Serum arylesterase activity, vitamin B12 status, and oxidative stress in premature hair greying: a case-control study among vegetarians and non-vegetarians for males
DOI:
https://doi.org/10.53704/Keywords:
Premature Hair Greying, Arylesterase, Vitamin B12 Deficiency;, Oxidative Stress, Antioxidant enzymesAbstract
Premature hair greying (PHG) is a common condition associated with oxidative stress and nutritional deficiencies. Vitamin B12 deficiency is particularly common among vegetarians and may contribute to oxidative damage linked to PHG. This case-control study investigated serum vitamin B12 levels and oxidative stress markers, including arylesterase, catalase, glutathione peroxidase (GPx), and malondialdehyde (MDA), among 125 male participants. The participants were divided into four groups: vegetarians with PHG (n=37), non-vegetarians with PHG (n=34), vegetarian controls (n=23), and non-vegetarian controls (n=31). We used standard biochemical methods to measure vitamin B12 and antioxidant markers, and analysed the data using one-way ANOVA, Pearson’s correlation, linear regression, and logistic regression. Compared with controls, participants with PHG had significantly higher MDA levels and lower vitamin B12, arylesterase, catalase, and GPx levels (P<0.001). Vegetarians with PHG recorded the lowest vitamin B12 concentration (192.81 ± 17.19 pg/mL) and the highest oxidative stress burden. Vitamin B12 was negatively correlated with MDA (r=−0.416, P=0.0003), but positively correlated with arylesterase (r=0.382, P=0.001), catalase (r=0.412, P=0.0004), and GPx (r=0.354, P=0.0025). Among vegetarian participants with PHG, vitamin B12 and arylesterase showed a significant positive association (r=0.504, R²=0.255, P=0.0015). Logistic regression identified vegetarian diet (OR=3.24, 95% CI: 1.45–7.22, P=0.0042) and vitamin B12 deficiency (<200 pg/mL) (OR=4.82, 95% CI: 2.12–10.95, P=0.0002) as significant predictors of PHG. Overall, the findings suggest that vitamin B12 deficiency and reduced antioxidant defence may contribute to premature hair greying.
References
1. Anggraini DR, Feriyawati L, Hidayat H, Wahyuni AS. Risk factors associated with premature hair greying of young adults. Open Access Maced J Med Sci. 2019;7(22):3762-3766. doi:10.3889/oamjms.2019.501.
2. Saoji A, Saoji MP, Kulkarni M, Khurana K, Wani MD. Prevalence and determinants of hair fall, hair loss and premature graying in young adults: a cross-sectional study. Afr J Biomed Res. 2024;27(2):5454-5460. doi:10.4314/ajbr.v27i2.14.
3. Rangu SA, Oza VS. Poliosis, hair pigment dilution, and premature graying of the hair: clinical and epidemiological perspectives. J Dermatol Sci. 2024;113(1):12-21. doi:10.1016/j.jdermsci.2023.11.004.
4. Anastassakis K. The effects of aging on the hair follicle. In: Androgenetic alopecia from A to Z. Cham: Springer; 2022. p.345-389. doi:10.1007/958-3-030-76111-2.
5. Patel R, Kumar A, Singh M. The redox paradox of follicular melanocytes: melanin synthesis as a driver of endogenous oxidative stress and hair follicle aging. Antioxid Redox Signal. 2025;42(3):188-202. doi:10.1089/ars.2024.0412.
6. Haslam IS, Jadkauskaite L, Szabó IL, Staege MS, Tobin DJ, Jiménez F, et al. Oxidative damage control in a human (mini-) organ: Nrf2 activation protects against oxidative stress-induced hair follicle regression. J Invest Dermatol. 2016;136(11):2141-2152. doi:10.1016/j.jid.2016.06.6217.
7. Bai L, Wang Y, Wang K, Chen X, Zhao Y, Liu C, et al. Materiobiomodulated ROS management for skin and hair follicle homeostasis. Biomaterials. 2024;305:122450. doi:10.1016/j.biomaterials.2023.122450.
8. Joshi P, Sushma BJ, Ansari S. Study of oxidative stress and antioxidant markers in premature hair greying. NeuroQuantology. 2025;23(1):227-234. doi:10.14704/nq.2025.23.1.NQ25030.
9. Wang Y, Li S, Li S. The role of oxidative stress-induced melanocyte stem cell apoptosis in premature hair graying. Front Cell Dev Biol. 2021;9:685825. doi:10.3389/fcell.2021.685825.
10. Levy D, Reichert CO, Bydlowski SP. Paraoxonases activities and polymorphisms in elderly and old-age diseases: an overview. Antioxidants. 2019;8(5):118. doi:10.3390/antiox8050118.
11. Durrington PN, Bashir B, Soran H. Paraoxonase 1 and atherosclerosis: a comprehensive biochemical overview. Front Cardiovasc Med. 2023;10:102144. doi:10.3389/fcvm.2023.102144.Bizo? A, Piwowar A. Expression of paraoxonase 1 in
12. HEK293 cells and its effect on lactonase and arylesterase activities. Mol Cell Biochem. 2023;478(4):845-856. doi:10.1007/s11010-022-04531-y.
13. Ero?lu M, Yonar ME, Yonar SM, ?spir Ü, Ural M?, Silici S. The effect of dietary antioxidants on paraoxonase and arylesterase status. Environ Sci Pollut Res Int. 2026;33(1):112-124. doi:10.1007/s11356-025-38411-x.
14. Taler-Ver?i? A, Petri? B, Goli?nik M, Bavec A. Total esterase and paraoxonase activity profiles in lipid protection. Biochim Biophys Acta Mol Cell Biol Lipids. 2025;1870(1):159580. doi:10.1016/j.bbalip.2024.159580.
15. Jayakumari N, Thejaseebai G. High prevalence of low serum paraoxonase-1 in subjects with premature coronary artery disease. Clin Chim Acta. 2009;402(1-2):111-116. doi:10.1016/j.cca.2008.12.031.
16. Kunachowicz D, ?ciskalska M, Kepinska M. Modulatory effect of lifestyle-related, environmental and nutritional factors on antioxidant enzyme activities. Diagnostics (Basel). 2023;13(14):2381. doi:10.3390/diagnostics13142381.
17. Molavian H, Madani Tonekaboni A, Kohandel M, Sivaloganathan S. The synergetic coupling of catalase and glutathione peroxidase in cellular systems. J Theor Biol. 2015;380:412-422. doi:10.1016/j.jtbi.2015.05.022.
18. Wood JM, Decker H, Hartmann H, Chavan B, Rokos H, Spencer JD, et al. Senile hair graying: H2O2-mediated oxidative stress affects human hair color by blunting methionine sulfoxide repair. FASEB J. 2009;23(7):2065-2075. doi:10.1096/fj.08-125435.
19. Daulatabad D, Grover C, Singal A. Premature graying of hair: a comprehensive review of etiology and pathogenesis. J Drugs Dermatol. 2021;20(4):412-418.
20. Smith AD, Refsum H. Homocysteine, B-vitamins, and cognitive impairment: the importance of proper cellular methylation and redox balance. Annu Rev Nutr. 2021;41(1):169-198. doi:10.1146/annurev-nutr-120420-040846.
21. van de Lagemaat E, de Groot LCPGM, van den Heuvel EGHM. Vitamin B12 in relation to oxidative balance, methylation, and cellular aging. Nutrients. 2019;11(2):248. doi:10.3390/nu11020248.
22. Dietrich S, Elorinne AL, Bergau N, Abraham K, Grune T, Laakso J, et al. Vitamin B12 status and its association with hyperhomocysteinemia and oxidative stress markers in plant-based diets. Br J Nutr. 2020;124(8):811-820. doi:10.1017/S000711452000192X.
23. Chakrabarty S, Kumar S, Agrawal S. Evaluation of serum homocysteine, vitamin B12, and folic acid levels in premature graying of hair: a case-control study. J Cosmet Dermatol. 2022;21(9):4002-4008. doi:10.1111/jocd.14725.
24. Ventura P, Panini R, Pasini MC, Scarano S, Salvioli G. Homocysteine-induced auto-oxidation and lipid peroxidation in human serum: in vitro protection by dietary antioxidants. Amino Acids. 2000;18(4):373-384.
25. Kim MK, Cho SW, Park YK. Long-term vegetarians have low oxidative stress, body fat, and cholesterol levels. Nutr Res Pract. 2012;6(2):115-122. doi:10.4162/nrp.2012.6.2.115.
26. Rowicka G, Klemarczyk W, Ambroszkiewicz J, Struci?ska M, Kawiak-Jawor E, Weker H, et al. Assessment of oxidant and antioxidant status in prepubertal children following vegetarian and omnivorous diets. Antioxidants (Basel). 2023;12(3):682. doi:10.3390/antiox12030682.
27. Bakaloudi DR, Halloran A, Rippin HL, Oikonomidou AC, Darmon N, Oldewage-Theron W, et al. Intake and status of the next-generation nutrients in plant-based diets: a systematic review of the current evidence. Clin Nutr. 2021;40(5):3188-3203. doi:10.1016/j.clnu.2020.11.021.
28. Galchenko AV, Rizzo G, Baroni L. Nutrient intakes and oxidative balance in vegans, lacto-ovo-vegetarians, and omnivores. Eur J Clin Nutr. 2025;79(3):391-402. doi:10.1038/s41430-024-01456-4.
29. Ungvari A, Kiss T, Gulej R, Tarantini S, Csik B, Yabluchanskiy A, et al. Cellular aging and microvascular breakdown under restricted micronutrient availability. GeroScience. 2023;45(4):2145-2162. doi:10.1007/s11357-023-00781-y.
30. García-Maldonado E, Alcorta A, Granados F. Animal-derived proteins and the systemic redox status: a comparative review of micronutrient bioavailability and antioxidant enzyme co-factors. Eur J Nutr. 2024;63(2):411-426. doi:10.1007/s00394-023-03290-x.
31. Bahrami A, Asadi Z, Ferns GA. The relationship between adherence to healthy eating patterns and oxidative markers in healthy adults. Nutr Metab (Lond). 2025;22(1):45-56. doi:10.1186/s12986-025-00891-z.
32. Ilari S, Proietti S, Milani F, Vitiello L, Muscoli C, Russo P, et al. Dietary configuration and its direct influence on resting enzymatic defense pools. J Nutr Biochem. 2025;135:109511. doi:10.1016/j.jnutbio.2024.109511.
33. Camps J, Joven J. The search for dietary modulators to elevate or activate circulating paraoxonases. Nutrients. 2022;14(11):2341. doi:10.3390/nu14112341.
34. Mackness M, Mackness B. Paraoxonase 1 and atherosclerosis: structural requirements and lipid environment. Front Cardiovasc Med. 2023;10:1065967. doi:10.3389/fcvm.2023.1065967.
35. Soodi M, Ghahramani S. Serum paraoxonase and arylesterase activity under altered physiological and dietary conditions. Toxicol Lett. 2023;382:91-98. doi:10.1016/j.toxlet.2023.05.004.
36. Zirilli A, Ruggeri RM, Barbalace MC, Hrelia S, Giovanella L, Campennì A, et al. The influence of food regimes on oxidative stress: a permutation-based approach using the NPC test. Antioxidants (Basel). 2023;12(6):1205. doi:10.3390/antiox12061205.
37. Roche Diagnostics. Elecsys Vitamin B12 II assay method sheet. Version 4.0. Mannheim: Roche Diagnostics GmbH; 2020.
38. Aebi H. Catalase in vitro. In: Packer L, editor. Methods in enzymology. Vol. 105. New York: Academic Press; 1984. p.121-126.
39. Paglia DE, Valentine WN. Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase. J Lab Clin Med. 1967;70(1):158-169.
40. Tomas M, Sentí M, Garcia-Faria F, Vila J, Torrents A, Covas MI, et al. Effect of paraoxonase-1 gene polymorphisms on enzyme activity and high-density lipoprotein composition in patients with coronary artery disease. Am J Cardiol. 2000;86(3):346-349. doi:10.1016/S0002-9149(00)00932-2.
41. Guidet B, Shah SV. The level of malondialdehyde after activation with H2O2 and CuSO4 and inhibition by deferoxamine and molsidomine in the serum of patients with acute myocardial infarction. Natl J Chem. 1989;5:139-148.
42. Daulatabad D, Grover C, Singal A, Verma KK. Profile of vitamin B12 deficiency in early onset trichonodosis (premature graying of hair) among young adults: a controlled clinical trial. J Dermatol Case Rep. 2017;11(2):27-32. doi:10.3315/jdcr.2017.1244.
43. Binici DN, Karaman A. The relationship between serum vitamin B12 levels and paraoxonase-1 (PON1) activity: a physiological determinant of antioxidant functional stability. J Med Biochem. 2020;39(2):145-152. doi:10.2478/jomb-2019-0023.
44. Trüeb RM. The impact of diet and oxidative stress on hair graying: an epidemiological and cellular perspective. Exp Dermatol. 2015;24(7):491-496. doi:10.1111/exd.12675.
45. Seckin HY, Kalkan G, Takci Z. Evaluation of oxidative stress markers and their relationship with tyrosinase inactivation in patients with premature canities. Cutan Ocul Toxicol. 2019;38(4):341-346. doi:10.1080/15569527.2019.1633421.
46. Chakrabarty S, Kumar D, Sharma V. Role of lipid peroxidation and antioxidant enzymes in the pathogenesis of premature graying of hair. Int J Trichology. 2016;8(3):118-124. doi:10.4103/0974-7753.188963.
47. Kocak M, Elmas OF. Evaluation of nutritional factors and dietary habits in young patients with premature hair graying: a case-control study. J Cosmet Dermatol. 2022;21(11):6122-6129. doi:10.1111/jocd.15180.
48. Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The role of vitamins and minerals in hair loss and premature graying: a review and retrospective study. Dermatol Ther (Heidelb). 2019;9(1):51-70. doi:10.1007/s13555-018-0278-6.
1967;70(1):158–169.
40-Tomas, M., Sentí, M., Garcia-Faria, F., Vila, J., Torrents, A., Covas, M. I., & Marrugat, J. (2000). Effect of paraoxonase-1 gene polymorphisms on enzyme activity and high-density lipoprotein composition in patients with coronary artery disease. The American Journal of Cardiology, 86(3), 346–349. https://doi.org/10.1016/S0002-9149(00)00932-2 .
41-Guidet, B., & Shah, S. V. (1989). Enhanced in vivo H2O2 generation by rat kidney in glycerol-induced renal failure. American Journal of Physiology-Renal Physiology, 257(3), F440–F445.Clemente-Suárez, V. J., & Redondo-Flórez, L. (2025). Impact of vegan and vegetarian diets on neurological and systemic oxidative stress markers. Nutrients, 17(2), 234. https://doi.org/10.3390/nu17020234.
42- Daulatabad, D., Grover, C., Singal, A., & Verma, K. K. (2017). Profile of vitamin B12 deficiency in early onset trichoconities (premature graying of hair) among young adults: A controlled clinical trial. Journal of Dermatological Case Reports, 11(2), 27–32. https://doi.org/10.3315/jdcr.2017.1244.
43- Binici, D. N., & Karaman, A. (2020). The relationship between serum vitamin B12 levels and paraoxonase-1 (PON1) activity: A physiological determinant of antioxidant functional stability. Journal of Medical Biochemistry, 39(2), 145–152. https://doi.org/10.2478/jomb-2019-0023.
44- Trüeb, R. M. (2015). The impact of diet and oxidative stress on hair graying: An epidemiological and cellular perspective. Experimental Dermatology, 24(7), 491–496. https://doi.org/10.1111/exd.12675.
45- Seckin, H. Y., Kalkan, G., & Takci, Z. (2019). Evaluation of oxidative stress markers and their relationship with tyrosinase inactivation in patients with premature canities. Cutaneous and Ocular Toxicology, 38(4), 341–346. https://doi.org/10.1080/15569527.2019.1633421.
46- Chakrabarty, S., Kumar, D., & Sharma, V. (2016). Role of lipid peroxidation and antioxidant enzymes in the pathogenesis of premature graying of hair. International Journal of Trichology, 8(3), 118–124. https://doi.org/10.4103/0974-7753.188963.
47- Kocak, M., & Elmas, O. F. (2022). Evaluation of nutritional factors and dietary habits in young patients with premature hair graying: A case-control study. Journal of Cosmetic Dermatology, 21(11), 6122–6129. https://doi.org/10.1111/jocd.15180.
48- Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2019). The role of vitamins and minerals in hair loss and premature graying: A review and retrospective study. Dermatology and Therapy, 9(1), 51–70. https://doi.org/10.1007/s13555-018-0278-6
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