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Indian Journal of Community Medicine

A Study of Lipid Profiles Among Male Voluntary Blood Donors in Chennai City

Author(s): R.S. Bharadwaj

Vol. 30, No. 1 (2005-03 - 2005-03)

Abstract

Research Question : What is the effect of blood donation on the serum lipid profile of male voluntary blood donors, in an urban setting?

Objective: To find out the lipid profile pattern among the voluntary blood donors and look for differences in the values between the recent (Those who had donated blood within the last one year) & the past donors.

Study design: Cross-sectional.

Study population: Male voluntary blood donors who had donated blood within the last two years (Aug 2000 to Aug 2002) in the Blood Bank, Government general hospital, Chennai.

Sample size: 157 male voluntary blood donors among the 1,012 identified.

Study variables: Age, Body mass index (Weight/Height2), Food habits, Smoking, Alcohol consumption, Hypertension, Diabetes mellitus, Serum lipoid profile.

Statistical analysis: Means and proportions with tests of significance applied wherever required.

Results: Out of the 157 donors, 78 were recent donors and 79 past donors. Overall the lipid profile values were within the normal range in both groups. There was, however, a statistically significant difference in the mean values of the major lipid parameters (as specified by the NCEP guidelines). A stratified analysis for the same between different age groups also revealed similar results. Comparison between smokers and non-smokers in the groups separately showed a statistically significant difference in the value of only HDL among the past donors. There was thus a more healthy lipid profile among the recent donors when compared to the past donors.

Key Words: Blood donors, Lipid profile (Total Cholesterol, Low density lipoprotein (LDL), High density lipoprotein (HDL), Very low density lipoprotein (VLDL), Triglycerides

Introduction

"Safe blood starts with me, Blood saves lives" was the WHO theme for 2000 AD. There is a considerable shortage of blood even in large metropolises with the supply being less than 50% of requirement1. Also studies in the past have shown a lowered risk of cardiovascular morbidity and mortaily among regular blood donors2-5. This effect was shown to last at least for a period of 3 years from the last donation6. The present study was aimed at assessing the lipid profile including Total cholesterol, HDL, LDL, VLDL, TG and Total cholestrol /HDL ratio among the voluntary blood donors and then make an analysis to look for any significant differences in the mean values between the Recent and Past donors. Since in a previous study it was found in Chennai city that the main hindrance to blood donation was parental disapproval7, this study was commenced with the idea of identifying any indications of beneficial effects of blood donation which if detected could be used as a powerful tool in health education thus ensuring a healthy community participation in transfusion services.

Material and Methods

The complete list of male blood donors who had donated blood in the blood bank, Govt. General Hospital, Chennai between Aug. 2000 - Aug. 2002 was obtained. Out of the 1,012 donors enlisted, 157 were selected by simple random technique using the random numbers table for the study. The sample size of 157 was arrived upon on the basis of a previous study8. Fasting blood sugars along with details of demographic and personal history and medical / medication history were obtained using a questionnaire. Lipid profile and fasting sugar samples were analyzed in the Institute of biochemistry, Madras Medical College, Chennai. The lipid profile was done using the semi auto analyzer technique.

Results

A total of 157 males healthy voluntary blood donors were studied. Out of total 58.6% were in 18-30 year age group, 20.4% in 30-40 yrs age group and 21% were in 40-50 yrs age group. Amount the 157 donors 49.68% were recent donors (donated within the last one year) & 50.32% were past donors. 12.74% were smokers, and 19.2% were vegetarian and 10.8% of the donors were alcohol consumers. The proporation of smokers, alcohol consumers & vegetarians was not statistically different in the two groups. The mean lipid profile values of the group showed as a whole, normal values within the expected range. Analysis for difference between recent and past donors showed noteworthy

Table I : Lipid Profile in Recent and Past Donors

  RECENT DONORS PAST DONORS P. Values
  Mean SD Mean SD  
Total Cholesterol 167.5 20.3 175.5 25.3 P<0.05
HDL 51.2 5.9 41.5 4.8 P<0.001
LDL 92.6 20.3 108.9 21.8 P<0.001
VLDL 23.7 8.7 25.0 8.9 P>0.05
Triglycerides 112.2 43.9 115.1 44.6 P>0.05
T.Cho/HDL 3.3 0.6 4.2 0.6 P<0.001
Department of PSM, Madras Medical College & RI, Chennai

Table II : Mean Lipid Profile Value in Recent and Past Donors, Based on Age Group

  18 to 30 years 30-40 years 40-50 years
  Recent Past   Recent Past   Recent Past  
Total                  
Cholesterol 161.7 171.4 * 170.9 177.7 0 176.8 189.7 *
HDL 51.4 41.0 + 54.4 42.4 + 48.6 42.4 +
LDL 89.4 108.2 + 96.3 105.0 0 96.5 117.9 *
VLDL 20.9 22.2 0 20.3 30.3 * 31.7 29.32 0
Triglycerides 104.9 111.0 0 101.3 151.3 * 158.3 146.6 0
T.Cho/HDL 3.2 4.2 + 3.2 4.2 + 3.7 4.5 +
  * = P < 0.05, (+ = P<0.01), 0 = P>0.05

differences with the recent donors showing statistically significant lower mean values of Total cholestrol, LDL, & Total Cho/HDL ratio and a higher mean HDL. (Table I). Stratified analysis by classifying into age groups revealed among the recent donors a statistically significant higher mean value of HDL [p<0.001] for all the age group & a lower T. Cho/ HDL for all the age groups. Further in the 18-30 yrs age group a difference was found with the recent donors having a lower mean Total.Cho and LDL. In the 30-40 yrs class the recent donors showed a lower mean of Triglycerides and VLDL as compared to the past donors (Table II) The comparison between smokers and non smokers separately in the recent and past donors showed an important difference only in the HDL value among the past donors, with the non smokers showing a statistically significant higher HDL. No any difference was found among the recent donors. All the other values showed no difference.

Discussion

It was found that majority of donors belonged to the < 30 years age group i.e. younger generation. This is in conformity with the fact that the younger generation plays a major role in the blood transfusion services. Considering the major risk factors for coronary heart diesase it was found that none of the donors were hypertensive or diabetic. This may be attributed to the donor selection criteria. Also their lipid profiles were in the normal range. The blood donors appear to be a protected group with a reduced risk of CAD as has been substantial by various past studies9-10. The reasons for this reduction was attributed to the "iron hypothesis" which proposed that the reduction in the iron load with each blood donation was the reason for the fall in incidence of cardiovascular problems. This has since been disproved by other studies11. Further studies have borne out that blood donation may be beneficial by increasing the serum HDL concentration12 & also that it may be considered a treatment modality for hypercholesterolemia13. The Meyers study revealed that the benefit of blood donation was limited to the male donors who had donated blood in the most recent last 3 years6.

The results of this study showed that lipid profile had a significantly healthier pattern among the recent donors as compared to the past donors. Also the stratified analysis showed a statistically significant difference in mean HDL and T.Cho/HDL values in all the age group and since these are the two factors of prime importance in the primary prevention goal of CHD14, it can be said that the recent donors had a significantly greater protective effect against CHD than the past donors though both the groups had lipid profile range within the normal limits.

The comparison between smokers and non smokers showing a statistically significant difference only in HDL among the past donors and no other difference in any of the other parameters in the recent donors may imply that there is some amount of negation of the harmful effect of smoking at least up to 1 year from the date of blood donation.

In conclusion it might be said that blood donors are as a whole a protected group against CHD but there seems to be a reduction in benefit of blood donation as the duration from the date of last donation increase which agrees with the Meyers study. The recommendation that can be offered at this juncture is that the male blood donors would probably benefit more if they donate frequently i.e. at least once a year. This study also opens up further avenues for research in a prospective manner for more definitive results.

Acknowledgements

My sincere thank to Dr. V. Piruthivi, Dr. R. Murali and Dr. B.W.C. Sathiyasekaran for their encouragement and guidance. Also my heartfelt gratitude to the Professor and staff, Deptt. of Biochemistry, Madras Medical College & RI for their kind support.

References

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  12. Henretha van jaarsweld, Beneficial effects of blood donation on high density lipoprotein concentration and the oxidative potential of low density lipoprotein. Journal of atherosclerosis 2002;161:395-402.
  13. Chatterjee C, Repeated blood donations effective in treating hypercholesterolemia, Indian association of Physicians, Jun 1994.
  14. An evidence based assessment of national cholesterol education programme (NCEP). Adult treatment guidelines JAMA 1999;282:2015-57.
Department of PSM, Madras Medical College & RI, Chennai
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