Abstract

Background: Blood group is not only a part of identity but also has a crucial role in the field of transfusion medicine. The relationship between bleeding time, clotting time and blood group is especially relevant in certain clinical conditions like surgery, thrombosis, and epistaxis. Several studies have found variations in bleeding tendencies among different ABO blood groups.Hence this study was done to find the association of bleeding time and clotting time with ABO blood groups. Objective: To compare the bleeding time and clotting time among various ABO blood groups. Materials and Methods: 192 MBBS students, between the age group of 17-22years, of Rani Duragavati Medical College, Banda, Uttar Pradesh, were enrolled after taking written informed consent. Bleeding time was estimated using Duke’s method, clotting time using capillary tube method and blood group using standard antisera. Results: Among 192 students, the most common blood group was B (35%), followed by O (31%), A (21%) and AB (13%).The significance of association of bleeding time and clotting time with ABO blood groups was determined using Kruskal-Wallis test. The test revealed that the distribution of bleeding time and clotting time is same across different ABO blood groups. So, there is no significant association of bleeding time and clotting time with ABO blood groups (p=0.087 for BT; p=0.112 for CT). Conclusion: There was no significant association between bleeding time, clotting time and ABO blood groups.

Description

Karl Landsteiner was the first to describe the ABO blood group system. It comprises of carbohydrate structures that are expressed on a variety of cells, including red blood cells (RBCs), platelets and endothelial cells (ECs).1–3These carbohydrate structures, called A, B and H antigens, are terminal sugars at the end of complex glycan chains.4 The precursor H glycan structure is converted into A or B antigen by addition of specific sugar residues, catalyzed by either A- or B-glycosyl transferase enzymes respectively. In blood group O, there is no A- or B-transferase activity, and so, H glycan structure is present at the terminal of its oligosaccharide chains.4 The significant role of the ABO blood group system in the field of blood transfusion and organ transplantation is widely recognized. Interestingly, there have also been notable connections observed between ABO blood groups and various medical conditions, such as duodenal ulcers, gastric cancer, and several types of infections, including those caused by Helicobacter pylori, Salmonella typhi, and Plasmodium falciparum.5,6 Recent research findings indicate that the ABO blood group can affect the chances of having a severe COVID-19 infection.7,8 Multiple studies have highlighted that ABO blood type is a significant and separate risk factor for both cardiovascular disease and venous thromboembolism.5,9Furthermore, genome-wide association studies have revealed that the ABO blood group not only serves as a risk factor for atherosclerosis but also plays a crucial role in the development of acute coronary syndrome and heart attacks.10,11 Additionally, clinical research has shown that individuals with blood type O experience a significant decrease in both the size of infarct and overall mortality.12 Although the connection between ABO blood groups and blood coagulation was initially suggested over six decades ago, the specific biological mechanisms responsible for this association are still not well comprehended.13 von Willebrand factor (vWf) is a glycoprotein found in the blood that plays a crucial role in hemostasis. It is produced by endothelial cells and megakaryocytes. vWf facilitates platelet adhesion and aggregation, serving as a carrier for clotting factor VIII (also known as antihemophilic factor A). Consequently, vWf plays a significant part in the formation of a temporary hemostatic plug and its transformation into a stable blood clot through the activation of the clotting process.14As reported by Mourant15 and Qureshi and Bhatti16, there is a distinct correlation between ABO blood group and von Willebrand factor (vWf). A deficiency of vWf can result in bleeding disorders, while elevated levels are associated with an increased risk of thrombosis.17–19However, in their study, Daniel et al. were unable to identify any link between ABO blood groups and von Willebrand factor (vWf).20 So the aim of this study is to find if there is any relationship between bleeding time (BT), clotting time (CT) and ABO blood groups.