ABO BLOOD GROUPS AND INCREASED RISK FOR VASCULAR INVOLVEMENT IN THE PATIENTS WITH BEHÇET’S DISEASE

E. Bektaş, A. Büyükdemir, Y. Yalçinkaya, B. Artim-Esen, M. Inanc, A. GülIstanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey  Background Behçet’s disease (BD), a multisystem inflammatory disorder of unknown etiology, is classified as a variable vessel vasculitis affecting all types and sizes of blood vessels; and a tendency for thrombosis in association with inflammatory endothelial activation is an important characteristic of BD vasculitis. Recent studies suggest an association between ABO blood groups and vascular disease in particular in those carrying non-O (A, B, and AB) groups [1]. Objectives We aimed to investigate the potential contribution of ABO blood groups to the risk of vascular involvement in patients with BD. Methods We retrospectively analyzed the records of BD patients followed between 1978 and 2022. Patients fulfilling the ISG Criteria for diagnosis of BD were screened, and those with information about ABO blood groups were included into the study. Presence or absence of vascular involvement and its features were recorded using a standard form. The chi-square test, t-test, Mann-Whitney U test, and logistic regression tests were used for statistical analyses. Results The study group consisted of 411 patients with available blood group data, and 143 (34.8%) were carrying O [58% men, mean age at diagnosis 31.4±10.1 years, median follow-up period 153 (98-219) months], and 268 (65.2%) were carrying non-O blood groups [60.1% men, mean age at diagnosis 30.7±8.4 years, median follow-up period 148 (92-204) months]. There was no statistical significance between O and non-O groups in regard to the potential confounding factors affecting the risk for vascular disease, including sex, age at diagnosis, family history, HLA-B51 positivity, smoking, comorbidities, and prothrombotic mutations. Vascular involvement was observed in 39 (27.3%) patients with blood group O [venous in 35 (24.5%), and arterial in 11 (7.7%)], whereas 109 patients (40.7%) with non-O blood groups had vascular involvement [venous in 95 (35.4%), and arterial in 38 (14.2%)]. The frequencies of total vascular and venous involvements between the two groups were significantly different (p=0.007, p=0.023, respectively). Unadjusted and adjusted ORs with different models in the multivariate logistic regression analyses are shown in Table 1. After adjustments for age, sex and comorbidities, the risk for arterial disease was also found to be increased in association with non-O blood groups. Conclusion Vascular involvement with a tendency for thrombosis is an important feature of BD, and inflammatory characteristics resulting in endothelial dysfunction have been considered as the main underlying pathology. The results of the preliminary study supports the previous reports revealing the potential contribution of ABO blood groups in the development of vascular disease and suggest an approximately two-fold increased risk for vascular involvement in BD patients. Reference [1]Vasan SK, et al. ABO Blood Group and Risk of Thromboembolic and Arterial Disease: A Study of 1.5 Million Blood Donors. Circulation. 2016;133(15):1449-1457. Table 1. Logistic regression analysis to estimate unadjusted and adjusted risk for vascular events comparing O with non-O blood groups. Model 1: ABO blood group, Model 2: Model 1 plus age at diagnosis and sex, Model 3: Model 2 plus comorbidities, Model 4: Model 3 plus malignancy, Model 5: Model 4 plus smoking (missing value for 84 patients). Total vascular involvement Venous involvement Arterial involvement p-value OR (CI %95) p-value OR (CI %95) p-value OR (CI %95) Model 1 0.007 1.8 (1.2-2.8) 0.023 1.7 (1.1-2.7) 0.057 2.0 (0.9-4.0) Model 2 0.007 1.9 (1.2-3.1) 0.024 1.7 (1.1-2.8) 0.062 2.0 (0.9-4.0) Model 3 0.005 2.0 (1.2-3.2) 0.022 1.8 (1.1-2.9) 0.038 2.2 (1.0-4.7) Model 4 0.006 2.0 (1.2-3.2) 0.023 1.8 (1.1-2.9) 0.046 2.2 (1.0-4.6) Model 5 0.029 1.9 (1.1-3.2) 0.038 1.8 (1.0-3.2) 0.102 2.0 (0.9-4.5) Acknowledgements: NIL. Disclosure of Interests None Declared. Keywords: Organ damage, Vasculitis, Behcet’s disease DOI: 10.1136/annrheumdis-2023-eular.196Citation: , volume 82, supplement 1, year 2023, page 1954Session: Other orphan diseases (Publication only)