CC BY
25
journal of clinical medicine of Kazakhstan
Озык, Макала / Оригинальная Статья / Original Article DOI: 10.23950/1812-2892-JCMK-00427
Is having O blood type a risk factor for Fibromyalgia syndrome? The importance of nutrition in Fibromyalgia syndrome
Tuba Tulay Koca1, Filiz Ozdemir2, Rabia Baykara1
Abstract
Aim: Fibromyalgia syndrome (FS) is characterized with diffuse pain and sensitivity at specific anatomical points and occurs together with mood, sleep and cognitive disorders. Life quality of the patients was destroyed and this situation creates an important economical issue in the medical care system.
According to different antigens placed on the surface of red blood cells, there are four different blood type groups such as A, B, O and AB. To give nutritional recommendations for different blood types became one of the most popular topics in last decades. In this study, we investigated the link between FS and ABO blood types.
Methods: In this study, we included 200 female patients with FS diagnosis (according to American College of Rheumatology, 2010 criteria) who visited our Physical Medicine and Rehabilitation Clinic between July 2015 and December 2015. The patients' age, blood group, Rh antigen system were saved. Control group was also formed from 185 volunteer healthy female patients. P<0.05 was evaluated as statistically significant.
Results: In our study, age distribution of FS group (N=200) was 40.6±10.8 and for control group (N=185), it was 43.0±14.8. In the control group, 58 people was A type (%31,4), 29 people was B type (%15.7), 23 people was AB type (%12.4) and 75 people (40.5%) was O type blood group according to ABO classification system. In the FS group, 60 people was A type (%30), 21 people was B type (%10.5), 10 people was AB type (%5) and 109 people (54.5%) was O type blood group according to ABO classification system. In both groups, a statistically significant difference was observed (p=0.03). There were more O type blood group carrying patients were detected in FS group.
Conclusion: Most of the treatments used for FS are not effective. In order to decrease oxidative stress, weight management, nutritional condition, diet and nutrition supplement are important in these patients. To see more O type carrying people in FS group will guide us for etiopathogenesis, monitoring, clinical follow and treatment.
Keywords: fibromyalgia - ABO blood type -nutrition.
0 ЦАН ТОБЫ ФИБРОМИАЛГИЯ СИНДРОМЫНА ЦАТЕРЛ1 ФАКТОР БОЛЫП ТАБЫЛА МА? ФИБРОМИАЛГИЯ СИНДРОМЫ КЕ31НДЕГ1 ТАМАЦТАНУДЫЦ МАЦЫЗДЫЛЫГЫ
Tuba Tülay KOCA1, Filiz Özdemir2, Rabia Baykara1
1 Зерттеу-бтм беру клиникасы, Физиотерапия жэне оцалту, Малатья, Typkm
2 Инёню атындагы Университет, Физиотерапия жэне оцалту, Малатья, Typkm
Т¥ЖЫРЫМДАМА
Максаты: Фибромиалгия синдромы (Фс) белго анатомиялык HYктелердегi араласкан ауыру мен сез1мталдыкпен сипатталады жэне кецт-^йдщ, уйкыныц жэне таным кабтетЫщ бузылуымен пайда болады. Осындай пациенттердщ eмiр CYPУ сапасы бузылган жэне бул жагдай денсаулык сактау ЖYЙесiнде мацызды экономикалык проблема тудырады.
Эритроциттердщ бетЫе орналаскан эртYрлi антиденелерге сэйкес А, В, О жэне АВ сиякты кан топтарыныц эр TYрлерi бар. ^ан тобыныц эр TYрлерi Yшiн тамактану бойынша усыныстар беру соцгы онжылдыкта ец eзектi такырыптардыц бiрi болды. Осы зерттеуде 6í3 ФС мен АВО кан тобыныц TYрлерi арасындагы байланысты зерттедiк.
'Department of Physical Therapy and Rehabilitation, Research and Training Hospital, Malatya, Turkey 2Department of Physical Therapy and Rehabilitation, Inonu University, Malatya, Turkey
© ®
This work is licensed under a Creative Commons Attribution 4.0 International License
Received: 09-03-2017 Accepted: 28-03-2017 uDC:616.441-002 616.12-008-08/615.332
J Clin Med Kaz 2017; 1(43):20-23
Автор для корреспонденции: Tuba Tulay Koca, Malatya Research and Training Hospital, PMR Clinic, Turkey. +90 5063819295, tuba_baglan@yahoo.com
Эдютерк Осы зерттеуге 6Í3 200 пациентт - ФС-мен эйелдердi кiргiздiк (Американдык ревматология колледжЫщ 2010 жылгы елшемдерЫе сэйкес), ол эйелдер бiздiц физикалык медицина жэне оцалту клиникамызга 2015 жылгы шiлде мен желтоксан аралшында келдi. Пациенттщ жасы, кан тобы, резус-антигенi ЖYЙесi сакталды. Бакылау тобы сондай-ак 185 денi сау, еркт эйелдерден куралды. P<0.05 статистикалык мэндi керсеткiш ретiнде багаланды.
Нэтижелерi: БЬдщ зерттеуде ФС тобын жасына карай Yйлестiру 40.6±10.8 жас болды, ал бакылау тобына (N=185) 43.0±14.8 жасты курады. Бакылау тобында 58 адам А кан тобымен болды (%31,4), 29 адам - В (%15.7), 23 адам - АВ (%12.4) жэне 75 адам О кан тобымен (40.5%), АВО жiктеу ЖYЙесiне байланысты. ФС тобында 60 адам А кан тобымен (%30), 21 адам - В (%10.5), 10 адам - АВ (%5) жэне АВО жктеу ЖYЙесiне байланысты 109 адам (54,5%) О кан тобымен. Ею топта да статистикалык айырма (р=0,03) байкалады. ФС тобында О кан тобымен пациенттер аса кеп аныкталды.
Корытынды: ФС-га арналып колданылган емдеудщ кептеген тэсiлдерi тиiмдi емес. ^ышкылдандыратын стрестi темендету Yшiн бул пациенттерге мацызды: салмакты TYзету, диетарлык мэртебесi, диеталык жэне кунарлы коспалар. ФС тобындагы О кан тобымен пациенттердщ кебi бiздi этиопатогенезге, мониторингтеуге, клиникалык бакылауга жэне емделуге жолдайды.
Мацызды сездер: фибромиалгия - ABO кан тобыныц TYрi - тамактану.
является ли группа крови о фактором риска для синдрома фибромиалгии? значимость питания при синдроме фибромиалгии
Tuba Tülay KOCA1, Filiz Özdemir2, Rabia Baykara1
]Исследовательско-образовательнпя клиника, Физиотерапия и реабилитация, Малатья, Турция 2Университет имени Инёню, Физиотерапия и реабилитация, Малатья, Турция
РЕЗЮМЕ
Цель: Синдром фибромиалгии (СФ) характеризуется диффузной болью и чувствительностью в определенных анатомических точках и появляется вместе с расстройствами настроения, сна и познавательной способности. Качество жизни таких пациентов было испорчено и эта ситуация создает важную экономическую проблему в системе здравоохранения.
В соответствии с различными антигенами, размещенными на поверхности эритроцитов, существует четыре разных типа группы крови, такие как A, B, O и AB. Дать рекомендации по питанию для различных типов группы крови стало одной из самых актуальных тем в последние десятилетия. В настоящем исследовании мы изучили связь между СФ и типами группы крови ABO.
Методы: В настоящее исследование мы включили 200 пациентов, женщин с диагнозом СФ (в соответствии с критериями Американского колледжа ревматологии 2010), которые обратились в нашу клинику физической медицины и реабилитации в период с июля по декабрь 2015 года. Система возраста, группы крови, резус-антигена пациента были сохранены. Контрольная группа также была сформирована из 185 здоровых женщин добровольцев. P<0.05 был оценен как статистически значимый показатель.
Результаты: В нашем исследовании, возрастное распределение группы СФ (N=200) было 40.6±10.8 лет, а для контрольной группы (N=185), составило 43.0±14.8 лет. В контрольной группе, 58 человек было с группой крови A (%31,4), 29 человек - B (%15.7), 23 человека - AB (%12.4) и 75 человек (40.5%) с группой крови O, в соответствии с классификационной системой ABO. В группе СФ, 60 человек с группой крови A (%30), 21 человек - B (%10.5), 10 человек - AB (%5) и 109 человек (54.5%) с группой крови O, в соответствии с классификационной системой ABO. В обеих группах, наблюдалось статистически значимое различие (p=0.03). Больше пациентов с группой крови О выявлено в группе СФ.
Заключение: Большинство способов лечения, использованных для СФ не эффективны. Для того, чтобы снизить окислительный стресс, для этих пациентов важны: коррекция веса, диетарный статус, диетические и питательные добавки. Больше пациентов с группой крови О в группе СФ направит нас на этиопатогенез, мониторинг, клиническое наблюдение и лечение.
Ключевые слова: фибромиалгия - тип группы крови ABO - питание.
Introduction
Fibromyalgia syndrome (FS) is a complex disease which characterized by diffuse pain and sensitivity and it shows up as a central pain paradigm. Since it is frequently seen in people in the same family, it is thought that it has a genetic origin [1]. In the diagnosis of the FS, we see some heterogeneous disorders which contains neuroendocrine, neuropsychiatric and autonomous systems. Psychological incapability-related personality traits are also seen in FS patients [2,3].
There are four different blood groups. This difference is sourced from different antigens localized on the surface of the red blood cells. These antigens recognize foreign agents and they produce specific antibodies against them [4]. FS is a multisystem disorder that we have been still learning. There is not any data which links FS and ABO blood types in the literature. In this study, we aimed to investigate the relationship between FS and ABO blood types in terms of etiology, clinical follow-up and treatment procedure.
Material and methods
In this study, we included 200 female patients with FS diagnosis (according to American College of Rheumatology, 2010 criteria) who visited our Physical Medicine and Rehabilitation Clinic between July 2015 and December 2015. FS patients' age, blood group, Rh antigen system were saved. Control group was also formed from 185 volunteer healthy female patients. Both groups were compared in terms of their
age, ABO blood type and Rh antigen systems. All patients were informed about the study, which was performed according to the terms of the Helsinki Declaration and received prior ethics committee approval.
The SPSS21 version was used for data analysis. Normal distribution of data was checked using the Kolmogorov-Smirnov test. For each parameter, a comparison was done between the two groups group. The t-test was used for normally distributed groups while the Mann-Whitney U-test was used for abnormal distribution. P<0.05 was evaluated as statistically significant.
Results
In our study, age distribution of FS group (N=200) was 40.6±10.8 and for control group (N=185), it was 43.0±14.8. In the control group, 58 people was A type (%31,4), 29 people was B type (%15.7), 23 people was AB type (%12.4) and 75 people (40.5%) was O type blood group according to ABO classification system. In the FS group, 60 people was A type (%30), 21 people was B type (%10.5), 10 people was AB type (%5) and 109 people (54.5%) was O type blood group according to ABO classification system. In both groups, a statistically significant difference was observed (p=0.03). There were more O type blood carrying patients were detected in FS group. In control group, H antigen positive patients were 172 (93%) and negative patients were 13 (7%) in terms of Rh antigen. On the other hand, there were 180 H antigen positive patients (90%) and 20 negative patients (10%) in FS group. There was not
statistically different between two groups (p=0.19). The findings of the study were summarized in Table 1.
The summary of results
Control FS patient p value
n: 185 n:200
Age 43.0±14.8 40.6±10.8 -
Blood group (n %) 0,003
A 58 (31.4) 60 (30)
B 29 (15.7) 21 (10.5)
AB 23 (12.4) 10 (5)
O 75 (40.5) 109 (54.5)
Rh (n %) 0,19
Positive 172 (93) 180 (90)
Negative 13 (7) 20 (10)
Discussion
FS affects 1-5% of the population and almost 90% of the patients are women. Since FS is a quite important health problem, there are lots of researches to identify its pathophysiology. Although its etiology is not known, people are more focused on combination of both genetic tendency which triggers gene expression and environmental exposure [5].
In the last two decades, studies showed that etiology of FS is sourced from a genetic polymorphism in catecholaminergic, dopaminergic and serotoninergic systems of pain transmission and process. Genetic factors may play a role in the development and the progression of this disease. It is thought that, FS belongs to effective spectrum disorders which contains psychiatric and medical disorders [6]. The co-occurrence ofFS and psychological disorders stands for a physiopathology that is related with change in neurotransmitter level. Since the cognitive behavior therapy and antidepressant drugs are effective on FS treatment, this situation supports the relationship between FS and psychiatric, psychological and behavioral factors [2].
Torres X and colleagues categorized FS patients according to their personality traits, clinical seriousness, psychosocial problems and they compared their results in the end of 6-months treatment procedure [7]. It was observed that patients in group 1 were still anxious and depressed after treatment. Personality-related sub-classification of the patients may provide a chance to develop specific treatment strategies.
ABO blood groups were discovered by an Austrian scientist, Karl Landsteiner. Today, International Society of Blood Transfusion (ISBT) defines 29 different blood types. ABO blood system consists of four antigens (A, B, D and AB). These are oligosaccharide antigens and they are usually expressed on the plasma membrane of red blood cells and they are also expressed in saliva and blood serum [8]. Blood type classification depends on the contribution of the ABO and H genes. D or Rho antigen is the closest blood type antigen to ABO antigens. These antigens are the main components of red blood cells [9]. When they are normal they provide stability to plasma membrane, otherwise they shorten cellular lifetime.
The link between blood type and personal traits became an issue of concern in some countries in like Japan. in the study of Mao X et al, a significant correlation was detected between
ABO blood types and Type A behavior [10]. According to a study which is done in Japan by Nawata K, any relationship was not shown between blood type and personality [11]. In recent studies, some results prove a relation between either ABO and dopamine beta-hydroxylase genes or ABO blood type and decreased oocyte reserves [12,13]. Therefore, we can conclude that there is not any scientifically proven finding between ABO blood types and personal traits.
In 1996, naturalist Dr. Peter D'Adamo published his study which is titled Eat right for your typ [14]. According to D'Adamo, an ideal and healthy diet is not universal, but it can be modified by individual's blood type. He states that, blood type defines which food is beneficial for body chemistry, immune system and blood type-related weight loss depends on these elements. D'Adamo refers that since our ancestors usually are fed with meat, O blood type mostly fits with a diet which consists of plant, root, fruit, seed and nut. Type A came up after soil frameworks, therefore individuals with Type A blood mostly tolerate seeds. Since type B came up in the period which milk products consumed, these individuals with type B blood can tolerate dairy products [14].
In the last decade, diets depend on ABO blood system are thought to be healthy and they are thought as a good method to decrease several diseases. The efficiency of blood type dependent diets has not been proven, yet. It has not been any diet shown to help patients with chronic diseases like FS, yet [15,16].
In FS treatment, various types of medical interventions are used; a multidisciplinary treatment approach which contains pharmacologic and non-pharmacologic treatment modalities. Nutritional managements are promising ones in terms of non-pharmacologic treatment approaches [17]. Obesity and being overweight is commonly seen in FS patients and this situation decreases patients' quality of life by causing acute pain, bad sleep quality and frequent mood disorders. For this reason, weight management is a useful tool to attenuate symptoms. Besides different hypotheses about etiopathogenesis of the FS, oxidative stress is counted among possible causes. To avoid consumption of some foods which increase oxidative stress affect patients' health in a good way. Additionally, non-celiac gluten sensitivity can be seen together with FS syndrome. Avoiding gluten consumption also leads clinical improvement in FS patients. It is clear that specific dietetic interventions have positive effects on treatment [18,19].
According to our study, we can say that FS is more frequently seen in individuals carrying O type blood. The relationship between O type blood group and FS can be evaluated in different areas. Are people who have O blood type more prone to FS? How can this situation can be explained etiopathogenetically? Does this relationship between FS and blood group depend on personality disorder? D'Adamo recommends these people who are O type to consume plant, root, fruit, seed and nut, etc. [14]. It has been proven with several studies that plant-based (vegetarian), anti-oxidative type of foods is more beneficial for FS treatment. In addition, plant-based feeding provides an advantage for weight management, too. Beneficial effects of gluten-free diet on FS patients shows the importance of personal prescription.
The quality of life of these patients are low and they cannot continue with their daily activities. FS patients are young-middle aged women who are in their fertile period. These women's life quality and their contribution to national economy
cannot be denied. We need more studies investigating the effect of non-pharmacologic treatment strategies such as dietary modifications in FS treatment. We also need to give some dietary recommendations and provide some nutritional supplements to these patients, because pharmacologic treatment is not enough by itself. It is also critical to recall the importance of behavioral therapy in these patients.
Conclusion
FS is characterized with diffuse pain and sensitivity at specific anatomical points and occurs together with mood, sleep and cognitive disorders. Life quality of the patients was
destroyed and this situation created an important economical issue in the medical care system. In most of the FS patients, pharmacological treatments are not effective by itself. Weight management, decrease in oxidative stress, nutritional condition, diet and nutrition supplement are quite important in terms of non-pharmacological treatment strategies. In this study, we reported that FS is more often seen in people who are O blood type and this result will be a guide for etiopathogenesis, clinical follow and the treatment. It is required to follow an individual therapy for FS patients.
There is no conflict of interest.
References
1. Ablin JN, Buskila D. Update on the genetics of the fibromyalgia syndrome. Best Pract Res Clin Rheumatol. 2015; 29(1):20-28.
2. Fietta P, Fietta P, Manganelli P. Fibromyalgia and psychiatric disorders. Acta Biomed. 2007; 78(2):88-95.
3. Gonzalez B, Baptista TM, Branco JC, Novo RF. Fibromyalgia characterization in a psychosocial approach. Psychol Health Med. 2015;20(3):363-368.
4. Tsuchimine S, Saruwatari J, Kaneda A, Yasui-Furukon N. ABO Blood Type and Personality Traits in Healthy Japanese Subjects. Plos One. 2015; 10(5):e0126983. doi: 10.1371/journal.pone.0126983.
5. Park DJ, Kang JH, Yim YR, Kim JE, Lee JW, Lee KE, et al. Exploring Genetic Susceptibility to Fibromyalgia. Chonnam Med J. 2015; 51(2):58-65.
6. Ablin JN, Cohen H, Buskila D. Mechanisms of Disease: genetics of fibromyalgia. Nat Clin Pract Rheumatol. 2006; 2(12):671-678.
7. Torres X, Bailles E, Valdes M, Gutierrez F, Peri JM, Arias A, et al. Personality does not distinguish people with fibromyalgia but identifies subgroups of patients. GenHospPsychiatry. 2013; 35(6):640-648.
8. Hosoi E. Biological and clinical aspects of ABO bloodgroup system. J Med Invest. 2008; 55(3-4):174-182.
9. Sigmon JM. Basic principles of the ABO and Rh blood group systems for hemapheresis practitioners. J ClinApher. 1992; 7(3):158-162.
10. Mao X, Xu M, Mu S, Ma Y, He M. [Study on relationship between human ABO blood groups and typeA behavior pattern]. Hua Xi Yi Ke DaXueXueBao. 1991; 22(1):93-96.
11. Nawata K. [No relationship between blood type and personality: evidence from large-scale surveys in Japan and the US]. Shinrigaku Kenkyu. 2014; 85(2):148-156.
12. Caruso M, Check JH. Absence of blood type A or AB may be associated with diminished oocyte reserve. Clin Exp Obstet Gynecol. 2015; 42(4):426.
13. Nejat EJ, Jindal, Berger D, Buyuk E, Lalioti M, Pal L. Implications of blood type for ovarian reserve. Hum Reprod. 2011; 26(9):2513-2517.
14. D'adomo, PJ. Eat Right For Your Type. Putnam Adult. (1997-01-06). ISBN 978-0399142550.
15. Cusack L, De buck E, Compernolle V, Vandekerckhove P. Blood typedietslacksupportingevidence: a systematicreview. Am J ClinNutr. 2013; 98(1):99-104.
16. Mitra R, Mishra N, Rath GP. Blood groups systems. Indian J Anaesth. 2014; 58(5):524-528.
17. Rossi A, DI Lollo AC, Guzzo MP, Giacomelli C, Atzeni , Bazzichi, et al. Fibromyalgia and nutrition: what news?. Clin Exp Rheumatol. 2015; 33(1;88):117-125
18. Arranz LI, Canela MA, Rafecas M. Fibromyalgia and nutrition, what do we know?. Rheumatol Int. 2010; 30(11):1417-1427
19. Buskila D, Neumann L. Genetics of fibromyalgia. Curr Pain Headache Rep. 2005; 9(5):313-315.
How to cite this article: Koca TT, Ozdemir F, Baykara R. Is having O blood type a risk factor for Fibromyalgia syndrome? The importance of nutrition in Fibromyalgia syndrome. J Clin Med Kaz 2017;1(43):20-23
