients whose medical records were reviewed, 92 (30.8%) were carrying blood group A, 175 (58.5%) had blood group O, 13 (4.3%) had blood group B, and 19 (6.4%) had blood group AB.The diagnosis of ischemic disease (ID) was higher in patients with blood group A (61.2%) than in other blood groups, and the diagnosis of non-ischemic disease (NID) was higher in patients with blood group O (73.6%) compared to other groups. In patients with blood group B or AB compared to non-B or non-AB, respectively there was no statistically significant difference in ID incidence.Main risk factor for ID was smoking (56.5%), hypertension (18.4%) and diabetes (14.3%).In our study, there was no statistical difference between blood group A and non-A in myocardial infarction (MI) incidence (p = 0.09, 95% CI = 0.99-2.83) but a statistically significant difference between blood group A and non-A in stroke and coronary artery disease (CAD) incidence (p < 0.0001, 95% CI = 1.80-3.37 and p < 0.0001 95% CI = 1.82-3.41 respectively) was found.The incidence of ID in men was significantly higher in blood group A (95% CI = 2.26-4.57, p < 0.0001) compared with non-A group, while there was no statistically significant difference in women (p = 0.35). However, an overall effect was detected to be statistically significant regardless of gender (p < 0.0001).ConclusionOur study suggests an association between blood group A and ID in sub-Sahara Africans.In African countries, where most of health facilities are understaffed, more rigorous studies with a larger population are needed to give a high level of evidence to confirm this association in order to establish the need to be more aggressive in risk factor control in these individuals.

Dataset Information

Relationship between ABO blood groups and cardiovascular disease in type 1 diabetes according to diabetic nephropathy status.

Publications

Relationship between ABO blood groups and cardiovascular disease in type 1 diabetes according to diabetic nephropathy status.

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