A Demographic and Biochemical Profile of Patients with Premature Graying of Hair (Canities) at a Tertiary Care Centre: A Case-Control Study.

Context:Although the primary cause of premature hair graying (PHG) is considered to be genetic, certain environmental factors also play a role. Trace element deficiencies such as Vitamin B12, Vitamin D3, and calcium may also be associated with PHG. However, India-specific data are relatively sparse.Aims:The present study aimed at identifying factors associated with PHG in Indian patients.Settings and Design:A case–control study was conducted at a trichology clinic in Bengaluru between October 2013 and April 2014 with a total of 37 cases of PHG and 37 age- and gender-matched controls.Materials and Methods:A total of 100 subjects were investigated for various parameters such as hemoglobin, serum ferritin, zinc, copper, calcium, Vitamin B12, and Vitamin D after obtaining informed consent.Statistical Analysis Used:Chi-square test was used to compare proportions between groups. Means were compared between groups using Student's t-test.Results:Serum ferritin levels were lower in patients with PHG as compared to the control group and the differences were statistically significant (P < 0.001). Furthermore, as compared to the controls, patients with PHG had lower serum Vitamin B12 levels (P < 0.001). Individuals with PHG had significantly lower levels of high-density lipoprotein cholesterol (HDL-C) as compared to the control group (P < 0.001). Significant proportions of patients with PHG had a sedentary lifestyle and admitted to having irregular eating habits.Conclusion:PHG is associated with low serum ferritin, Vitamin B12, and HDL-C levels in Indian patients aged <25 years. However, studies with large sample sizes may be required to conclusively define these putative associations.

Background In today's busy world, health is often neglectedespecially among full-time workers.Consequently, lifestyle disorders such as vitamin deficiencies are increasing, perhaps because of inadequate nutrition and lack of sunlight due to long hours working indoors. These deficiencies can lead to various short-term and long-term complications. Objective To estimate serum levels of vitamin B12 and vitamin D3 among vegetarian employees. Methods and materials A questionnaire about dietary and exercise habits was administered to participants who fulfilled the inclusion criteria and provided informed written consent. Participants also were asked about drug and supplement intake, history of smoking and alcohol, specific symptoms of vitamin B12 and D3 deficiency, and sociodemographic status. Blood samples were collected to estimate serum B12 and D3 levels. Results The results indicated that 14.00% of participants were vitamin B12 deficient and 82.00% were D3 deficient. Differences by gender were not statistically significant; vitamin B12 deficiency was identified in 10.00% of women and 14.44% of men, and vitamin D3 deficiency occurred in 100.00% of the women and 80.00% of men. Among 71 participants aged 35-45 years, 15.49% and 91.55% were deficient in B12 and D3, respectively; among 25 participants aged 46-55, 12.00% and 64.00% were deficient in B12 and D3, respectively; among four participants older than 55, no vitamin B12 deficiency was observed, but 25.00% were deficient in vitamin D3 (p=0.00002). Nearly all (96.15%) participants who reported never exercising were found to be vitamin D3 deficient, compared to 77.02% of those who exercised (OR=0.13, p=0.043). No significant association was found between alcohol consumption and vitamin B12 (p=1) or D3 (p=0.713) deficiency. Conclusions The results revealed a prevalence of both vitamin B12 and D3 deficiencies among corporate employees who identified as vegetarians. Increased awareness, dietary modifications, conscious physical activity, and most importantly, attention to one's health may help improve vitamin sufficiency. Women over age 45 should pay particular attention due to their increased risk of vitamin D3 deficiency. Further research is needed to assess nutrition profiles among other populations to better understand vitamin deficiencies and design adequate preventive measures.

BackgroundLow folate and vitamin B12 levels have negative effect on pregnancy outcomes but there is paucity of data on their levels among Indian women. Ferritin and haemoglobin are associated with maternal mortality and low birth-weight. Our aim was to estimate the prevalence of deficiency of serum folate and vitamin B12, and low levels of serum ferritin and blood haemoglobin among women of childbearing age from a rural population of South India.MethodsWe conducted a community-based cross-sectional study among 15-35 year women in a rural district. We used multistage stratified random sampling. Trained staff interviewed women to collect socio-demographic information and draw blood samples. We analysed samples for serum folate, vitamin B12, ferritin and blood haemoglobin levels and computed means and medians. We computed the proportion of deficiency based on cut-offs recommended by WHO. We examined the association of levels with age, parity and current pregnancy or breastfeeding by multi-variable regression using Stata 13.0.ResultsWe recruited 979 women. One-fifth (185, 19%) were pregnant and one-fifth (196, 20%)were breastfeeding. Median serum folate levels were 2.5 ng/ml (IQR, 1.2-4.8), median vitamin B12 levels were 228.0 pg/ml (IQR, 121 - 390), median ferritin levels were 13.0 μg/l (IQR, 6.0 - 20.0) and median blood haemoglobin levels were 12.1 mg/dl (IQR, 10.7 – 13.6). Low levels of serum folate, vitamin B12, ferritin and haemoglobin were found in 57% (95% CI, 54-60%), 44% (95% CI, 41-48%), 46% (95% CI, 43-49%) and 28% (95% CI, 25-31%) respectively. Women with folic acid deficiency had two times higher prevalence of having vitamin B12 deficiency. In adjusted regression analysis folate levels were lower in older and breastfeeding women, but not associated with parity and were higher among pregnant women. Similar associations were not found with Vitamin B12 deficiency. Ferritin levels were higher in older women; but not associated with parity, pregnancy or breastfeeding. Haemoglobin levels were lower in pregnant and breastfeeding women.ConclusionOur findings suggest that folic acid, vitamin B12 and iron deficiency are important public health problems in India. We observed that half of the women of childbearing age were deficient in these nutrients. Folic acid and vitamin B12 deficiencies co-exist and should be supplemented together.

Dear Madam, Hair is said to grey prematurely when a minimum of five grey hairs occur before the age of 20 in Caucasians, 25 in Asians and 30 in Africans1. Some authors propose using 25 years as a cut-off for people in the South Asian subcontinent. Also, there's no universal grading system for premature greying of hair (PGH). This letter addresses the various evolving risk factors for PGH in young adults worldwide. PGH may be familial or genetically influenced, traveling in an Autosomal Dominant pattern. A positive family history, in particular the paternal history is the most powerful risk factor2. PGH is also linked to nutritional deficiencies including vitamins (especially B12) and minerals. For example in one study, significantly lower levels of serum calcium, ferritin, vitamin B12, and high HDL were observed in patients3. T3 and T4 act on hair follicles to cause melanogenesis and their deficiency is therefore associated with PGH, alopecia, and changes in hair morphology. Another study found notably reduced levels of copper in cases (PGH) as compared to the control group. This study, however, did not observe lower levels of zinc or iron among the affected population. A separate case-control study concerning the association of epidemiological and biochemical factors with PGH reported that a significantly higher percentage of individuals with premature greying had atopic diathesis, led sedentary lifestyles, had family histories of the condition, smoked, and had reported higher levels of perceived stress compared to controls. Though, interestingly enough, regular application of hair oil seemed to confer a safeguarding effect against premature greying. Upon further review of the literature, it became apparent that both BMI and exposure to sunlight emerged as substantial predictors of PGH. Despite the prescription of various vitamins and minerals like biotin, calcium pantothenate, zinc, copper, and selenium (all of which have been recognized as risk factors), the outcomes have been disappointing. Calcium pantothenate is frequently recommended for premature greying of hair (PGH)4. This highlights an existing knowledge gap concerning the precise causative risk factors, necessitating further investigation for a comprehensive understanding and improved management of individuals experiencing premature greying of hair.

Background:The incidence of self-reported premature hair graying (PHG) seems to be on the rise. PHG has a profound impact on the patient's quality of life. It remains an incompletely understood etiology with limited and modest treatment options.Aim:The evaluation of the demographic and clinical profile of patients with premature canities, and exploration of the association of this entity with certain systemic disorders suspected to be related to its etiology.Methods:Seventy-one cases of premature canities (onset noticed by patients before 25 years of age) presenting to an urban skin clinic in Gurugram, India, between September 2012 and September 2015 with this complaint were retrospectively analyzed. The patient records were retrieved that provided details of the onset, duration and pattern of involvement, history, and examination findings (scalp, cutis, and general physical). Since all these patients had been screened for anemia, thyroid disorder, fasting blood glucose, and Vitamin B12 levels at the time of presentation, these parameters were also available for analysis.Results:The mean age at onset of graying was 10.2 ± 3.6 years (range: 5–19 years), with an almost equal gender distribution. The earliest age of onset recorded was 5 years. A positive family history of PHG (at least one of the biological parents or siblings) was obtained in 64 (90.1%) of the cases. The temporal regions of the scalp (35.2%) were most commonly involved followed by the frontal region (18.3%). Hypovitaminosis B12 and hypothyroidism showed significant association with the disorder, whereas anemia, serum ferritin, and fasting blood glucose did not.Conclusion:The age of onset of hair graying can be as low as 5 years. Temporal and frontal areas are the most commonly involved sites. A strong family history, Vitamin B12 deficiency, and hypothyroidism are strongly associated with PHG. Larger case–control studies are mandated for discerning the correlation of these and other risk factors with PHG.

Background:Hair pigmentation is one of the most conspicuous phenotypes in humans ranging from black, brown, and blonde to red. Premature graying of hair occurs more commonly without any underlying pathology but is said to be inherited in autosomal dominant pattern. Premature graying has been shown to be associated with a few of the autoimmune disorders. A role for environmental factors and nutritional deficiencies has also been postulated. However, to date the exact etiology of premature graying has not been established.Aim:The objective of our study was to conduct an epidemiological and investigative study of premature graying of hair in higher secondary and pre-university school children of the semi-urban area.Materials and Methods:A total of 35 cases and controls were investigated for various parameter such as Hemoglobin, total iron binding capacity, serum ferritin (S. Ferritin), serum calcium (S. Ca), serum iron (S. Iron), vitamin B12, and vitamin D3 after taking informed consent. Epidemiological and investigations correlation was established using the Chi-square and Mann Whitney test and P < 0.05 values were considered significant.Result:Among the various laboratory parameters S. Ca, S. Ferritin and vitamin D3 were low in patients with premature graying of hair. There was significant high number of vitamin D3 deficient and insufficient among the cases compared to the controls.Conclusion:According to our study S. Ca, S. Ferritin, vitamin D3 may play a role in premature graying of hair in our society.

To compare serum thyroid hormone, vitamin B12, vitamin D3, folic acid, and ferritin levels between pediatric chalazion patients and healthy children. Under 18-year-old chalazion patients and age- and sex-matched healthy controls were included into this retrospective case-control study. The peripheric blood sampling results obtained within six months from ophthalmological examination were investigated for statistical analysis. Free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), vitamin B12, vitamin D3, folic acid, and ferritin levels of the chalazion and control groups were compared. The male-to-female ratio was 8/28 in the chalazion group and 22/48 in the control group (p > 0.05). The mean age was 13.891 ± 3.924years (3-17) and 12.346 ± 3.963years (4-17) in the groups, respectively (p > 0.05). The mean time between ophthalmological examination and peripheric blood sampling was 3.012 ± 2.201months (0-6) and 2.092 ± 1.906months (0-6) in the groups, respectively (p > 0.05). The mean value of ferritin was 18.641 ± 8.971μg/L (5.900-38.600) in the chalazion group and 35.455 ± 24.561μg/L (11.850-106.100) in the control group (p = 0.019). The mean values of FT3, FT4, TSH, vitamin B12, vitamin D3, and folic acid levels were similar between the groups (p > 0.05 for all). This study reports that pediatric chalazion patients have lower serum ferritin level than healthy children.

Background: Premature canities, also known as premature graying of hair, is the graying of hair before 20 years old in Caucasians, before 25 years old in Asians, and before 30 years old in African–Americans. The risk factors for premature canities are multifactorial. The role of micronutrient deficiency has long been suggested to be involved in the etiopathogenesis of premature canities. The management of premature canities remains limited and far from satisfactory; hence, knowing what vitamins and minerals can help in treating premature canities is vital. Aim: This study aims to analyze serum vitamin B12, iron, ferritin, copper, calcium, and zinc levels in premature canities. Methods: The MEDLINE/PubMed electronic database, Cochrane library, ClinicalTrials.gov, EBSCO, Scopus, ProQuest, Cambridge Core, reference lists, conference proceedings, and researchers in fields of eligible studies were searched. Twelve studies (n = 1791 subjects) were included in qualitative analysis of which nine studies (n = 1381 subjects) were included in meta-analysis. Serum levels of micronutrients (vitamin B12, iron, ferritin, copper, calcium, and zinc) were compared in the premature canities and nonpremature canities groups. Result: Pooling of data using fixed-effects model found the overall effect mean difference serum vitamin B12 level was −0.697 ± 0.105 (95% CI = −0.904 to −0.490), p &lt; 0.001. The overall mean difference serum iron level was 0.146 ± 0.105 (95% CI = −0.058 to 0.350), p = 0.161. The overall mean difference serum ferritin level was 0.720 ± 0.071 (95% CI = 0.585 to 0.854), p &lt; 0.001. The overall mean difference serum copper level was 0.230 ± 0.118 (95% CI = −0.003 to 0.463, p = 0.053. The overall mean difference serum calcium level was −0.443 ± 0.114 (95% CI = −0.655 to −0.212), p &lt; 0.001. The overall mean difference serum zinc level was −0.104 ± 0.138 (95% CI = 0.377 to 0.170, p = 0.457. Qualitative analysis showed that vitamin B12 plays an important role in DNA synthesis in the proliferation of hair follicle cells and in melanogenesis. Iron, ferritin, copper, calcium, and zinc also play important roles in stabilizing and increasing tyrosinase activity in several stages of the melanogenesis process. Conclusion: The meta-analysis showed that serum levels of vitamin B12, ferritin, and calcium were significantly lower in premature canities. Although the lower serum iron, copper, and zinc levels were not significantly different in premature canities compared with nonpremature canities. Qualitative analysis found that deficiency of vitamin B12, iron, ferritin, zinc, copper, and calcium can affect the physiology of hair melanogenesis that causing premature canities.

Background: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal disorders with a prevalence of 50-66%. The prevalence of hematinic deficiencies including ferritin and vitamin B12 deficiencies and their role in the prophylaxis and development of RAS is not well known. Many studies have demonstrated a high prevalence of hematinic deficiencies in patients with RAS. This study aimed to compare the serum level of ferritin and vitamin B12 in patients with recurrent aphthous ulcers and healthy controls. Subjects, Materials and Methods: The data were collected from patients who needed blood analysis to exclude anemia from November 2020 to May 2021. The study was approved by the institutional ethics committee. After recording patients' demographics ( age, gender, occupation, address) 5ml of blood was drawn from patients and controls in educational laboratories centrifuged at 3000 rpm for 10 minutes, then serum was stored at -20°C till the time of assessment of both serum ferritin and vitamin B12. The data were expressed as Mean ± SD. Students Unpaired t-test was used for comparing biochemical parameters between patients and controls and a p-value of &lt;0.05 was considered as a statistically significant while a p-value of&lt;0.001 was considered highly statistically significant. Results: A total of 30 RAS patients and 30 healthy control with age and gender matches were included. In the present study statistically, significant differences were observed in the serum level of ferritin and vitamin B12 between the two groups, 40% of the patients had low serum ferritin levels and 56.6 % of the patients had low serum vitamin B12 levels. Conclusion: Measuring serum ferritin and vitamin B12 levels are necessary for patients with recurrent aphthous stomatitis. It is also important for recurrent aphthous ulcer patients to have a nutritional diet containing iron and vitamin B12 to prevent the recurrence of aphthous ulceration

Background:Premature hair graying (PHG) is often a matter of great concern for patients as it is viewed as a sign of increasing age, debility, decreasing vigor, and may lead to low self-esteem and psychological morbidity. Its etiopathogenesis is not completely understood but genetic, and various acquired factors have been implicated. The present study was undertaken to evaluate various epidemiological and biochemical variables associated with PHG.Materials and Methods:A cross-sectional case–control study was conducted at a tertiary care hospital in North India for 1 year which comprised 120 patients and equal number of controls. Various epidemiological variables were recorded and compared to controls. Serum ferritin, serum calcium, serum Vitamin D, serum Vitamin B12, lipid profile, thyroid profile, and fasting blood sugar were measured and compared among cases and controls.Results:Significantly higher proportion of cases had atopic diathesis, sedentary lifestyle, family history, history of smoking, and higher perceived stress values as compared to controls. Hair oiling seemed to protect against premature graying. Significantly, lower levels of serum calcium, ferritin, Vitamin B12, high-density lipoprotein-cholesterol, and high low-density lipoprotein-cholesterol were observed among cases.Conclusion:In the light of the present study, further studies with larger sample size are required to establish the definite etiological significance of these variables and formulate various preventive and therapeutic targets to prevent and treat PHG.

To evaluate the relationship between pterygium and serum thyroid hormone, vitamin B12, vitamin D3, folic acid, and ferritin levels between pterygium patients and control and to assess its correlation with clinical findings. 18–65-year-old 100 pterygium patients and age and sex matched 60 healthy control subjects were included. The peripheric blood sampling results were investigated. Free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), vitamin B12, vitamin D3, folic acid, and ferritin levels of pterygium and control groups were compared. FT3 level was higher in the patient group compared to the control group, while vitamin B12, vitamin D3, folic acid and ferritin levels were significantly lower in the patient group compared to the control group (p < 0.05) No significant difference was found between the patient and control groups in terms of age, gender and body mass index (BMI) (p = 0.295, p = 0.625, p = 0.547, respectively). This study reports that pterygium patients have lower serum vitamin B12, folic acid, ferritin and vitamin D3 levels than healthy individuals.

The etiology of premature hair graying (PHG) remains incompletely understood with limited treatment options, although has profound impacts on patient's quality of life. To assess demographic and clinical profiles of Egyptian PHG patients and explore association of various epidemiological risk factors and serum vitamin D and ferritin levels with PHG. Three hundred PHG patients and equal number of controls, aged <30 years, were included. Assessment of epidemiological and clinical characteristics, biometric data and stress perception using perceived stress scale (PSS-10) was done, with measurement of serum vitamin D and ferritin levels for all subjects. PHG was graded into mild, moderate, and severe if <10, 10-100, and >100 gray hairs, respectively. Statistical significance for various compared parameters was done employing suitable tests, with P-value≤.05 considered significant. Results reported significant positive relation of PHG with family history, sedentary life style, and stress (P=.001, .029, and .001, respectively), while no significant relation with smoking, body mass index, or frequent hair dyes use (>3 per year) (P=.425, .5, and .65, respectively). No significant difference was found in mean vitamin D between patients and controls (23.79±13.01 ng/mL vs 24.85±13.19 ng/mL, P=.701), while low serum ferritin (<20 ng/mL) was significantly associated with PHG (14.7 % patients vs 2.7% controls, P=.017). PHG in Egyptian population is significantly associated with positive family history, stress, sedentary life style, and low serum ferritin level, while role of vitamin D deficiency should be further evaluated.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in premenopausal women. PCOS impacts women of reproductive age regardless of ethnic origin, although the signs and symptoms may vary by ethnic group. Symptoms include obesity, hirsutism, acne, amenorrhea, sterility, occasional menometrorrhagia. The objectives of thi study is to assess the possible association of vitamin D3 with BMI in PCOS and to investigate the role of serum leptin and vitamin D3 levels in the pathogenesis of PCOS. To shed light on the pathophysiology of PCOS. A case-control study was performed in Al- Batool Teaching Hospital in Baquba city during the period from 1st December 2020 to the end of March 2021. It included 50 PCOS patients and 34 subjects as healthy control. The biomarkers studied were: serum Vitamin D3, Leptin, LH and FSH and then Serum Vitamin D3 and Leptin were measured by ELISA technique. But serum LH and FSH were measured by Cobas e 411 system. Serum Vitamin D3 levels have decreased significantly and FSH in the patients’ group as compared to the control group, while for the other variables, the mean values of leptin, LH, LH/FSH, &amp; BMI were significantly more significant in the PCOS group than in the control group. In conclusion, women who suffer from polycystic ovarian syndrome PCOS were more prone to lack vitamin D and FSH levels than those without PCOS. At the same time, there is higher LH, LH/FSH, and BMI levels for PCOS patients from healthy women. The PCOS group had higher blood leptin concentrations, especially in overweight and obese patients; because leptin is produced from adipose tissue, obesity seems to exacerbate blood higher leptin in PCOS patients, significantly impairing reproductive functions. A significant negative correlation was found between serum vitamin D3 levels and BMI in the PCOS group; as a result, obesity contributes to vitamin D deficiency risk.

Nutritional anemia is a significant public health concern worldwide, particularly affecting young adults and children in Saudi Arabia, where inadequate nutrition is considered a primary contributing factor. This study aims to (i) examine the levels of serum iron, folate, and vitamin B12 in young adult students, with a focus on identifying any deficiencies and their association with anemia; (ii) explore the prevalence of mixed-deficiency anemia resulting from deficiencies in serum iron, folate, and vitamin B12 (iii) explore how sociodemographic characteristics and dietary habits influence serum iron, folate, and vitamin B12 levels. This cross-sectional study encompassed 158 young adult students at Jazan University, Saudi Arabia. Blood samples were collected following a comprehensive questionnaire addressing sociodemographic and health characteristics. These samples were analyzed for complete blood count, serum iron, folate, and vitamin B12 levels. The findings of this study revealed a significant decrease in serum iron levels, with 70.6% of males and 88% in females exhibiting reduced level. Additionally, low levels of folate were observed in 4% of the study population, while deficiency in vitamin B12 was found in 2.2% of the study population. However, the simultaneous presence of low serum iron levels along with deficiencies in folate or vitamin B12 was not observed in the study participants. The study indicates that there is a high incidence of low serum iron and ferritin levels among university students in Saudi Arabia, which poses a considerable public health concern. Conversely, the prevalence of folate and vitamin B12 deficiencies among the students was comparatively low, and notably, there were no cases where these deficiencies were observed alongside iron deficiency.

BACKGROUND: Vitamin D3 is an essential regulator of immune function, however its bioavailability is limited. Liposomes as nanocarriers can enhance vitamin D3 absorption and delivery, however the application of liposomal vitamin D3 in postmenopausal remains underexplored, particularly in preclinical models. Estrogen deficiency during menopause promotes immune dysregulation and elevates proinflammatory cytokines, including interleukin (IL)-6 and tumor necrosis factor (TNF)-α. This study was conducted to evaluate the effects of liposomal vitamin D3 supplementation on serum vitamin D3, IL-6, and TNF-α levels in an ovariectomy-induced menopausal mouse model.METHODS: Mice were randomly divided into four groups comprising non-surgical control (N), ovariectomized without treatment (D−), conventional vitamin D3-treated (D+), and liposomal vitamin D3-treated (LD). Treatments were administered daily via oral gavage for two months. Serum vitamin D3, IL-6, and TNF-α levels were measured by enzyme-linked immunosorbent assay (ELISA). IL-6 and TNF-α data were analyzed by ANOVA with Duncan’s post-hoc test, while vitamin D3 data were analyzed using the Brown-Forsythe test with Games-Howell post-hoc test (p&lt;0.01).RESULTS: Ovariectomy significantly decreased vitamin D3 levels and increased IL-6 and TNF-α levels in the D− group. Conventional vitamin D3 supplementation (D+) significantly decreased serum vitamin D3 levels and slightly decreased IL-6 and TNF-α levels. Liposomal vitamin D3 (LD3) significantly increased vitamin D3 levels and decreased TNF-α, only slightly decreasing IL-6. Correlation analysis showed a negative association between serum vitamin D3 levels and both cytokines.CONCLUSION: Administration of vitamin D3 liposomes was able to increase vitamin D3 levels and suppress IL-6 and TNF-α towards normal levels. LD3 offers enhanced bioavailability and anti-inflammatory effects, making it a promising therapeutic strategy for managing menopause-associated inflammation and related systemic disorders.KEYWORDS: menopause, liposomal VD3, inflammation, IL-6, TNF-α