title: ABO blood group is associated with peripheral arterial disease in African Americans: The Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: BACKGROUND
  Peripheral artery disease (PAD) affects 8.5 million Americans and thus improving our understanding of PAD is critical to developing strategies to reduce disease burden. The objective of the study was to determine the association of ABO blood type with ankle brachial index (ABI) as well as prevalent and incident PAD in a multi-ethnic cohort.
  
  
  METHODS
  The Multi-Ethnic Study of Atherosclerosis includes non-Hispanic White, African, Hispanic, and Chinese Americans aged 45-84. ABO blood type was estimated using ABO genotypes in 6027 participants who had ABI assessed at the baseline exam. Associations with ABO blood type were evaluated categorically and under an additive genetic model by number of major ABO alleles. After excluding those with ABI>1.4, prevalent PAD was defined as ABI≤0.9 at baseline and incident PAD as ABI≤0.9 for 5137 participants eligible for analysis.
  
  
  RESULTS
  There were 222 prevalent cases and 239 incident cases of PAD. In African Americans, each additional copy of the A allele was associated with a 0.02 lower baseline ABI (p=0.006). Each copy of the A allele also corresponded to 1.57-fold greater odds of prevalent PAD (95% CI, 1.17-2.35; p=0.004), but was not associated with incident PAD. No associations were found in other racial/ethnic groups for ABI, prevalent PAD, or incident PAD across all races/ethnicities.
  
  
  CONCLUSIONS
  Blood type A and the A allele count were significantly associated with baseline ABI and prevalent PAD in African Americans. Further research is needed to confirm and study the mechanisms of this association in African Americans.
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. Electronic address: pikem@xavier.edu.
authors.forename: Mindy M
authors.initials: MM
authors.lastname: Pike
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. Electronic address: Larson.Nicholas@mayo.edu.
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Larson
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA. Electronic address: cwassel@med.uvm.edu.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Wassel
authors.affiliation: Department of Cardiovascular Diseases and Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA. Electronic address: Cohoon.Kevin@mayo.edu.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Cohoon
authors.affiliation: Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA. Electronic address: tsaix001@umn.edu.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Tsai
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. Electronic address: pankow@umn.edu.
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.affiliation: Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA. Electronic address: hanso047@umn.edu.
authors.forename: Naomi Q
authors.initials: NQ
authors.lastname: Hanson
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. Electronic address: Decker.Paul@mayo.edu.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Decker
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA. Electronic address: cberardi@montefiore.org.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Berardi
authors.affiliation: Department of Medicine, University of Vermont, Burlington, VT, USA. Electronic address: kristine.alexander@nih.gov.
authors.forename: Kristine S
authors.initials: KS
authors.lastname: Alexander
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA. Electronic address: mary.cushman@med.uvm.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA. Electronic address: neil.zakai@med.uvm.edu.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Zakai
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. Electronic address: Bielinski.Suzette@mayo.edu.
authors.forename: Suzette J
authors.initials: SJ
authors.lastname: Bielinski
mesh_terms: D000017:ABO Blood-Group System / Q000235:genetics*; D001741:Black or African American / Q000235:genetics; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D055109:Ankle Brachial Index; D001213:Asian / Q000235:genetics; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D005260:Female; D005838:Genotype; D006630:Hispanic or Latino / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D015995:Prevalence; D012307:Risk Factors; D044465:White People / Q000235:genetics
chemical_list: D000017:ABO Blood-Group System
keywords: ABO blood group; Ankle brachial index; Atherosclerosis; Epidemiology; Peripheral arterial disease