Relationship between non-O blood groups and microvascular risk in type 2 diabetes

IntroductionABO groups impact macroangiopathy risk in T2D. It is unknown whether such modulation extends to microvascular complications.MethodSingle-centre cross-sectional study including 1,006 T2D patients.ResultsPrevalence of overall microangiopathy was 51%. No significant differences (ANOVA) were observed between ABO groups in terms of age, sex, diabetes duration, BMI, hypertension, chronic kidney disease or diabetic foot. Insulin sensitivity and the hyperbolic HOMA product [BxS] were lower among non-O groups (-20% and -14%, respectively; p 0.001 and 0.013), while HbA1c and lifetime hyperglycaemia exposure were higher (+5% and +25%, respectively; p 0.006 and 0.002). Overall microangiopathy was more prevalent among non-O patients (+23%; p 0.001), as was neuropathy (+44%; p 0.005). Differences across ABO groups were significant for overall microangiopathy (p 0.009) and neuropathy (p 0.027) (ANOVA). In multivariate analysis, group A (vs O) was associated with overall microangiopathy (OR=1.62; 95%CI: 1.18-2.22; p 0.003) after adjustment for diabetes duration, HbA1c, smoking, remnant-C and hypertension.ConclusionT2D patients of blood group A have increased frequency of overall microangiopathy, regardless of other risk factors. Group O subjects exhibit better glucose homeostasis, with better insulin sensitivity and β-cell function. The ABO system therefore impacts both glucose homeostasis and microvascular susceptibility in T2D.