ASSOCIATION OF ABO AND RHESUS BLOOD GROUPS WITH TYPE 2 DIABETES MELLITUS: A CASE–CONTROL STUDY
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Keywords
Type 2 Diabetes Mellitus; ABO blood group; Rhesus factor; Body mass index; HbA1c; Case–control study
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is a major global public health concern influenced by complex genetic and environmental factors. ABO and Rhesus (Rh) blood group antigens have been implicated in several metabolic and cardiovascular disorders; however, evidence regarding their association with T2DM remains inconsistent across populations. Aim: To evaluate the association between ABO and Rhesus blood groups and Type 2 Diabetes Mellitus and to assess their relationship with glycemic control and age at diagnosis.
Materials and Methods: This hospital-based case–control study was conducted in the Department of Physiology in collaboration with the Department of Endocrinology at Government Medical College, Jammu, over a period of one year (2024–2025). A total of 300 participants were enrolled, including 150 patients with confirmed T2DM and 150 age-unmatched but sex-matched non-diabetic controls. ABO and Rh blood grouping was performed using the microcolumn gel method. Anthropometric parameters, blood pressure, fasting blood glucose, and glycated hemoglobin (HbA1c) were assessed. Statistical analysis was carried out using SPSS version 27.0, and associations were tested using the chi-square test and Student’s t-test. A p value <0.05 was considered statistically significant. Results: The mean age of diabetic patients was significantly higher than that of controls (49.58 ± 11.04 vs. 26.39 ± 8.88 years; p<0.001). Patients with T2DM had significantly higher body mass index, systolic blood pressure, fasting blood glucose, and HbA1c levels compared to controls (p<0.001). Blood group O was the most common among cases (33.3%), while blood group B predominated among controls (34.7%). However, no statistically significant association was observed between ABO blood groups (p = 0.259) or Rh factor (p = 0.652) and T2DM. Additionally, no association was found between blood groups and glycemic control or age at diagnosis. In contrast, higher BMI showed a strong and significant association with both T2DM and poorer glycemic control (p<0.001). Conclusion: The present study found no significant association between ABO or Rhesus blood groups and Type 2 Diabetes Mellitus. Body mass index emerged as a key modifiable risk factor strongly linked to diabetes and poor glycemic control. These findings suggest that blood group phenotyping has limited utility as a predictive marker for T2DM, and preventive strategies should primarily focus on lifestyle-related risk factors.
References
2. International Society of Blood Transfusion. Red Cell Immunogenetics and Blood Group Terminology [Internet]. Amsterdam: International Society of Blood Transfusion; 2024..
3. Varshney V, Bedi M. Ghai’s textbook of practical physiology. 10th ed. New Delhi: Jaypee Brothers Medical Publishers Pvt Limited; 2022. p. 60.
4. Dean L. Blood groups and red cell antigens. Bethesda (MD): National Center for Biotechnology Information (NCBI); 2005. p. 26–27.
5. Reid ME, Lomas-Francis C, Olsson ML. The Blood Group Antigen FactsBook. Burlington: Elsevier Science; 2012. p. 29.
6. Ewald DR, Sumner SC. Blood type biochemistry and human disease. Wiley Interdiscip Rev Syst Biol Med 2016;8(6):517-35.
7. Pal GK, Pal P, Nanda N. Textbook of medical physiology. 4th ed. New Delhi: Elsevier India; 2021. p. 117–8.
8. Franchini M, Liumbruno GM. ABO blood group: old dogma, new perspectives. Clin Chem Lab Med 2013;51(8):1545-53.
9. Soumee B, Banerjee S, Devi AM Shanthala, Sitalakshmi S. Prevalence of ABO, Rh (D, C, c, E, and e), and Kell (K) antigens in blood donors: A single-center study from South India. Asian J Transfus Sci 2024;18(2):219-24.
10. Alanazi M, Alkhidhr M, Alhadhari A, Al-Hathloul A, Alsharif E, Albahli S et al. Associa-tion of Diabetes Mellitus with ABO Blood Groups & Rh. Egypt J Hosp Med 2018;73:6535-40.
11. Wagner FF, Flegel WA. RHD gene deletion occurred in the Rhesus box. Blood 2000;95(12):3662-8.
12. Hall JE, Hall ME. Guyton and Hall textbook of medical physiology. 14th ed. Philadelphia: Elsevier; 2021. p. 473, 986.
13. Liumbruno GM, Franchini M. Beyond immunohaematology: the role of the ABO blood group in human diseases. Blood Transfus 2013;11(4):491-9.
14. Garratty G. Blood Groups and Disease: A Historical Perspective. Transfus Med Rev 2000;14(4):291-301
15. Keisam R, Ranabir S, Anjana Y. Is there an association between ABO blood groups and type 2 diabetes mellitus? Ann Int Med Dent Res 2018;4(4):1-3.
16. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classifi-cation of diabetes: standards of care in diabetes - 2025. Diabetes Care. 2025;48(Supplement_1):S27–S49
17. American Diabetes Association; Standards of medical care in diabetes. Diabetes Care 2024; 37 (Supplement_1): S14–S80.
18. International Diabetes Federation. IDF Diabetes Atlas: 10th edition global fact sheet. Brus-sels: International Diabetes Federation; 2021.
19. World Health Organization. The top 10 causes of death [Internet]. 2024. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
20. Maiti S, Akhtar S, Upadhyay AK, Mohanty SK. Socioeconomic inequality in awareness, treatment and control of diabetes among adults in India: Evidence from National Family Health Survey of India (NFHS), 2019–2021. Sci Rep 2023;13:2971.
21. Ortiz-Martínez M, González-González M, Martagón AJ, Hlavinka V, Willson RC, Rito-Palomares M. Recent developments in biomarkers for diagnosis and screening of type 2 diabe-tes mellitus. Curr Diab Rep 2022;22(3):95–115
22. Wang X, Bao W, Liu J, OuYang YY, Wang D, Rong S et al. Inflammatory markers and risk of type 2 diabetes: A systematic review and meta-analysis. Diabetes Care 2013;36(1):166-75.
23. Weykamp C. HbA1c: a review of analytical and clinical aspects. Ann Lab Med 2013;33(6):393-400.
24. Cserti CM, Dzik WH. The ABO blood group system and Plasmodium falciparum malaria. Blood 2007;110(7):2250-8.
25. Abegaz SB. Human ABO blood groups and their associations with different diseases. Biomed Res Int 2021;2021:6629060.
26. Bener A, Yousafzai MT. The distribution of the ABO blood groups among the diabetes melli-tus patients. Niger J Clin Pract 2014;17(5):565-8.
27. Anjana RM, Unnikrishnan R, Deepa M, Pradeepa R, Tandon N, Das AK et al. ICMR-INDIAB Collaborative Study Group. Metabolic non-communicable disease health report of In-dia: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). Lancet Diabetes Endocrinol 2023;11(7):474-89.
28. He M, Wolpin B, Rexrode K, Manson JE, Rimm E, Hu FB, et al. ABO blood group and risk of coronary heart disease in two prospective cohort studies. Arterioscler Thromb Vasc Biol 2012;32(9):2314-20.
29. Glynn M, Drake WM, editors. Hutchison's Clinical Methods: An Integrated Approach to Clinical Practice. 24th ed. Elsevier Health Sciences; 2018. p. 196-198.
30. Dali Sahi M, Aour Metri A, Belmokhtar F, Belmokhtar R, Boazza F. The relationship be-tween ABO/Rhesus blood groups and Type 2 Diabetes Mellitus in Maghnia, Western Algeria. S Afr Fam Pract 2011;53(6):568-72.
31. Dodiya D, Patel A, Jadeja J. Association of ABO blood group with diabetes mellitus. Int J Basic Appl Physiol 2016;5(1):63-6.
32. Bener A, Yousafzai MT. The distribution of the ABO blood groups among the diabetes melli-tus patients. Niger J Clin Pract 2014;17(5):565-8.
33. Alanazi M, Alkhidhr M, Alhadhari A, Al-Hathloul A, Alsharif E, Albahli S et al. Associa-tion of Diabetes Mellitus with ABO Blood Groups & Rh. Egypt J Hosp Med 2018;73:6535-40.
34. Chang AM, Halter JB. Aging and insulin secretion. Am J Physiol Endocrinol Metab 2003;284(1):E7-12.
35. Centers for Disease Control and Prevention (CDC). Prevalence of Overweight and Obesity Among Adults with Diagnosed Diabetes - United States, 1988--1994 and 1999--2002. MMWR Morb Mortal Wkly Rep 2004;53(45):941-4.
36. Michaelidou M, Pappachan JM, Jeeyavudeen MS. Management of diabesity: Current con-cepts. World J Diabetes. 2023;14(4):396-411.
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Dr. Vanita Sharma
Professor and HOD, Department of Physiology, Government Medical College Jammu, India ((mail id: [email protected]
Dr. Shazia
Assistant Professor, Department of Physiology, Government Medical College Jammu, India (mail id: [email protected])
Dr. Suman Kotwal
Assistant Professor and HOD, Department of Endocrinology, Government Medical College Jammu, India (mail id: [email protected])
Dr. Humairah Shafi
Senior Resident, Department of Physiology, Government Medical College Srinagar, India (mail id: [email protected] )
Dr. Maliha Mufti
Senior Resident, Department of Physiology, Government Medical College Srinagar, India (mail id: [email protected]
Dr Farrukh Mushtaq
Senior Resident, Department of Physiology, Government Medical College Srinagar, India (mail id: [email protected])
Dr. Syed Henna
Post-graduate scholar resident, Department of Physiology, Government Medical College Srinagar, India (mail id: [email protected]
Dr. Henna Bashir
Senior Resident, Department of Physiology, Government Medical College Srinagar, India (mail id: [email protected])
