METHODS: We searched PubMed, Web of Science, Embase, Scopus, Cochrane, and several regional databases from their inception until Feb 16, 2024, with the aim of identifying systematic reviews with meta-analyses of observational studies exploring associations between ABO and Rh blood groups and diverse health outcomes. For each association, we calculated the summary effect sizes, corresponding 95% confidence intervals, 95% prediction interval, heterogeneity, small-study effect, and evaluation of excess significance bias. The evidence was evaluated on a grading scale that ranged from convincing (Class I) to weak (Class IV). We assessed the certainty of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation criteria (GRADE). We also evaluated the methodological quality of included studies using the A Measurement Tool to Assess Systematic Reviews (AMSTAR). AMSTAR contains 11 items, which were scored as high (8-11), moderate (4-7), and low (0-3) quality. We have gotten the registration for protocol on the PROSPERO database (CRD42023409547).
RESULTS: The current umbrella review included 51 systematic reviews with meta-analysis articles with 270 associations. We re-calculated each association and found only one convincing evidence (Class I) for an association between blood group B and type 2 diabetes mellitus risk compared with the non-B blood group. It had a summary odds ratio of 1.28 (95% confidence interval: 1.17, 1.40), was supported by 6870 cases with small heterogeneity (I2 = 13%) and 95% prediction intervals excluding the null value, and without hints of small-study effects (P for Egger\'s test > 0.10, but the largest study effect was not more conservative than the summary effect size) or excess of significance (P < 0.10, but the value of observed less than expected). And the article was demonstrated with high methodological quality using AMSTAR (score = 9). According to AMSTAR, 18, 32, and 11 studies were categorized as high, moderate, and low quality, respectively. Nine statistically significant associations reached moderate quality based on GRADE.
CONCLUSIONS: Our findings suggest a potential relationship between ABO and Rh blood groups and adverse health outcomes. Particularly the association between blood group B and type 2 diabetes mellitus risk.
方法:我们搜索了PubMed,WebofScience,Embase,Scopus,科克伦,以及从成立到2024年2月16日的几个区域数据库,目的是确定系统评价,并对观察性研究进行荟萃分析,探索ABO和Rh血型与不同健康结局之间的关联。对于每个协会,我们计算了汇总效应大小,相应的95%置信区间,95%预测区间,异质性,小的研究效果,和过度显著性偏差的评估。在从令人信服(I类)到弱(IV类)的分级范围内评估证据。我们根据建议分级评估评估了证据的确定性,发展,和评价标准(等级)。我们还使用A测量工具评估系统评价(AMSTAR)评估纳入研究的方法学质量。AMSTAR包含11个项目,得分高(8-11),中等(4-7),质量低(0-3)。我们已经在PROSPERO数据库(CRD42023409547)上注册了协议。
结果:当前的综述包括51篇系统综述和270篇关联的荟萃分析文章。我们重新计算了每种关联,发现与非B血型相比,仅有一个令人信服的证据(I类)证明血型B与2型糖尿病风险之间的关联。它的汇总赔率比为1.28(95%置信区间:1.17,1.40),由6870例具有较小异质性(I2=13%)和95%预测区间(不包括空值)的病例支持,并且没有小研究效应的提示(Egger检验的P>0.10,但最大的研究效应并不比汇总效应大小更保守)或超过显著性(P<0.10,但观察到的值小于预期)。使用AMSTAR(得分=9)证明了该文章具有较高的方法学质量。根据AMSTAR,18、32和11项研究被归类为高,中度,低质量,分别。9个具有统计学意义的关联基于GRADE达到中等质量。
结论:我们的研究结果表明ABO和Rh血型与不良健康结局之间存在潜在的关系。特别是血型B与2型糖尿病风险之间的关联。