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Genetic and behavioral modification of hemoglobin and iron status among first‐time and high‐intensity blood donors
Author(s) -
Mast Alan E.,
Langer John C.,
Guo Yuelong,
Bialkowski Walter,
Spencer Bryan R.,
Lee TzongHae,
Kiss Joseph,
Cable Ritchard G.,
Brambilla Donald,
Busch Michael P.,
Page Grier P.
Publication year - 2020
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.15743
Subject(s) - hemoglobin , medicine , anemia , hematocrit , ferritin , physiology
BACKGROUND Some people rapidly develop iron deficiency anemia following blood donation, while others can repeatedly donate without becoming anemic. METHODS Two cohorts of blood donors were studied. Participants (775) selected from a 2‐year longitudinal study were classified into six analysis groups based on sex, donation intensity, and low hemoglobin deferral. Associations with iron supplement use, cigarette smoking, and four genetic variants of iron metabolism were examined at enrollment and with longitudinal regression models. An unbiased assessment of genetic variability and ability to repeatedly donate blood without experiencing low hemoglobin deferral was conducted on participants (13,403) in a cross‐sectional study who were examined by genome wide association (GWA). RESULTS Behaviors and genetic variants were associated with differences in hemoglobin and ferritin change following repeated donation. At least weekly iron supplement use was associated with improved status in first‐time donors, while daily use was associated with improved status in high‐intensity donors. Cigarette smoking was associated with 0.5 g/dL increased hemoglobin in high‐intensity donors. A736V in TMPRSS6 was associated with a rapid drop in hemoglobin and ferritin in first‐time females following repeated donation. Conversely, the protective TMPRSS6 genotype was not enriched among high‐intensity donors. H63D in HFE was associated with increased hemoglobin in female high‐intensity donors. However, no differences in genotype between first‐time and high‐intensity donors were found in GWA analyses. CONCLUSION Behavioral and genetic modifiers contributed to first‐time donor hemoglobin and iron status, while iron supplement use was more important than underlying genetics in high‐intensity donors.