Secretor status of blood group antigens in saliva is implicated to be associated with several infectious and immune related diseases. Prospective analytical study carried out in a tertiary hospital in South India to study the association of ABO secretor status with type II diabetes mellitus and its microangiopathic complications. A total of 198 patients with type II diabetes mellitus, diagnosed and treated in the hospital were studied. 200 healthy controls were studied from healthy volunteers working in the hospital. ANOVA, Pearson's Chi Square Test and Cox Univariate and Multivariate analysis are the statistical methods used to analyse the data. 21.2% of diabetics and 33.5% of healthy controls were ABO secretors. Secretors were found to have a statistically significant risk of association with type II diabetes mellitus when adjusted for other potential confounding factors. Secretor status was in addition found to have significant association with hypertension. Non-secretors were significantly associated with increasing age of the patient and had increased risk of urinary tract infections (UTI). The risk of microangiopathic complications due to type II diabetes mellitus were significantly higher with increasing levels of glycated haemoglobin (HbA1c). In our study, we found significant association of secretors with type II diabetes mellitus and hypertension while non-secretors were associated with increased risk of urinary tract infections.

Keywords: Secretor status, Type II diabetes mellitus, Hypertension, UTI, microangiopathic Complications.

1. Prakobphol A, Leffler H, Fisher SJ. The high molecular-weight human mucin is the primary salivary carrier of ABH, Le(a), and Le(b) blood group antigens. Crit Rev Oral Biol Med 1993;4:325-333.
2. Metgud R, Khajuria N, Mamta GR. Evaluation of the Secretor Status of ABO Blood Group Antigens in Saliva among Southern Rajasthan Population Using Absorption Inhibition Method. Journal of clinical and diagnostic research 2016;10:ZC01-ZC03
3. Albertolle ME, Hassis ME, Ng CJ, Cuison S, Williams K, Prakobphol A, et al. Mass spectrometry based analyses showing the effects of secretor and blood group status on salivary N-glycosylation. Clinical Proteomics 2015;12:1-16
4. Patrick AW, Collier A: An infectious aetiology of insulin-dependent diabetes mellitus? Role of the secretor status. FEMS Microbiol Immunol 1989;1:411-416.
5. D'Adamo PJ, Kelly GS. Metabolic and immunologic consequences of ABH secretor and Lewis subtype status, Alternative Medicine Review 2001;6 (4):395.
6. Suadicani P, Hein HO, Gyntelberg F: Genetic and life-style determinants of peptic ulcer. A study of 3,387 men aged 54 to 74 years: The Copenhagen Male Study. Scand J Gastroenterol 1999;34:12-17.
7. Kulkarni DG, Venkatesh D: Non-secretor status; a predisposing factor for vaginal candidiasis. Indian J Physiol Pharmacol 2004;48:225-229.
8. Lomberg H, Jodal U, Leffler H, De Man P, Svanborg C. Blood group non-secretors have an increased inflammatory response to urinary tract infection. Scand J Infect Dis. 1992;24:77-83
9. Yazawa S, Yokobori T, Ueta G, Ide M, Altan B, Thongprachum A, et al. Blood group substances as potential therapeutic agents for the prevention and treatment of infection with Noroviruses proving novel binding patterns in human tissues. PLoS ONE 2014;9: e89071.
10. Nasir W, Frank M, Koppisetty CAK, Larson G, Nyholm PG. Lewis histo blood group α1,3/ α1,4 fucose residues both mediate binding to GII.4 noroviruses. Glycobiology 2012;22:1163-1172.
11. Trang NV, Vu TH, Le NT, Huang P, Jiang X, Anh DD. Association between Norovirus and Rotavirus infection adnHisto-blood group antigen types in Vietnamese Children. Journal of Clinical Microbiology 2014;52:1366-1374.
12. Wacklin P, Tuimala J, Nikkila J, TIms S, Makivuokko H, Alakulppi N, et al. Fecal Microbiota composition in adults is associated with FUT2 gene determining the secretor status. PloS one 2014;9: e94863.
13. Abd ST. Individual variations in secretory and group antigen. International Journal of Science and Nature 2015;6:447-451.
14. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH. Manual of Clinical Microbiology. 6th Edition. Washington, DC: ASM Press; 1995
15. Clinical and Laboratory Standards Institute (CLSI) (2016) Performance standards for antimicrobial susceptibility testing; twenty-sixth informational supplement. CLSI document M100-S21. The Institute, Wayne (PA)
16. McGovern DP, Jones MR, Taylor KD, Marciante K, Yan X, Dubinsky M, et al. Fucosyltransferase 2 (FUT2) non-secretor status is associated with Crohn's disease. Human molecular genetics.2010 Jun 22;19:3468-76
17. Blackwell CC, Weir DM, Patrick AW, et al. Secretor state and complement levels (C3 andC4) in insulin dependent diabetes mellitus. Diabetes Res 1988;9:117-119
18. Peters WH, Gohler W. ABH-secretion and Lewis red cell groups in diabetic and Normal subjects from Ethiopia. ExpClin Endocrinol 1986;88:64-70.
19. Saboor M, Ullah A, Qamar K, Mir A. Frequency of ABH secretors and non secretors: A cross sectional study in Karachi. Pakistan journal of medical sciences 2014;30:189.
20. Mottram L, Gudrun G, Larson G, Qadri F, Svennerholm AM. FUT2 non-secretor status is associated with altered susceptibility to symptomatic enterotoxigenic Escherichia coli infection in Bangladeshis. Scientific reports 2017;7: 10649.
21. Smyth DJ, Cooper JD, Howson JMM, Clarke P, Downes K, Mistry T, et al. FUT2 non secretor status links type I diabetes susceptibility and resistance to infection. Diabetes 2011;60:3081-3084.
22. Gomez-Arango LF, Barrett HL, Mcintyre D, Callaway LK, Morrison M, Nitert MD. Increased systolic and diastolic blood pressure is associated with altered gut microbiota composition and butyrate production in early pregnancy. Hypertension 2016;68:974-981.
23. Ishitoya S, Yamamoto S, Mitsumori K, Ogawa O, Terai A. Non secretor status is associated with female acute uncomplicated pyelonephritis. British Journal of Urology International 2002;89:851-854.
24. Sheinfeld J, Schaeffer AJ, Cordon-Cardo C, Rogatko A, et al. Association of the Lewis blood-group phenotype with recurrent urinary tract infections in women. N Engl J Med 1989;320:773–777.
25. J, Yang W, Fang N, Zhu W, Wei M. The association between intensive glycemic control and vascular complications in type 2 diabetes mellitus: A meta-analysis. Nutrition, Metabolism and Cardiovascular diseases 2009;19:596-603.
26. Chen P, Ong RT-H, Tay W-T, Sim X, Ali M, et al. A Study Assessing the association of Glycated Hemoglobin A1C (HbA1C) Associated Variants with HbA1C, Chronic Kidney Disease and Diabetic Retinopathy in Populations of Asian Ancestry. PLoS ONE 2013;8: e79767.
27. Jaff MS. Higher frequency of secretor phenotype in O blood group–its benefits in prevention and/or treatment of some diseases. International journal of nanomedicine. 2010;5:901.

Dr Rajesh Nachiappa Ganesh

Additional Professor, Department of Pathology, JIPMER, Puducherry – 605006, India

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