Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
Semin Thromb Hemost. 2012 Jul;38(5):535-48. doi: 10.1055/s-0032-1315758. Epub 2012 Jun 27.
It is well known that the ABO blood group exerts a major influence on hemostasis, as O blood group individuals have lower von Willebrand factor and factor VIII levels than non-O blood group subjects. To evaluate the possible clinical implication of the different ABO blood groups on the risk of developing venous thromboembolism (VTE), we conducted a meta-analysis of the existing literature. After an electronic search strategy using Medline and Embase and a manual review of abstract books of the International Society on Thrombosis and Haemostasis and of reference lists of all retrieved articles, we included in the systematic review 38 studies with 10,305 VTE cases. The prevalence of non-O blood group was significantly higher in VTE patients compared with controls with a resulting pooled odds ratio (OR) of 2.09 (95% confidence interval [CI], 1.83, 2.38; p < 0.00001). Similar findings were obtained when the genotypes A1O/BO/A2B (OR 1.73, 95% CI, 1.47, 2.05; p < 0.00001) and A1B/A1A1/BB (OR 1.87, 95% CI, 1.84, 2.44; p < 0.00001) were analyzed. The maximum VTE risk was observed in non-O-factor V Leiden patients (OR 7.60, 95% CI, 3.21, 17.99), while for G20210A prothrombin mutation it was not possible to perform a pooled analysis due to a paucity of published studies. Finally, the association between non-O blood group and VTE was weaker when provoked VTE cases were considered (OR 1.33, 95% CI, 1.18, 1.50), while it was substantially unchanged when unprovoked VTE cases were analyzed (OR 1.88, 95% CI, 1.42, 2.50). In conclusion, considering its prevalence, non-O blood group is a candidate to be one of the most important genetic risk factors for venous thrombosis.
众所周知，ABO 血型对止血有重大影响，因为 O 型血个体的 von Willebrand 因子和因子 VIII 水平低于非 O 型血个体。为了评估不同 ABO 血型对静脉血栓栓塞 (VTE) 风险的可能临床意义，我们对现有文献进行了荟萃分析。我们使用 Medline 和 Embase 进行电子检索策略，并对国际血栓和止血学会的摘要书籍以及所有检索文章的参考文献进行了手动审查，将 38 项研究纳入了系统综述，其中包括 10305 例 VTE 病例。与对照组相比，VTE 患者中非 O 型血的患病率明显更高，合并优势比 (OR) 为 2.09 (95%置信区间 [CI]，1.83 至 2.38; p < 0.00001)。当分析 A1O/BO/A2B (OR 1.73, 95% CI, 1.47, 2.05; p < 0.00001) 和 A1B/A1A1/BB (OR 1.87, 95% CI, 1.84, 2.44; p < 0.00001) 基因型时，也得到了类似的发现。非 O 因子 V Leiden 患者的最大 VTE 风险最高 (OR 7.60, 95% CI, 3.21, 17.99)，而对于凝血酶原突变 G20210A，由于发表的研究较少，因此无法进行合并分析。最后，当考虑到诱发 VTE 病例时，非 O 型血与 VTE 之间的关联较弱 (OR 1.33, 95% CI, 1.18, 1.50)，而当分析非诱发 VTE 病例时，关联基本不变 (OR 1.88, 95% CI, 1.42, 2.50)。总之，考虑到其患病率，非 O 型血是静脉血栓形成最重要的遗传危险因素之一。
