Abstract
Association between ABO blood group and rheumatic diseases is not well characterized. This study assessed distribution of ABO blood group and Rh factor in patients with rheumatic diseases and healthy blood donors. We retrospectively evaluated data of patients with rheumatic diseases who attended the hospital from September 2015 to January 2020, and the documented evidence of blood group of healthy blood donors. Data from 5000 healthy donors and 3165 patients with rheumatic disease were assessed. Overall, blood type O was the most prevalent (42.94% and 43.14%) followed by B (33.21% and 30.08%), A (17.66% and 21.48%) and AB (6.19% and 5.30%) in patients with rheumatic disease and healthy donors, respectively. This distribution was statistically different between the groups, with blood group A being more common in healthy donors than in patients with rheumatic disease (<i>P</i><0.0001). Distribution of ABO groups among rheumatic disease types was similar (<i>P</i>=0.2921). More individuals had Rhesus (Rh) (+) factor (93.97%) than Rh (-) (6.03%), however, its distribution was comparable across healthy donors and patients with rheumatic disease (<i>P</i>=0.1145). Patients with blood group A had significantly lower risk of developing rheumatic diseases compared to blood group O (OR [95% CI]: 0.94 [0.780, 1.134]; <i>P</i><0.0318). Similarly, patients bearing blood type A+ (0.98 [0.62, 1.54]; <i>P</i>=0.0037) and O+ (1.08 [0.694, 1.68]; <i>P</i>=0.0215) were at a lower risk for developing rheumatic diseases compared to those with O- blood group. The most common blood type was O followed by B, A and AB in patients with rheumatic disease and healthy donors. Individuals with blood group A had lower risk of developing rheumatic diseases compared to other blood types.
Highlights
Rheumatic diseases are a group of autoimmune disorders of musculoskeletal system and connective tissue affecting a wide range of age groups and causes disability in terms of poor quality of life, loss of productivity leading to significant health and socioeconomic burden [1, 2]
Considering non-homogeneous distribution of gender between patients of both groups, logistic regression for gender-matched cohort was applied and the results showed that patients with blood group A were significantly less likely to be associated with rheumatic diseases compared to those with blood group O (Table 5)
Our study reported that blood type O was more common in patients with fibromyalgia, gout, granulomatosis with polyangiitis (GPA), rhupus and sarcoidosis; type B was commonly seen in those with adult-onset Still’s disease (AOSD), inflammatory arthritis: UD, antiphospholipid syndrome (APS) and psoriatic arthritis (PsA); and type A, in patients with enteropathic arthritis (EA)
Summary
Rheumatic diseases are a group of autoimmune disorders of musculoskeletal system and connective tissue affecting a wide range of age groups and causes disability in terms of poor quality of life, loss of productivity leading to significant health and socioeconomic burden [1, 2]. Pathogenesis of rheumatic diseases is multifactorial, involving various genetic and environmental risk factors [3, 4] Both ABO and Rhesus (Rh) blood group systems have been important genetic factors associated with rheumatic diseases [5, 6]. The ABO antigens are complex carbohydrates that are expressed on the epithelium, neurons, platelets, and vascular endothelial cells [7, 10]. Beside their variable structural diversity, they are involved in immune mechanisms that render susceptibility or protection against diseases [11]. Association between blood group A and risk of stomach cancer was first reported in 1953, and that of ABO and Rh blood groups with cancer [12, 13], hypercoagulability [14], infections [15, 16], and diabetes mellitus [17] have been demonstrated subsequently
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