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CHEM 4060U Lecture Notes - Abo Blood Group System, Pernicious Anemia, Serum Iron

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CHEM 4060U

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1 Physiology Department College of Medicine University of Nigeria, Enugu Campus Enugu, Nigeria
School of Medical Laboratory Sciences, University of Nigeria Teaching Hospital Enugu. Nigeria
*E-mail: waltercares 007 @
Summary: Iron deficiency anaemia is a common tropical disease. Iron plays a very important role in
the human body. The understanding of the different blood groups ability to retain iron in their system
can give an insight into their ability to handle the disease Iron deficiency anaemia. Serum Iron, Total
Iron Binding Capacity (TIBC) and Percentage Transferrin Saturation (%TS) levels were studied in
2260 apparently healthy Nigerian volunteers in Enugu, Eastern Nigeria. The ABO blood groups of the
subjects were also determined. They were aged between 10 and 25 years, males were 1808 and females
452 (M/F ratio- 8:2).In all the results obtained, the females had lower values. Serum iron (micromol/L)
was highest in the group A (26.3 7.2 - males, 18.7 5.2 -females) and lowest in group 0 (22.0 4.7 -
males, 15.6 4.5 - females). Groups B and AB had values of 23.0 5.2 (males) 16.3 3.2 (females)
and 23.3 3.8 (males), 16.5 6.8 (females) respectively. The TIBC value (micromol/L) was highest in
group A (60.2 9.0 - males, 42.7 6.0 - females) and lowest in group 0 (51.8 0 14.2 - males, 36.8
12.2 - females), while the values for groups B and AB were 54.7 7.5 (males), 38.8 2.5 (females)
and 54.4 4.8 (males), 38.6 3.8 (females) respectively. The percent TS was highest in the group A
(43.7 2.0 - males, 31.0 1.0 - females) and lowest in those of B (42.0 1.4 - males, 29 0.4 -
females) while groups AB and 0 had values of 42.8 1.0 (males), 30.4 3.0 (females) and 42.5 1.9
(males), 30.2 4.8 (females) respectively. There were significant differences between the intra group
comparisons of the results of groups A and O only in the serum iron and TIBC parameters. No
significant differences were observed in the percentage TS among the different blood groups. The
values obtained for the percentage distribution of the different blood groups agrees with already
established values for the population. Since the values obtained for the parameters studied all fall
within the normal range, this work provides useful data on the environment of South Eastern Nigeria.
Key Words: Serum Iron. Total Iron Binding Capacity. ABO Blood Groups. Transferrin Saturation.
Iron is a very important requirement
for the formation of RBC. It forms a major
portion of Hb molecule, the oxygen carrying
pigment in the blood. It is required for Hb
synthesis. Iron liberated from old RBC is
normally retained and re-utilized. Body Iron
comes from both plant and animal sources.
The form of iron present in the body includes
ferrous (Fe 2+), ferric (Fe 3+), Hb,
Haemosiderin, Myoglobin, Ferritin and
Transferrin (Siderophilin). Iron is also
an important constituent of the enzyme
catalase, peroxidase and cytochrome C.
These are involved in cellular respiration.
Serum contains a small amount of iron 14-
32 mol/L (males) and 10-28 mol/L
(females) (Lee, 1993; Jandl, 1996) which is
bound to the globulin fraction of serum
proteins. The physical role of this protein-
bound iron is the transportation of iron in the
body. Low values of serum iron are found in
haemorrhagic and hypochromic types of
anaemia, while high values are found in
pernicious anaemia etc (Jandl, 1996).
Presence of iron in the body is estimated by the
determination of Serum Iron and Total Iron
Binding Capacity (TIBC) of blood, which is
the serum iron level when the iron transport
protein transferrin is completely saturated. The
levels of TIBC in serum has been determined
Nigerian Journal Of Physiological Sciences 21 (1-2):9-14© Physiological Society Of Nigeria, 2006

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as 45 72 mol/L (Jenkins and
Williams,1969 ;Lee,1993), the value
increasing in iron deficiency and in the last
trimester of pregnancy, while low values occur
in acute and chronic infections (Jenkins and
Williams, 1969 ;Lee, 1993).
The knowledge of blood grouping has
helped tremendously in alleviating the
complications hitherto associated with
transfusion reactions. Interest in blood group
research dates back to 1656, when Christopher
Wren injected fluids into the veins of dogs
(Ukaejiofor, 1996). The ABO blood group was
discovered in 1900 - 1901 by Karl Landsteiner
(Ukaejiofor, 1996).
Blood group distribution in Nigerians
(1gbo’s, Hausa’s and Yoruba’s) have been
documented and compared with those of the
British ((Ukaejiofor, 1996). There have
been many documented evidence associating
human blood groups with diseases. They
include the protective effect of blood group O
in rheumatic fever and its increased
predisposition to duodenal ulcers (Glyn and
Holborow,1969;Ukaejiofor, 1996) , increased
occurrence in group A of pernicious anaemia
(Ukaejiofor and Tagbo,1995) and Plasmodium
Vivax malaria (Gupta and Chowdhuri,1980)
etc. The present study was aimed at
determining the levels of Serum iron and TIBC
in different ABO blood group systems in our
environment, with a view of inferring from the
result the possibility of any tendency to iron
deficiency in any of the blood groups.
Materials and Methods
Subjects A total of two thousand two hundred
and sixty (2260) apparently healthy volunteers
were used for the study. The study was carried
out in Enugu, Eastern Nigeria. The subjects
were all Nigerians irrespective of tribe. They
were aged between 10 and 25years.Males were
1808 while the females were 452 (M/F ratio of
8:2). Using both physical sign (presence of
parlor) and laboratory result (Hb 10gm/dl -
males and Hb 8gm/dl - females) the subjects
who were anaemic were eliminated from the
study. ABO blood groups, Serum Iron and
TIBC levels of the subjects were determined.
Sample Collection
Under aseptic condition, 10mls of
venous blood was collected from each subject
by venepuncture using disposable pyrogen -
free needles and syringes (Becton Dickson.
Dublin, Ireland). The left antecubital vein was
used. The collected blood was put into a well
labeled acid-washed plastic test tube, allowed
to clot, centrifuged at a speed of 10,000
rotations per minute for 10 mins. The serum
obtained was decanted into another acid-
washed test tube. The serum and the RBCs
were stored at 40C until ready for analysis. The
samples were all collected between 11am and
11.05am to avoid variations (Hamilton et
al,1950; Delaney and Garratty, 1969;
Worlledge et al, 1974; Statland and Winkel,
Analytical Methods
The ABO blood groups were
determined using the standard method
described by Baker and Silverton (Baker and
Silveron, 1998). Serum iron estimation was
done using the method described by Persijin et
al, (1971).This same method was also used for
the determination of Unsaturated Iron Binding
Capacity (UIBC) from which TIBC and
percentage transferrin saturation were
computed. The % TS was derived from the
S1 x 100
Sigma iron and TIBC kit (Sigma Diagnostics,
St. Louis, USA) was used for the estimation.
Statistical Analysis
Results for the pooled data, the
different blood groups and for different sexes
were expressed as mean SD. In the intra
group analysis, results were expressed as mean
SEM and compared using one-way analysis
of variance (ANOVA). P values of 0.05
were considered to be statistically significant.
Results Table I, shows the raw data obtained
for the Serum iron, TIBC and percentage
transferrin saturation (% TS) in both the males
and the females. Table 2, shows the
approximate distribution of the different blood
group obtained in the study. Group 0 has the
highest value while Group AB is the lowest.
In Tables 3A and 3B, serum iron was
only significantly higher between groups A
and O in both the males and the females.
W. C. Nwafia et al
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