European Journal of Cardiovascular Medicine

Regular blood donation is increasingly recognized for its potential health benefits beyond its primary role in maintaining an adequate blood supply. One significant area of interest is its impact on lipid metabolism and cardiovascular risk [1]. Lipid profile assessment is an essential marker for evaluating cardiovascular disease risk, with elevated levels of low-density lipoprotein (LDL) cholesterol and total cholesterol being major contributors to atherosclerosis and other cardiovascular disorders [2]. Emerging evidence suggests that regular blood donation may influence lipid metabolism favorably, leading to potential reductions in cardiovascular risk [3].

One proposed mechanism behind these benefits involves the reduction of iron stores due to repeated blood loss. Excess iron in the body is known to contribute to oxidative stress, which promotes lipid peroxidation and subsequent endothelial damage [4]. By lowering iron stores, blood donation may help reduce oxidative stress, thereby preventing lipid peroxidation and lowering the likelihood of developing atherosclerosis [5]. Additionally, some studies have suggested that frequent blood donation may help modulate lipid profiles by reducing total cholesterol and LDL levels while maintaining or slightly increasing high-density lipoprotein (HDL) levels, which is beneficial for cardiovascular health [6].

Despite these potential advantages, the exact impact of regular blood donation on lipid metabolism remains a subject of debate. Some studies indicate that while total cholesterol and LDL levels tend to be lower in regular donors, changes in HDL and triglyceride levels are inconsistent across different populations [7]. Moreover, factors such as diet, lifestyle, and genetic predisposition may also influence the extent to which blood donation affects lipid profiles.

This study aims to assess the lipid profiles of regular blood donors compared to first-time donors and to determine whether frequent blood donation has a measurable impact on lipid metabolism. Understanding these effects could provide further incentives for voluntary blood donation, benefiting both donors and recipients.

Study Design and Participants

This observational cross-sectional study was conducted at the Department of Transfusion Medicine, Government Medical College, Thrissur. The study included 60 voluntary blood donors divided into two groups: regular donors (n=30) and first-time donors (n=30). Regular donors were defined as those who had donated blood consistently over the past two years without prolonged breaks, whereas first-time donors had never previously donated blood.

Inclusion and Exclusion Criteria

• Inclusion criteria: Voluntary blood donors aged between 18 and 50 years who met national donor selection criteria.
• Exclusion criteria: Individuals with a history of alcohol consumption, those on lipid-lowering medications, hypertensive or diabetic individuals on oral hypoglycemic medications.

Data Collection and Biochemical Analysis

Demographic data, including age, height, weight, BMI, blood pressure, and hemoglobin levels, were recorded. Blood samples were collected and analyzed in the Central Lab using the Mindray BS-390 fully automated chemistry analyzer. Hemoglobin levels were assessed via the capillary method using HemoCue.

Statistical Analysis

Categorical and quantitative variables were expressed as frequency (percentage) and mean ± standard deviation (SD), respectively. The independent t-test was used to compare lipid parameters between the two groups. A p-value <0.05 was considered statistically significant. A correlation analysis between blood donation frequency and lipid profiles was conducted using scatter plots.

The demographic and clinical characteristics of the study participants indicate that regular blood donors tend to be older, have higher BMI, and slightly lower systolic and diastolic blood pressure compared to first-time donors. The BMI difference between the groups suggests that regular blood donors might have a different metabolic profile, possibly due to lifestyle factors or physiological adaptations related to repeated blood donation. Haemoglobin levels were slightly higher in regular donors, which might reflect a physiological compensation for frequent blood donation and better overall iron regulation [Table 1].

Lipid profile analysis showed that regular blood donors had marginally lower total cholesterol and LDL levels compared to first-time donors, indicating a potential protective effect of regular blood donation against hyperlipidemia. Triglyceride and HDL levels were relatively lower lower in regular donors, even though the difference was not statistically significant. These findings suggest that while regular blood donation may contribute to lowering total cholesterol, triglyceride and LDL levels, its effect on HDL levels remains inconclusive and may be influenced by other factors such as diet, genetic predisposition, and lifestyle habits [Table 2].

When analyzing lipid profiles based on the frequency of blood donation, a clear trend emerged. Donors with more than seven donations exhibited lower total cholesterol, triglycerides, and LDL levels while showing a gradual increase in HDL levels compared to those with fewer donations. These results support the hypothesis that higher donation frequency is associated with a more favorable lipid profile. Notably, individuals who donated more frequently had improved cardiovascular risk markers, reinforcing the idea that regular blood donation could be beneficial for lipid metabolism and cardiovascular health [Table 3].

While regular blood donation has been associated with reductions in cholesterol, the scatter plot does not provide direct evidence of such an effect due to the lack of a clear trend. Inclusion of a greater number of samples may support the hypothesis that frequent blood donation may contribute to improved lipid metabolism by reducing total cholesterol, potentially lowering cardiovascular risk. Plot 1

Regular blood donation has been associated with beneficial effects on lipid profiles, including reductions in LDL cholesterol. However, its direct impact on HDL levels is less clear, as the second scatter plot does not indicate a significant relationship. As per studies higher HDL levels are associated with a reduced risk of atherosclerosis and improved lipid transport, indicating a protective effect of regular blood donation on lipid metabolism. Plot 2

Table 1: Demographic and Clinical Parameters

The lipid profile comparison is presented in Table 2. Regular donors exhibited lower total cholesterol (181.6 mg/dl) and slightly lower HDL levels (42.0 mg/dl) compared to first-time donors.

Table 2: Haemoglobin and Lipid Profile in First-time vs. Regular Blood Donors

The correlation between frequency of blood donation and lipid profile is shown in Table 3.

Table 3: Lipid Profile Based on Frequency of Blood Donation

Scatter diagram for cholesterol and number of donations

Scatter Plot 1: Correlation between Frequency of Blood Donation and Total Cholesterol

Scatter diagram for HDL and number of donations

Scatter Plot 2: Correlation between Frequency of Blood Donation and HDL Levels

The findings of this study suggest that regular blood donation may contribute to favorable changes in lipid profiles, potentially reducing cardiovascular risk. Regular donors exhibited lower total cholesterol and LDL levels compared to first-time donors, which aligns with previous studies suggesting that frequent blood donation helps lower atherogenic lipid fractions [8]. The slight decrease in triglyceride levels and the marginally higher HDL levels among regular donors, is supportive evidence, the complexity of lipid metabolism warrants further studies are needed to clarify these trends [9].

One of the proposed mechanisms behind the observed changes in lipid profiles is the reduction of iron stores in frequent blood donors. Iron plays a critical role in oxidative stress and lipid peroxidation, processes that contribute to the development of atherosclerosis. Regular blood donation leads to a decrease in iron levels, which in turn reduces oxidative stress and the associated lipid peroxidation of LDL cholesterol [10]. This mechanism may explain the lower LDL levels observed in regular donors, as oxidized LDL is a major contributor to endothelial dysfunction and plaque formation in arteries [11].

In addition, studies have suggested that blood donation may influence lipid metabolism by triggering mild erythropoietic stimulation, which could enhance lipid mobilization and utilization. However, the slightly lower HDL levels in regular donors is in line with some previous findings that have reported an increase in HDL levels with frequent blood donation [12-15]. This discrepancy between various studies may be attributed to variations in study populations, genetic factors, or dietary and lifestyle differences.

A key observation in this study was the correlation between the frequency of blood donation and lipid parameters. Individuals who had donated blood more than seven times exhibited significantly lower total cholesterol, LDL, and triglyceride levels, along with a gradual increase in HDL levels. These findings suggest a dose-dependent relationship, where higher donation frequency may contribute to better lipid regulation and improved cardiovascular health outcomes [13,17,18]. Similar trends have been reported in studies that assessed cardiovascular risk in long-term blood donors, reinforcing the hypothesis that regular donation is associated with reduced atherosclerotic burden and improved lipid metabolism [14].

Despite these promising findings, this study has some limitations. The relatively small sample size may not fully capture the broader effects of regular blood donation on lipid profiles. Additionally, dietary habits, physical activity levels, and genetic predispositions were not accounted for, which could have influenced lipid parameters independently of blood donation status. Future studies with larger sample sizes and longitudinal designs would help establish clearer causal relationships between blood donation frequency and lipid metabolism [15].

In conclusion, this study provides evidence that regular blood donation may have beneficial effects on lipid profiles, particularly by lowering total cholesterol and LDL levels. While the effects on triglycerides and HDL are supportive, the overall trends suggest that frequent blood donation could serve as a simple and cost-effective intervention to improve cardiovascular health. Encouraging voluntary blood donation not only supports the healthcare system but may also offer health benefits to donors, reinforcing the importance of regular blood donation in public health strategies.

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