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ABO/Rhesus Blood Group and Correlation with Sickle Cell Disease and Type-II Diabetes Mellitus in South East and South-South of NigeriaAlagwu EA 1., Akukwu D 2, Ngwu EE 1, Uloneme GC 21Physiology Department, Faculty of Basic Medical Sciences, Imo State University- 460222, Owerri2Anatomy and Neurobiology Department, Faculty of Medicine, Imo State University- 460222, OwerriReceived: 01-Oct-2016, Accepted: 30-Oct-2016Keyword: ABO/Rhesus blood group, Sickle cell disease, Diabetes mellitus type 2DOI. AbstractCorrelation between ABO/Rhesus blood group, Sickle cell disease (SCD) and Diabetes mellitus (DM) was investigated in Okwe, Asaba, Delta State and Ihiala, Anambra State,Nigeria. 100 proven cases of sickle cell patients (HBSS) from the sickle cell clinic in the General Hospital, Okwe, Asaba, Delta State, Nigeria, were studied. 200 normal individuals, 100 with genotype AA and 100 with genotype AS were taken as control for comparison from Okwe town.
Furthermore, 50 proven cases of adults diabetic mellitus type2 from the diabetic clinic of our Lady’s of Lourdes Hospital Ihiala, Anambra State were studied. Samples of 50 normal adult individuals were taken from the Hospital town as control for comparison.
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In the ABO/Rhesus blood group and SCD, the result showed that there was a correlation between ABO/Rhesus blood group and sickle cell disease (p0.05). It was also observed that blood group O (78%) was most commonly distributed in diabetes mellitus type2, followed by A (22%), blood group 0 (0%) and AB (0%) did not show any incidence of type2 diabetes mellitus. When Rh positive and Rh negative where matched against DM and the control, Rh positive was 94% in DM and 88% in control (P0.05). Rh negative was 6% in DM and 12% in control, (P0.05). It was observed that Rh positive was more in DM than the control, and Rh negative was more in control than in DM patient. Therefore, correlation between ABO/Rhesus blood group and diabetes mellitus type 2 was not proven. It is accordingly, concluded that ABO/Rhesus blood group has positive correlation with sickle cell disease and fell short of such correlation with diabetes mellitus.1 IntroductionCorrelation between ABO blood group, SCD and DM was studied in Asaba Delta State and in Ihiala, Anambra State, Nigeria.
ABO blood groups are groups of antigens, located on the cell membrane, coded by alleles at different loci on the chromosome molecules, and classified into blood groups, A, B, AB and O. Blood groups of individuals depend upon the presence or absence of two genes, A and B, and are expressed on the end of long polylactosamine chains 1. Individuals are all divided into 4 major blood groups namely A, B, AB andO blood groups depending on the antigen present on the red cell membrane 2,3. Study in Nigeria showed that blood group O is the most common, followed by A, B, and least in AB with over 95% of Rhesus positive and 5% of Rhesus negative.
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A blood group has natural antibodies B in the plasma, B has antibodies A, AB has no antibodies in their plasma while 0 blood group has both A and B antibodies in the plasma. Sickle cell disease is the most prevalent hemoglobinopathy in human population. It is genetically transmitted in a recessive form.
It is an inherited disorder/disease. WHO (2010) reported that 2% of new born in Nigeria were affected by the disease with a total of 150,000 affected children born every year in Nigeria 4. Hemoglobin genotypes are inherited characters determined by different combination of these chains which include HbAA, HbAS, HbSD, HbSE and HbSS. HbSS differs from HbAA by the substitution of valine, a neutral amino acid for glutamic acid at position 6 in the Beta polypeptide chain 5-7. DM is a disease characterized by impaired carbohydrate, fat and protein metabolisms caused by either lack of insulin secretion or decrease sensitivity of tissues to insulin, resulting in hyperglycemia in the blood. Three types of DM exist namely, Type1, Type2 and Type3 8.Type 1 is juvenile onset diabetes also called insulin dependent DM. Type2 is adult onset DM which results in inability of the body to utilize insulin produced by the body effectively or deficiency production by the Beta cells of the pancreas.
Type3 is gestational diabetes which usually disappears after pregnancy. WHO recommended for normal person fasting blood glucose of 70-110mg/dl as normal 4. In Nigeria with over 140 million people according to 2006 population census, it was estimated that 6 million people have full blown diabetes mellitus. 1992, natural prevalent study on non-communicable disease conducted by the Federal Ministry of Health, on 13 states of the federation indicated prevalence of 2.7% in adult female. DM-etiology is complex but factors like genetics, habit, immunological and environment may be involved. But has genetic and familial predispositions, although environmental factors do play their role in the genetic expression. WHO, defined DM as a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively utilize the insulin it produced.
Insulin is a hormone produced by the pancreas that regulates blood sugar. It is known that ABO/Rhesus blood group and SCD are genetically transmitted/inherited while DM has familial tendencies and predisposition. There are conflicting reports about the correlations between ABO/Rhesus blood group, sickle cell disease and diabetes mellitus. Yamamoto 2003 reported relationship between diabetes mellitus and Rhesus blood group as inconsistent 9. Rhman 1976 described that there is no association between ABO blood group and type2 diabetes mellitus 10.
Nemesure and Hennis stated that the incidence of diabetes mellitus was not associated with the distribution of the ABO blood group 11. However, reported association between ABO blood group and diabetes mellitus. Huston et al, 2002 reported association between a particular ABO genotype and increased susceptibility to certain diseases 12,13. Homozygote dominance (HbAA) is reported to be most susceptible to plasmodial parasite infection than sickle cell heterozygote (HbAS). Sickle cell homozygote (HbSS) is most vulnerable to malaria infection than the other members of the genotypes 14.