title: Mortality and cancer in relation to ABO blood group phenotypes in the Golestan Cohort Study.
abstract: BACKGROUND
  A few studies have shown an association between blood group alleles and vascular disease, including atherosclerosis, which is thought to be due to the higher level of von Willebrand factor in these individuals and the association of blood group locus variants with plasma lipid levels. No large population-based study has explored this association with overall and cause-specific mortality.
  
  
  METHODS
  We aimed to study the association between ABO blood groups and overall and cause-specific mortality in the Golestan Cohort Study. In this cohort, 50,045 people 40- to 70-years old were recruited between 2004 and 2008, and followed annually to capture all incident cancers and deaths due to any cause. We used Cox regression models adjusted for age, sex, smoking, socioeconomic status, ethnicity, place of residence, education and opium use.
  
  
  RESULTS
  During a total of 346,708 person-years of follow-up (mean duration 6.9 years), 3,623 cohort participants died. Non-O blood groups were associated with significantly increased total mortality (hazard ratio (HR) = 1.09; 95% confidence interval (CI): 1.01 to 1.17) and cardiovascular disease mortality (HR = 1.15; 95% CI: 1.03 to 1.27). Blood group was not significantly associated with overall cancer mortality, but people with group A, group B, and all non-O blood groups combined had increased risk of incident gastric cancer. In a subgroup of cohort participants, we also showed higher plasma total cholesterol and low-density lipoprotein (LDL) in those with blood group A.
  
  
  CONCLUSIONS
  Non-O blood groups have an increased mortality, particularly due to cardiovascular diseases, which may be due to the effect of blood group alleles on blood biochemistry or their effect on von Willebrand factor and factor VIII levels.
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. arash.etemadi@nih.gov.
authors.forename: Arash
authors.initials: A
authors.lastname: Etemadi
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
authors.forename: Akram
authors.initials: A
authors.lastname: Pourshams
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
authors.forename: Ashkan
authors.initials: A
authors.lastname: Emadi
mesh_terms: D000017:ABO Blood-Group System; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D005169:Factor VIII; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D010641:Phenotype; D016016:Proportional Hazards Models; D012306:Risk; D012907:Smoking; D012923:Social Class; D014841:von Willebrand Factor
chemical_list: D000017:ABO Blood-Group System; C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D005169:Factor VIII