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ORIGINAL ARTICLE
Year : 2016  |  Volume : 16  |  Issue : 1  |  Page : 57-61

Correlation of perceived stress with blood group A and O among medical students and its effect on lipid profile in a medical college of Eastern India


1 Department of Physiology, Burdwan Medical College and Hospital, Burdwan, India
2 Department of Anaesthesiology, National Medical College Kolkata, Kolkata, West Bengal, India
3 Department of Gynaecology and Obstetrics, Burdwan Medical College, Burdwan, India

Date of Web Publication7-Jan-2016

Correspondence Address:
Arunima Chaudhuri
Department of Physiology, Burdwan Medical College and Hospital, Krishnasayar South, Borehat, Burdwan - 713 102, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-6308.173469

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  Abstract 

The theory that there is a possible correlation between blood types and personality characteristics, other diseases, neurological disorders have been prevalent for a long-time. Background/Aims: To find correlation of perceived stress with blood group A and O among medical students and its effect on lipid profile in a medical college of eastern India. Materials and Methods: This cross-sectional study was conducted in a time span of 6 months after taking approval from the institutional ethics committee and informed consent of the subjects. Stress level in the subjects was assessed according to the presumptive life event stress scale (PSLES). 465 subjects with scores above 200 were chosen for the study. Blood groups of the subjects were assessed (blood group O 185; A 95; B 150: AB 35 [total 465]). Lipid profiles of subjects with blood group O and A were analyzed following exposure to stress. The perceived stress scale (PSS) of Sheldon Cohen was used to measure perceived stress. Data were analyzed using SPSS version 16. Results: There was no significant difference in PSLES scores, body mass index, total cholesterol, triglyceride, high-density lipoprotein, very low-density lipoprotein between subjects of blood group O and A. PSS score was significantly higher in group O as compared to group A (22.4 ± 4.6 vs. 19.36 ± 4.9; P value 0.036*). Low-density lipoprotein-cholesterol (LDL-C) was significantly higher in group O (132.63 ± 19.43 vs. 115.59 ± 18.7; P value 0.004**). PSS scores were positively correlated with LDL with r value of 0.03 [P < 0.01]). Conclusions: The results of our study indicate that subjects with blood group perceived more stress as compared to subjects of blood group A and perceived stress significantly worsened LDL-C levels.

  Abstract in Arabic 

العلاقة بين التوترو فصيلتي الدم A و O وسط طلاب الطب وأثره في مستوى الدهون في كلية الطب في شرق الهند
النظرية القائلة بأن هناك علاقة محتملة بين فصائل الدم والخصائص الشخصية، وأمراض أخرى، و الاضطرابات العصبية قد انتشرت لفترة طويلة.
الخلفية / الأهداف: العثور على علاقة بين التوترو فصيلتي الدم A و O بين طلاب الطب وأثره في مستوى الدهون في كلية الطب في شرق الهند.
المواد والطرق: أجريت هذه الدراسة في فترة زمنية من 6 أشهر بعد أخذ الموافقة من لجنة الأخلاقيات المؤسسية والموافقة منعينة الدراسة. تم تقييم مستوى التوتر في عينة الدراسة وفقا لأحداث الحياة المفترضة والإجهاد (PSLES). وقد تم اختيار 465 شخصا للدراسة. تم تقييم فصائل الدم من عينة الدراسة (فصيلة الدم O 185؛ A 95؛ B 150: AB 35 [مجموع 465]). وقد تم تحليل ملامح من المادة الدهنية من المفحوصين مع فصيلة الدم O و A بعد التعرض للإجهاد. تم استخدام مقياس (PSS) شيلدون كوهين لقياس الإجهاد. وقد تم تحليل البيانات باستخدام SPSS الإصدار 16.
النتائج: لم يكن هناك اختلاف كبير في درجات PSLES، مؤشر كتلة الجسم، والكوليسترول الكلي، الدهون الثلاثية، البروتين الدهني عالي الكثافة، جدا البروتين الدهني منخفض الكثافة بين أشخاص فصيلة الدم O وA. PSS النتيجة كانت أعلى بكثير في مجموعة O مقارنة
المجموعة (أ) (22.4 ± 4.6 مقابل 19.36 ± 4.9؛ P قيمة 0.036 *). كان البروتين الدهني منخفض الكثافة الكولسترول (LDL-C) أعلى بكثير في مجموعة O (132.63 ± 19.43 مقابل 115.59 ± 18.7؛ P قيمة 0.004 **). كانت مرتبطة PSS أيجابيا مع LDL مع قيمة ص من 0.03 [P <0.01]).
الاستنتاجات: أشارت نتائج الدراسة إلى أن عينات الدراسة مع فصيلة الدم O أظهروا المزيد من الضغط بالمقارنة مع عينة الدراسة من فصيلة الدم A وأظهروا التوتركما تفاقمت بشكل كبير مستويات LDL-C.

Keywords: Blood group, lipid profile, perceived stress


How to cite this article:
Chaudhuri A, Ray M, Hazra SK, Goswami A, Bera S. Correlation of perceived stress with blood group A and O among medical students and its effect on lipid profile in a medical college of Eastern India. Saudi J Sports Med 2016;16:57-61

How to cite this URL:
Chaudhuri A, Ray M, Hazra SK, Goswami A, Bera S. Correlation of perceived stress with blood group A and O among medical students and its effect on lipid profile in a medical college of Eastern India. Saudi J Sports Med [serial online] 2016 [cited 2023 Feb 8];16:57-61. Available from: https://www.sjosm.org/text.asp?2016/16/1/57/173469


  Introduction Top


The antigens of the ABO system were the first to be recognized as blood groups and the first human genetic markers known. The ABO system has come to grow in complexity over the years. The mass of knowledge relating to carbohydrate chemistry, enzymology, molecular genetics, and structural and evolutionary biology is now enormous and has provided with data to form a solid platform of evidence-based transfusion and transplantation medicine used every day in laboratories and clinics around the globe.[1] There is an established association between blood groups and cancers, peptic ulcer, coagulation disorders, bleeding disorders, clotting disorders, infections, and renal diseases. Past research has associated ABO blood type and mental stress with cardiovascular risk. Neumann et al.[2] studied the effects of blood type (A vs. O) coupled with a mirror drawing stressor on very low-density lipoprotein (LDL) toxicity-preventing activity (TxPA) and plasma cortisol levels. Exposure to the stressor significantly decreased TxPA and increased cortisol for the total group of 25 older adult males. However, the stress response patterns of the 15 blood type A males were different from those of the 10 type O subjects. The blood type A group had higher initial levels of TxPA and cortisol, as well as quicker stress recovery rates than the type O group.[2]

The theory that there is a possible correlation between blood types and personality characteristics, other diseases, neurological disorders have been prevalent for a long-time.[3] The High School Personality Questionnaire, Form A (10 items per factor) was given to 581 Italian or Italo-American boys averaging 14 years of age in four different cities by Cattell et al. They were also classified for ABO types. Analysis of variance was used to detect associations between ABO type and the 13 personality factors and intelligence. An association beyond the P < 0.01 level was found for I factor, Premsia versus Harria (“tender-minded vs. tough-minded”), A blood type being more premsic, and 0, B, and AB more harric, in that order. A relationship which appeared to warrant further investigation was personality factor J, coasthenia, with blood group AB.[4]

Previous studies have suggested that mental status may influence serum lipid levels. A study Shahnam et al. was conducted on the adult population living in rural and urban areas in Central Iran to assess the correlation between stress level and lipid profile disorders. The study population consisted of 9752 adults aged ≥19 years living in three districts namely Isfahan, Arak and Najaf Abad. Demographic data, age, and sex were recorded. Blood samples were taken to determine the lipid levels including total cholesterol (TC), LDL cholesterol (LDL-C), low levels of high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs). Stress levels were assessed using the General Health Questionnaire. Logistic regression and Chi-square tests were used for statistical analysis. The odds ratios of high stress in individuals with high levels of TC, LDL-C and low levels of HDL-C compared to normal individuals after adjustment for age and sex.[5]

The present study was conducted to find correlation of perceived stress with blood group A and O among medical students and its effect on lipid profile in a medical college of eastern India, so that intervention activities toward reduction of stress levels in early life may be useful as part of the strategy for cardiovascular disease prevention.


  Materials and Methods Top


This cross-sectional study was conducted in a medical college of eastern India in a time span of 6 months. Approval from the institutional ethics committee and informed consent of the subjects was taken before conduction of this pilot project.

Inclusion criteria

Medical students in the age group of 18–20 years were selected.

Exclusion criteria

Subjects suffering from chronic debilitating diseases such as cardiac arrhythmias, hypertension, diabetes, ischemic heart disease, retinopathy, nephropathy, or respiratory diseases, smokers, persons receiving any drug that may affect the autonomic reflexes were excluded. Subjects on treatment from psychiatry problem, pregnant women, puerperal mothers, subjects on regular meditation and exercise regime were excluded. Women on oral contraceptives were not included.

On the first appointment, histories of the subjects were carefully recorded. Five hundred and eighty-one subjects were finally selected. Subjects were asked to tally a list of 43 life events based on a relative score. The stress level in the subjects was assessed according to the presumptive life event stress scale (PSLES).[6]

Accordingly, they were categorized into no stress, less/moderate stress and severe stress. Score stress up to 40: No stress; 41–200 less/moderate stress; more than 200 severe stress. Finally, 465 subjects with scores above 200 were chosen for the study, as they had a higher risk of developing the illness.[6]

Blood groups of the subjects were assessed. Blood groups were collected from past medical records during admission and reconfirmed during the blood grouping, practical classes. Blood samples were taken by finger pricks by the students and the open slide method of ABO blood groups testing was followed. RBCs suspended in isotonic saline were treated with anti-A, anti-B and anti-D antisera on glass slides and mixed with separate applicator sticks. The mixture was observed for agglutination with corresponding antisera and compared with the control for confirmation.[3] Uncertainty was clarified with focusing the slide under the microscope (blood group O 185; A 95; B 150: AB 35 [total 465]).

Lipid profiles of subjects with blood group O and A were analyzed following exposure to acute stress during semester examinations. The perceived stress scale (PSS) of Cohen et al.,[7] the most widely used psychological instrument for measuring the perception of stress, was used for assessing stress levels. It is a measure of the degree to which situations in one's life are appraised to be stressful. Items were designed to find how unpredictable, uncontrollable, and overloaded respondents find their lives. The scale also includes a number of direct queries about current levels of experienced stress. The questions in the PSS ask about feelings and thoughts during the last month. It comprises of 10 items, four of which are reverse-scored, measured on a 5-point scale from 0 to 4. PSS scores are obtained by reversing responses (e.g., 0 = 4, 1 = 3, 2 = 2, 3 = 1 and 4 = 0) to the four positively stated items (items 4, 5, 7, and 8) and then summing across all scale items. Total score ranges from 0 to 40.

The computer software Statistical Package for the Social Sciences (SPSS) version 16 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0., SPSS Inc., Chicago, IL, USA) was used for analysis of data. The data were considered significant and highly significant if the analyzed probability values were P < 0.05* and P < 0.01** respectively.


  Results Top


Five hundred and eighty-one subjects were initially screened for the study. Among them, 465 subjects with PSLES scores above 200 were chosen, as they had a higher risk of developing the illness. Blood groups of these 465 subjects were as follows: O 185; A 95; B 150: AB 35. Parameters of 185 subjects with O blood group and 95 subjects with blood group A were compared. These groups were age, sex matched. Both groups had similar dietary habits. There was no significant difference in PSLES scores, body mass index, TC, TG, HDL, and VLDL between the two groups [Table 1]. PSS score was significantly higher in group O as compared to group A (22.4 ± 4.6 vs. 19.36 ± 4.9; P value 0.036*). LDL-C was significantly higher in group O (132.63 ± 19.43 vs. 115.59 ± 18.7; P value 0.004**). PSS scores were positively correlated with LDL with r value of 0.03.
Table 1: Mean and SD values of different parameters studied in two groups on examination

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  Discussion Top


ABO blood type may be an important behavioral hematologic variable to assess in studies concerning biochemical stress response or cardiovascular risk.[8],[9],[10],[11],[12] O-type blood occurs more frequently in manic-depressive patients.[4] People with blood group O are more prone to duodenal ulcers and perceived stress is thought to be a significant contributor in developing the disease.[1],[2],[3],[4] The results of our study indicate that subjects with blood group perceived more stress as compared to subjects of blood group A and perceived stress significantly worsened LDL-C levels.

A recent study [8] hypothesized that dopamine beta-hydroxylase gene is in linkage with the ABO gene. The population consisted of 1,427 Japanese subjects who completed the temperament and character inventory (TCI). Each subject's ABO blood type was determined by genotyping the rs8176719 and rs8176746 ABO gene single-nucleotide polymorphisms using a TaqMan genotyping assay. The relationships between the six ABO genotypes or four ABO phenotypes and personality traits were examined using a multivariate analysis of covariance (MANCOVA), controlling for age and sex. The MANCOVA data showed a significant difference in TCI scores among the ABO genotype groups. A subsequent univariate analysis showed a significant difference in the mean scores for Persistence among the genotype groups. Dividing the ABO blood type into four phenotypes revealed a significant difference among the phenotype groups. A subsequent univariate analysis showed a significant difference among the phenotype groups in the mean scores for Persistence. The study observed a significant association between ABO blood group genotypes and personality traits in a large number of healthy Japanese subjects.

A study by Gsellhofer et al.[9] explored the relationship between individual strategies of coping and blood pressure responses during and after mental stress. Blood pressure behavior was measured noninvasively and continuously before, during and after a mental stress situation in 27 normotensive subjects. Coping strategies were assessed with the Stressverarbeitungsfragebogen (SVF; coping with stress inventory). Two extreme groups were formed on the basis of the scores in the SVF. Results were: (a) Individuals who used coping strategies characterized by controlling the situation directly and constructively, in contrast to probands not using these strategies, exhibited lower blood pressure during the stress situation and a faster return to baseline levels after cessation of stress. (b) Subjects using a coping behavior characterized by the use of defense mechanisms such as suppression and denial also showed lower blood pressure during stress, but a significantly delayed return to baseline levels of blood pressure after stress was concluded. O blood group subjects in our study perceived greater stress in the present study and they had poor coping skills.

The aim of a study conducted by Anandarajan et al. was to explore a possible correlation between blood groups and scholastic performance of medical students in south India. A total of 450 1st year MBBS medical students of the age group 18–19 years were included. Blood groups were collected and for assessment of scholastic performance we used +2 (12th standard) marks and overall internal assessment marks of the first MBBS students. The study revealed a considerable difference in academic scores between the blood groups O and A.[3]

A study reported that nearly 6% of total deaths and as many as 9% of cardiovascular deaths could be attributed to having non-O blood groups, a condition that was also found to be associated with increased risk of gastric cancer.[13]

Our study demonstrated increased stress levels were associated with increased LDL-C. Studies by Shahnam et al.[5] also showed similar results. We had conducted another study on male MBBS students in 2014 and had found dyslipidemia in stressed subjects, which improved following relaxation exercises.[14]

Our results are also similar to studies by Neumann et al.[2] where the stress response patterns of the blood type A males were different from those of the type O subjects. The blood type A group had higher initial levels of TxPA and cortisol, as well as quicker stress recovery rates than the type O group.

The results of our study indicate that subjects with blood group perceived more stress as compared to subjects of blood group A and perceived stress significantly worsened LDL-C levels. Intervention activities towards reduction of stress levels in early life in individuals having O blood group needs to be implemented as useful part of the strategy for cardiovascular disease prevention.


  Limitations and Future Scope Top


We conducted this study in a single institution on a particular group of students which does add a limitation to the present study. Future studies with larger samples from different geographical areas are on the way.


  Conclusion Top


The results of our study indicate that subjects with blood group perceived more stress as compared to subjects of blood group A and perceived stress significantly worsened LDL-C levels.

Acknowledgement

We here by acknowledge the West Bengal university of health sciences for encouraging us to conduct the study

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Storry JR, Olsson ML. The ABO blood group system revisited: A review and update. Immunohematology 2009;25:48-59.  Back to cited text no. 1
    
2.
Neumann JK, Arbogast BW, Chi DS, Arbogast LY. Effects of stress and blood type on cortisol and VLDL toxicity preventing activity. Psychosom Med 1992;54:612-9.  Back to cited text no. 2
    
3.
Anandarajan B, Prathiba A, Dorairaj VS, Banu KK, Muthukumar S. Correlation of academic scores with blood group among first MBBS medical students. Int J Biomed Adv Res 2015;6:328-30.  Back to cited text no. 3
    
4.
Cattell RB, Young HB, Hundleby JD. Blood groups and personality traits. Am J Hum Genet 1964;16:397-402.  Back to cited text no. 4
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5.
Shahnam M, Roohafza H, Sadeghi M, Bahonar A, Sarrafzadegan N. The correlation between lipid profile and stress levels in central Iran: Isfahan healthy heart program. ARYA Atheroscler 2010;6:102-6.  Back to cited text no. 5
    
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Singh G, Kaur D, Kaur H. Presumptive stressful life events scale (psles) – A new stressful life events scale for use in India. Indian J Psychiatry 1984;26:107-14.  Back to cited text no. 6
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Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385-96.  Back to cited text no. 7
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Tsuchimine S, Saruwatari J, Kaneda A, Yasui-Furukori N. ABO blood type and personality traits in healthy Japanese subjects. PLoS One 2015;10:e0126983.  Back to cited text no. 8
    
9.
Gsellhofer B, Montoya P, Müller A, Piesbergen C, Schandry R. The correlation between coping with stress and blood pressure reaction. Z Exp Angew Psychol 1992;39:419-33.  Back to cited text no. 9
    
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Garratty G. Blood groups and disease: A historical perspective. Transfus Med Rev 2000;14:291-301.  Back to cited text no. 10
    
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Liumbruno GM, Franchini M. Beyond immunohaematology: The role of the ABO blood group in human diseases. Blood Transfus 2013;11:491-9.  Back to cited text no. 11
    
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Yamamoto F, Cid E, Yamamoto M, Blancher A. ABO research in the modern era of genomics. Transfus Med Rev 2012;26:103-18.  Back to cited text no. 12
    
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Franchini M, Lippi G. The intriguing relationship between the ABO blood group, cardiovascular disease, and cancer. BMC Med 2015;13:7.  Back to cited text no. 13
    
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Chaudhuri A, Ray M, Saldanha D, Bandopadhyay AK. Cardio-respiratory response of young adult Indian male subjects to stress: Effects of progressive muscle relaxation. Med J DY Patil Univ 2014;7:304-8.  Back to cited text no. 14
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