|Year : 2020 | Volume
| Issue : 1 | Page : 63-67
The inconspicuous health benefit of blood donation
Alhaji Bukar1, Erhabor Amos Tosan2, Osita Simon Obi3, Ajibola Sikiru Akinola4, Gimba Waziri3, Medugu Jessy Thomas3, Aghatise Kevin5, Christy Chinyere Fredrick5, Osareniro Eguagie Osakue5, Geogina Erifeta5, Humphrey B Osadolor5, Mathew Folaranmi Olaniyan5
1 Department of Haematology and Transfusion Services, University of Maiduguri Teaching Hospital, PMB 1414; Dreams Digital Diagnostic and Clinical Services, Lagos street, Unimaid, Maiduguri, Borno, Maiduguri, Nigeria
2 Laboratory Services Department, Medical Laboratory Science Council of Nigeria, Abuja, Nigeria
3 Department of Haematology and Transfusion Services, University of Maiduguri Teaching Hospital, PMB 1414, Maiduguri, Borno, Nigeria
4 Department of Medical Laboratory Science, Ministry of Health, Ibadan, Oyo State, Nigeria
5 Department of Medical Laboratory Science, School of Postgraduate Studies and Research, Igbinedion University Okada, PMB 001, Benin City, Edo State, Nigeria
|Date of Submission||16-Feb-2020|
|Date of Decision||04-Mar-2020|
|Date of Acceptance||19-Mar-2020|
|Date of Web Publication||17-Apr-2020|
Department of Haematology and Transfusion Services, University of Maiduguri Teaching Hospital, PMB 1414; Dreams Digital Diagnostic and Clinical Services, Lagos street, Unimaid, Maiduguri, Borno, Maiduguri
Source of Support: None, Conflict of Interest: None
Background and Objectives: Regular blood donations seem to be beneficial to the health of donors in many ways. There is evidence to suggest that blood donation lowers blood viscosity and alters lipid profile, which is an acceptable parameter for assessing the risk of coronary heart disease. The objective of this study was to assess the pattern in changes of lipid profiles and hematocrit due to blood donation. Methods: This was a cross-sectional study, which comprises 289 apparently healthy male blood donors who were recruited as family replacement and nonvoluntary donors. Those who were ineligible for donation were excluded. Fasting venous blood samples were collected serially before phlebotomy, 1 h, 3 days, 6 days, 9 days, and 12 days after phlebotomy. Lipid profile and hematocrit were estimated appropriately. Results: The mean hematocrit, total cholesterol (T-Chol), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-Chol (HDL-C), very low-density lipoprotein-cholesterol (VLDL-C), and triglycerides before donations were 32 ± 8 years, 0.46 ± 0.05, 5.04 ± 0.81 mmol/l 2.93 ± 0.56 mmol/l 1.35 ± 0.24 mmol/l, 0.76 ± 0.14 mmol/l, and 1.65 ± 0.29 mmol/l, respectively. Postdonation results indicated an increased in HDL-C and decreased in all the remaining parameters with time. There are statistically significant differences between the levels of the HDL-C (P < 0.001), T-Chol: HDL ratio (P < 0.001), LDL-C (P < 0.001), and T-Chol (P < 0.001) before and at 12 days after blood donations. There was also a decrease in VLDL-C (P = 0.061), triglyceride (P = 0.092), and hematocrit values (P = 0.056), which was not statistically significant. Conclusion: These findings indicated that blood donation may be beneficial to donors, on the short term, since there is decreasing serum T-Chol, LDL-C, VLDL-C, and triglycerides and increasing serum HDL-C concentration. Long-term effects need to be determined in this cohort of donors.
Keywords: Hematocrit, high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides, very low-density lipoprotein
|How to cite this article:|
Bukar A, Tosan EA, Obi OS, Akinola AS, Waziri G, Thomas MJ, Kevin A, Fredrick CC, Osakue OE, Erifeta G, Osadolor HB, Olaniyan MF. The inconspicuous health benefit of blood donation. Glob J Transfus Med 2020;5:63-7
|How to cite this URL:|
Bukar A, Tosan EA, Obi OS, Akinola AS, Waziri G, Thomas MJ, Kevin A, Fredrick CC, Osakue OE, Erifeta G, Osadolor HB, Olaniyan MF. The inconspicuous health benefit of blood donation. Glob J Transfus Med [serial online] 2020 [cited 2020 Aug 9];5:63-7. Available from: http://www.gjtmonline.com/text.asp?2020/5/1/63/282753
| Introduction|| |
Despite all advances in transfusion medicine, there is still no effective and efficient man-made blood substitute for human blood. That is why blood donation and transfusion remain an important modality for the treatment of anemia. Blood donations ought to be voluntary in all circumstances. Blood donation involves the process in which blood is voluntarily withdrawn from a person for transfusion into another person or for further processing and/or made into biopharmaceutical medications by a process called fractionation. Donation may be of whole blood (WB) or of specific components. Donors can also have blood drawn for their own future use (autologous donation). Blood donation is a relatively safe procedure, but some donors may experience bruising at venepuncture site or may feel faint. Lipid profiles, also known as coronary risk panel, are a group of tests that are used to determine risk of coronary artery disease; these include cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), very low-density lipoprotein-cholesterol (VLDL-C), and low-density lipoprotein-cholesterol (LDL-C)., Elevated serum lipids are a risk factor for cardiovascular disease. Regular blood donation tends to benefit the donor by lowering the risk of cardiovascular disease., Thus,blood donation may lower the risk of heart disease and heart attack. This is because it reduces the blood's lipid profile and viscosity.,, Blood donation also helps reduce the chances of accumulating body iron. Each unit of blood contains about 250 mg of iron, excess iron is linked to heart disease, but there is no mechanism for the excretion of iron except through the loss of epithelial cells or through blood loss. Bloodletting is, therefore, a means by which excess body iron may be regulated without the use of medication. Due to loss of blood by women of child-bearing age, this category of women may have half the iron stores and so suffer about half the heart attacks and deaths from heart disease as men of same age range.,,, Moderate iron deficiency tends to reduce heart disease risk and increased body iron has been associated with a risk factor for myocardial infarction., Blood donation also correlates with decrease in body mass index., History shows that the frequency of blood donation is inversely correlated to the level of hemoglobin concentration, hematocrit, and iron status and directly correlated with total iron-binding capacity. Repeated blood donations also reduce iron levels.,,,,
Blood donation is usually followed by reduction in blood pressure. However, blood volume and pressure were restored with time. Most studies on blood donors' lipid and packed cell volume profiles were cross-sectional. Therefore, there is a need to ascertain the pattern of progression and/or retrogression of the profiles longitudinally even though it is same single blood donation. This will state the pattern of changes over the period of the time. Regular blood donation is believed to help maintain blood bank stock which in turn maintains maximum utilization of donated WB. Maximal utilization of donated blood can be achieved by bottom and top or buffy coat blood processing methods which provides minimal wastage of component and reduced transmitted transfusion infection. Blood donation also lowers blood viscosity, thereby thinning the blood, which in turn reduces the workload on the heart. The general view is that blood donation may contribute in lowering the amounts of LDL and other lipids in the blood, thereby decreasing the likelihood of atherosclerosis and other cardiovascular events, such as angina or a heart attack or myocardial infarction.,, The study led by David Meyers, at the University of Kansas Medical Centre, USA, suggested that men who donate blood may lower their risk of heart attack and other cardiac illness by about 30%.,,
Aims and objectives
Blood or plasma donations have a direct effect on plasma protein concentration, including plasma viscosity and lipid profile;,, however, there is a paucity of reports on the effect of blood donation on plasma lipid profile in this environment. This study therefore aims to assess the effect of blood donation on lipid profile.
| Methods|| |
This study included 289 apparently healthy male blood donors attending the Lemunnom Specialist Health Centre and Wurno Maternity Clinic, as voluntary or family replacement blood donors, who did not smoke or take alcohol. All the donors passed the minimum criteria for blood donation., Five blood samples from each of the blood donors were collected serially, before phlebotomy, at 1 h, 3 days, 6 days, 9 days. and 12 days after phlebotomy. For each test, 10 milliliters venous fasting blood sample (exception of 1 h postdonation) was collected, 5 ml dispensed into lithium heparin bottles and 5 ml into ethylenediaminetetraacetic acid (EDTA) bottles, respectively. Plasma from lithium heparin was harvested and the lipid profile (VLDL-C high-density lipoprotein [HDL-C], triglycerides, and total cholesterol [T-Chol]) was analyzed, respectively, using fully automated Rx Daytona Chemistry analyser, Crumlin, Ulster, UK. Hematocrit was estimated manually from the EDTA sample using Hawksley Haematocrit centrifuge (Sussex, England, UK). LDL-C was calculated using the Friedewald equation.
Data were analyzed using SPSS 20.0 (2011, Illinois, Chicago, USA). Parameters were recorded as mean ± standard deviation. The difference between means was considered statistically significant when P ≤ 0.05.
Informed consent was obtained from 289 apparently healthy male blood donors who participated in the study. This study has been cleared by state institution.
| Results|| |
The mean age of the 202 donors who completed the study was 32 ± 8 years. The mean hematocrit values were recorded as shown in [Table 1]. [Table 2] shows the mean lipid profile before and after phlebotomy. [Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d, [Figure 1]e, [Figure 1]f shows the trends of the lipid profile against time. These curves reveal an increase or decrease in the level of lipids with time after donation. The concentrations of triglycerides (P = 0.092), VLDL-C (P = 0.061), LDL-C (P < 0.0001), T-Chol (P < 0.0001) and the ratio of T-Chol to HDL-C (P < 0.0001) declined, respectively, after donation, while the levels of HDL-C; P < 0.0001) increased after phlebotomy. As expected, the hematocrit (P = 0.056) declined insignificantly after donations [Table 1]. Overall, the changes in parameters are more pronounced on the 3rd day postdonation, with insignificant changes in the parameters between predonation and 1-h postdonation and as well between 9th day and 12th day postdonation, respectively.
|Figure 1: (a-f) Concentration of lipid profiles (mmol/l) versus postdonation time (days)|
Click here to view
| Discussion|| |
Transfusion medicine has emerged as a distinct subspecialty of clinical medicine. Coronary heart disease (CHD) is characterized by an inadequate supply of oxygen-rich blood to the heart muscle because of narrowing or blocking of the artery by lipid components. All the subjects recruited into this study were screened for risk factors of coronary artery disease, including hypertension, diabetes mellitus, and smoking before being selected. Previous studies have shown that blood donation confers many benefits, including lowering of lipids, thereby decreasing formation of atherosclerosis and ultimately decreasing the risk of coronary artery disease. The adult treatment guidelines indicate that the level of HDL-C and the ratio of T-Chol to HDL-C are the two parameters of major concern in the primary prevention of CHD. This study suggests that blood donation results in modification of the lipid profile of donors in favor of decreasing risk of coronary artery disease. The level of HDL-C, a good cholesterol, was shown to increase progressively postdonation. This finding resembles earlier work which demonstrated decreasing ratio of T-Chol: HDL-C. Several researchers asserted a potential benefit by regularly donating blood. However, most researcher study design was cross-sectional. Rather than cross-sectional, our study's design was longitudinal one. However, beside blood donation other contributing factor for CHD in relation to lipid profile is poor diet. Imbalance diet in favor of bad lipid is a contributing factor. In this research, from verbal interactions, it was found that feeding habit is another factor to be considered in correcting the lipid profiles to minimize the chances of CHD. In fact, most of the donors asserted that they do change their diet from the routine food and crave more for meat, cow milk fat and assorted drinks after donating blood. In our community, many households drink cattle derived milk-fat which is saturated fat. It is not a dispute that blood donation affects the lipid profiles of a donor positively; however, counseling on adequate diet is paramount if not the best in controlling the lipid profile which in turn reduces the risk of CHD. Blood donation also depletes excess iron from the body; hence, it is as important as the dietary control of lipid profile. As people find it difficult to control diet by regulating the ingesting of excess meat and saturated-fat, blood donation may be an important modality in controlling lipid profile and related imbalance of diet. However, adequate diet remains one of the major factors in regulating lipid profile to minimize the risk of CHD.
| Conclusion|| |
This study showed that the lipid profile of donors changed after donation resulting in an increase in HDL-C and a decrease in Chol: HDL ratio, low-density lipoprotein on the short term. The clinical implications of these observations in respect to the risk of coronary artery disease needs further studies in this cohort of donors.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Eder AF, Hillyer CD, Dy BA, Notari EP 4th
, Benjamin RJ. Adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds. JAMA 2008;299:2279-86.
Avram MM, Blaustein DA. Causes, risks and therapy of hyperlipidemia in chronic dialysis patients. Seminars in Dialysis. Vol. 10. Oxford, UK: Blackwell Publishing Ltd.; 1997 p. 267-71.
Puntmann VO. How-to guide on biomarkers: Biomarker definitions, validation and applications with examples from cardiovascular disease. Postgrad Med J 2009;85:538-45.
Bharadwaj RS. A study of lipid profiles among male voluntary blood donors in Chennai city. Indian J Community Med 2005;30:16-7. [Full text]
Sloop GD. Possible association of a reduction in cardiovascular events with blood donation. Heart 1998;79:422.
Rusdiah W, Muhiddin R, Arif M. Lipid profile analysis on regular and non-regular blood donors (analisis profil lipid di pendonor darahreguler dan non-reguler). Indones J Clin Pathol Med Lab 2018;23:27-30.
Uche E, Adediran A, Damulak O, Adeyemo T, Akinbami A, Akanmu A. Lipid profile of regular blood donors. J Blood Med 2013;4:39-42.
Meyers DG, Strickland D, Maloley PA, Seburg JK, Wilson JE, McManus BF. Possible association of a reduction in cardiovascular events with blood donation. Heart 1997;78:188-93.
Ramakrishna G, Rooke TW, Cooper LT. Iron and peripheral arterial disease: Revisiting the iron hypothesis in a different light. Vasc Med 2003;8:203-10.
Sullivan JL. Are menstruating women protected from heart disease because of, or in spite of, estrogen? Relevance to the iron hypothesis. Am Heart J 2003;145:190-4.
Yuan XM, Li W. The iron hypothesis of atherosclerosis and its clinical impact. Ann Med 2003;35:578-91.
Tuomainen TP, Salonen R, Nyyssönen K, Salonen JT. Cohort study of relation between donating blood and risk of myocardial infarction in 2682 men in Eastern Finland. BMJ 1997;314:793-4.
Salonen JT, Nyyssönen K, Korpela H, Tuomilehto J, Seppänen R, Salonen R. High stored iron levels are associated with excess risk of myocardial infarction in Eastern Finnish men. Circulation 1992;86:803-11.
Adias TC, Igwilo AC, Jeremiah ZA. Repeat whole blood donation correlates significantly with reductions in BMI and lipid profiles and increased gamma glutamic transferase (GGT) activity among Nigerian blood donors. Open J Blood Dis 2012;2:90-4.
Szymczyk-Nuzka M, Wołowiec D. Iron stores in regular blood donors. Pol Arch Med Wewn 2003;110:1415-21.
Djalali M, Neyestani TR, Bateni J, Siassi F. The effect of repeated blood donations on the iron status of Iranian blood donors attending the Iranian blood transfusion organization. Int J Vitam Nutr Res 2006;76:132-7.
Mahida VI, Bhatti A, Gupte SC. Iron status of regular voluntary blood donors. Asian J Transfus Sci 2008;2:9-12.
] [Full text]
Mittal R, Marwaha N, Basu S, Mohan H, Ravi Kumar A. Evaluation of iron stores in blood donors by serum ferritin. Indian J Med Res 2006;124:641-6.
] [Full text]
Norashikin J, Roshan TM, Rosline H, Zaidah AW, Suhair AA, Rapiaah M. A study of serum ferritin levels among male blood donors in Hospital Universiti Sains Malaysia. Southeast Asian J Trop Med Public Health 2006;37:370-3.
Alhaji B, Awharentomah DK, Osita OS, Thomus MJ, Gimba W, Isah LA, et al
. Strategy of blood component production for transfusion: The best method for developing countries. Sokoto J Med Lab Sci 2017;2:64-72.
Bukar A, Ajayi OI, Obi S, Olaniyam MF, Abba A, Aladenika S (2016. Effects of blood donations on haemorheology: A study on blood donors in wurno maternity clinic, Babaldu 2016. Sokoto J Med Lab Sci. 2016;1:152-155.
Ascherio A, Rimm EB, Giovannucci E, Willett WC, Stampfer MJ. Blood donations and risk of coronary heart disease in men. Circulation 2001;103:52-7.
Gebre-Yohannes A, Rahlenbeck SI. Coronary heart disease risk factors among blood donors in northwest Ethiopia. East Afr Med J 1998;75:495-500.
Salonen JT, Tuomainen TP, Salonen R, Lakka TA, Nyyssönen K. Donation of blood is associated with reduced risk of myocardial infarction. The kuopio ischaemic heart disease risk factor study. Am J Epidemiol 1998;148:445-51.
Choudhury D, Tuncel M, Levi M. Disorders of lipid metabolism and chronic kidney disease in the elderly. Semin Nephrol 2009;29:610-20.0.
Pedro-Botet J, Sentí M, Nogués X, Rubiés-Prat J, Roquer J, D'Olhaberriague L, et al
. Lipoprotein and apolipoprotein profile in men with ischemic stroke. Role of lipoprotein (a), triglyceride-rich lipoproteins, and apolipoprotein E polymorphism. Stroke 1992;23:1556-62.
Sentí M, Romero R, Pedro-Botet J, Pelegrí A, Nogués X, Rubiés-Prat J. Lipoprotein abnormalities in hyperlipidemic and normolipidemic men on hemodialysis with chronic renal failure. Kidney Int 1992;41:1394-9.
Duda K, Majerczak J, Zoładź JA, Kulpa J, Rychlik U, Duda JP, et al
. Effect of blood withdrawal on changes in plasma volume and protein concentration during incremental cycling exercise in men. Przegl Lek 2003;60:726-31.
Lewis SL, Kutvirt SG, Bonner PN, Simon TL. Plasma proteins and lymphocyte phenotypes in long-term plasma donors. Transfusion 1994;34:578-85.
Daniel C, Edward GD. Criteria for donor selection. In: Post Graduate Haematology. 5th
ed. Oxford OX4 2DQ, UK: Blackwell Publishing Ltd.; 2005. p. 249-76.
Gómez-Simón A, Navarro-Núñez L, Pérez-Ceballos E, Lozano ML, Candela MJ, Cascales A, et al
. Evaluation of four rapid methods for hemoglobin screening of whole blood donors in mobile collection settings. Transfus Apher Sci 2007;36:235-42.
Bain BJ, Lewis SM, Bates I. Basic haematological techniques. Dacie and Lewis practical haematology. 10th
Ed, 2006;4:19-46. Churchill Livingstone Publication.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499-502.
van Jaarsveld H, Pool GF. Beneficial effects of blood donation on high density lipoprotein concentration and the oxidative potential of low density lipoprotein. Atherosclerosis 2002;161:395-402.
Sullivan JL. Iron and the sex difference in heart disease risk. Lancet 1981;1:1293-4.
[Table 1], [Table 2]