The inconspicuous health benefit of blood donation

Alhaji Bukar; Erhabor Amos Tosan; Osita Simon Obi; Ajibola Sikiru Akinola; Gimba Waziri; Medugu Jessy Thomas; Aghatise Kevin; Christy Chinyere Fredrick; Osareniro Eguagie Osakue; Geogina Erifeta; Humphrey B Osadolor; Mathew Folaranmi Olaniyan

doi:10.4103/GJTM.GJTM_14_20

ORIGINAL ARTICLE

Year : 2020 | Volume : 5 | 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

Correspondence Address:
Alhaji Bukar
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

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/GJTM.GJTM_14_20

Abstract

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 2023 Mar 21];5:63-7. Available from: https://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.^[1] 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).^[2],[3] 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.^[4],[5] 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.^[6],[7],[8] 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.^[9] 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.^{[9],[10],[11],[12]} Moderate iron deficiency tends to reduce heart disease risk and increased body iron has been associated with a risk factor for myocardial infarction.^[13],[14] Blood donation also correlates with decrease in body mass index.^[15],[16] 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.^{[16],[17],[18],[19],[20]}

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.^[21] Blood donation also lowers blood viscosity, thereby thinning the blood, which in turn reduces the workload on the heart.^[22] 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.^{[23],[24],[25]} 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%.^{[26],[27],[28]}

Aims and objectives

Blood or plasma donations have a direct effect on plasma protein concentration, including plasma viscosity and lipid profile;^{[22],[29],[30]} 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.^[31],[32] 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).^[32] LDL-C was calculated using the Friedewald equation.^[33]

Statistics

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.

Ethics

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 3^rd day postdonation, with insignificant changes in the parameters between predonation and 1-h postdonation and as well between 9^th day and 12^th day postdonation, respectively.

Table 1: Mean hematocrit of 202 male donors with time after donation

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Table 2: Lipid profile before and up to 12 days after phlebotomy

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Figure 1: (a-f) Concentration of lipid profiles (mmol/l) versus postdonation time (days)

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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.^[34] 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.^[35] 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

Nil.

Conflicts of interest

There are no conflicts of interest.

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