Aktive protein C rezistansının ABO kan gruplarıyla ilişkisi

Abstract

The Relation of Activated Protein C Resistance with ABO Blood Types The aim of this study is to investigate the relationship between APCR normalized ratios and ABO blood groups. Althogh the reason is not well known, it is expected that, the individuals with blood group O have lower risk of thrombosis than with individuals with blood group non-O. There is not sufficient documents related to the relation between the blood groups and the most frequent cause of thrombophilia, APCR. In a study explaining the relation between blood groups and factor V Leiden which is the major cause of APCR, it was reported that, in FVL heterozygot individuals the prevalance of venous thrombosis and risk was higher in individuals with blood group non-0 compared to individuals with blood group O. We have studied plasma samples of 250 blood donor volunteers (208 M/42 F) with median age 33 (19-63 years) in blood center between March- June 2002. The study was started after the approval of local ethical committee confirmation and only volunteers who gave written informed consent were excepted for the study. APCR, detected by ProC® Global kit (Dade Behring, Marburg, Germany) was performed simultaniously with the standart and the modified (FV depted plasma) assays. The cut-off values for the standart assay and the modified assay were 0,69 and 0,86 and the values below these ratios were accepted as APCR(+). Seventeen pozitivities with the standart assay and 28 pozitivities with the modified assay were detected (p=0,03). Despite the APCR(+) subjects beeing the most in blood group AB and the least in group O, there was no difference betweeen the groups. With the standart assay the median APCR-NR was the highest in blood group O in APCR(-) subjects (p=0,016). There was no significant difference between the blood groups and the APCR-NR in the modified assay. When the subjects were divided into two groups as O and non-O, in the standart assay APCR pozitivity was %3,5(n=2) in group O, %7,8(n=15) in non-O (p=0,344), and in the modified assay %5,3(n=3) in group O, %13(n=25) in group non-O. When the APCR-NR's were evaluated in APCR(-) subjects, there was a significant difference in blood group O compared to blood group non-O with the standart assay (p=0,001), but no significant difference with the modified assay. Standart assay not being spesific for FV Leiden represents the in vivo physiological conditions better. With the satandan assay, there was a negative relation between APCR-NR's and blood group O. APCR-NR's were not different between the blood groups (even divided in two groups as O and non-O) with the modified assay known as the most spesific and sensitive assay for FVL. This situation may be explained by the high levels of FVIII in blood group non-O. The dilution made in the modified assay may have normalised this disadvantage. Even though it was not statistically different, the prevalance of APCR positivity was47 lower in blood group O compared to blood group non-O. The small number of subjects studied seems to be the limiting factor. This study suggests that, blood group O is physiologically away from activated protein C resistance and the APCR pozitivity may be low in blood group O. Key Words : ABO blood groups, Activated protein C resistance, activated protein C resistance normalized ratio, Factor V Leiden, ProC Global, standart and modified assays.