Premature Hair Greying and Diabetes Mellitus

Document Type : Original Article

Authors

Department of Dermatology and Andrology, faculty of medicine Minia university Egypt

Abstract

Background: Hair greying is a natural age-related process. It is considered as a cosmetic, not a medical, condition. However, as the chances of developing a disease increase with age, many studies have postulated that hair greying could be a predictor of some aging diseases such as diabetes mellitus. Aim: The present study aims to reveal onset, pattern of hair greying and its correlation to diabetes mellitus among individuals with various age groups and of both sex in Minia governorate. Patients and methods: The present study was conducted on 5000 individuals answered a questionnaire Results:11.9% of premature hair greying cases were suffering from diabetes mellitus either type 1 or type 2 and were receiving a regular daily treatment (before and during onset of hair greying) either insulin for type 1 DM and/or oral hypoglycemic for type 2 DM Conclusion: premature hair greying can be considered an alarming factor for DM and others systemic diseases.

Highlights

In conclusion;

there is an association between premature hair greying and diabetes mellitus. Premature hair greying should be considered as an alarming sign for early

onset of diabetes mellitus and other concomitant diseases as hypertension and coronary heart disease.

Keywords

Main Subjects


Introduction
Premature hair greying is hair greying at early age. It is associated with family history premature greying of hair, obesity and smoking. The National Cholesterol Education Program’s Adult Treatment Panel report viewed coronary artery disease as the primary outcome of metabolic syndrome, such as diabetes mellitus, obesity, hyperlipidemia and hypertension. Metabolic syndrome could induce precocious ageing. However, an association between metabolic syndrome and premature hair greying has seldom been studied (1).

 

Hair color can be affected by metabolic diseases such as phenylketonuria iron-deficient anemia and oculocutaneous albinism. Premature greying of the hair was thought to be a coronary risk factor in peoples under the age of fifty years but not related to diabetes(2).

 

Aim of the present work was to evaluate the relation between DM and hair greying

 

Patients and Methods                                     

The present study was conducted on 5000 individuals recruited from Dermatology outpatient clinic in Minia governorate from Minia University hospital, Minia Leprosy hospital and Minia Dermatology hospital to make sure that different social and educational classes of participants are included. Participants are of both sexes.

 

A written informed consent (after approval of ethical committee of faculty of medicine) was obtained from all participants approval number 4/2:2021 and approval date 15 February 2021.

All participants were answered for a pre designed questionnaire

 

Statistics

Statistical analysis was performed using the SPSS statistical software, version 20.0 (SPSS Inc., Chicago, IL). Statistical significance was determined as p-value <0.05. Significant: P value<0.05. Not significant: P value<0.05.

 

Results

Range of age of cases was from 12 to 70 years with mean ±SD 45.51 ±11.27 years with female predominance (68.56%), while males were presented in 31.44 % of participants.

In males hair greying appeared at mean age ± SD 33.17 ± 10.76 years. In females, hair greying started at mean age ± SD 34.98 ± 9.46 years.

 

597(11.9 %) of cases were having diabetes with earlier onset of hair greying in 49.9 % of cases. Age of onset of hair greying in diabetic cases was with a range from 12– 57 years with a mean age ± SD 33.78 ± 9.92 years. While, 4403 (88.1 %) of cases were non diabetics with age of onset of hair greying was from 18 – 56 years with a mean age ± SD 39.02 ± 8.65 years. Hair greying was significantly started earlier in diabetic patients in comparison to non-diabetic patients (p<0.001*) (fig 1).

 

In diabetic patients, premature hair draying started at temporal and frontal areas. 

Diabetes mellitus type 1 was presented in 197 cases (32.9 %) with age of onset of hair greying was from 2- 30 years with a mean age ± SD15.6 ± 8.3 years. Diabetes mellitus type 2 was presented in 400 (67.1%) of cases. Range of age of onset of hair greying was from 19- 44 years with a mean age ± SD 31.3 ± 6.4years.  Hair greying was significantly starting earlier in diabetic patients type 1 comparison to diabetic patients type 2 (p<0.001*) (table 2, fig 2).

 

 

 

 

Table 1: Relation between hair greying and diabetes mellitus

 

 

Do you have diabetes mellitus

 

P

 

Yes
(n = 597)

No
(n = 4403)

 

No.

%

No.

%

At which part of head hair greying started

 

 

 

 

 

 

Frontal

299

50.1

2398

54.5

c2=45.141*

<0.001*

Temporal

298

49.9

1773

40.3

Vertical

0

0.0

66

1.5

Occipital

0

0.0

166

3.8

At which age hair greying started

 

 

 

 

Min. – Max.

12.0 – 57.0

18.0 – 56.0

t=13.622*

<0.001*

Mean ± SD.

33.78 ± 9.92

39.02 ± 8.65

Median

35.0

40.0

c2Chi square test      t: Student t-test

p: p value for comparison between the studied categories *: Statistically significant at p ≤ 0.05 

 

 

Table 2: hair greying according to type of diabetes

 

 

Type of diabetes mellitus

 

P

 

Type I
(n =
197)

Type II
(n =
400)

 

No.

%

No.

%

At which age hair greying started

 

 

 

 

Min. – Max.

2.0 – 30.0

19.0 – 44.0

t=23.022*

<0.001*

Mean ± SD.

15.6 ± 8.3

31.3 ± 6.4

Median

 

16.0

32.0

             

 

 

 

 

 

Fig. 1: Diabetic and non diabetic cases

 

 

 

 

 

 

Fig. 2: Type of diabetes mellitus

 

 

 

Discussion

In the present study, 11.9% of cases had diabetes mellitus with a significant earlier age onset in comparison to non-diabetic patients. Premature hair greying occurs significant earlier in diabetic patients (type 1) than diabetic patients (type 2).

 

Our results goes with Wollina(3) as they observed early and higher frequency of diabetes in greying males aged with dark eyebrows compared to those with greying of the eyebrows.

 

Genetic, oxidative free radicals, nutrition and environment play roles in the etiopathogenesis of hair greying (4,5).  Aging and chronic systemic diseases may be a cause of hair greying by increasing oxidative free radicals (6).

 

In the other way, many reports showed that premature hair greying is a predictor of severe systemic diseases (7).

 

Acer et al., (8) observed that half of participants with hair greying of them had at least a history of one chronic disease.  There an association between hair greying and hypertension, diabetes mellitus, hypercholesterolemia, thyroid diseases, cardiovascular diseases, lung diseases, dyslipidemia and cancer respectively.

 

Also, ElFaramawy et al., (9) noted that high incidence of hair greying was associated with high risk of coronary heart diseases independent of chronological age.

 

Additional evidence comes from Kocaman et al., (10). They noted that hair greying, as a sign of human aging, was higher in coronary heart disease patients with diabetes.

 

On the other hand, there is no significant association between hair greying and diabetes or hypertension(11,12).

 

 

 

 

  1. References

    1. Anggraini DR, Feriyawati L, Hidayat H, et al., Risk Factors Associated with Premature Hair Greying of Young Adult. Open Access Maced J Med Sci. 2019 Nov 14;7(22):3762-3764.
    2. Rincón A, Mora L, Suarez-ObandoF, et al., Werner's Syndrome: Unders-tanding the Phenotype of Premature Aging-First Case Described in Colombia. Case Rep Genet. 2019 Feb 12; 2019: 8538325.
    3. Wollina Eyebrow colour in diabetics. Acta Dermatoven APA. 2005; Vol 14, No 4
    4. Daulatabad D, Singal A, Grover C, et al., Profile of Indian patients with premature canities. Indian J Dermatol Venereol Leprol. 2016; 82:169–172.
    5. Kumar A.B, Shamim H, Nagaraju U. Premature greying of hair: review with updates. Int J Trichol. 2018; 10:198–203
    6. McDonough P.H, Schwartz R.A. Premature hair greying. 2012; 89:161–165
    7. Tobin, D. J., Paus, R. (2001). Greying: gerontobiology of the hair follicle pigmentary unit. Experimental geron-tology. 2001, 36(1), 29-54.‏
    8. Acer, E., Kaya Erdoğan, H., İğrek, A., Parlak, H., Saraçoğlu, Z. N., & Bilgin, M. (2019). Relationship between diet, atopy, family history, and premature hair greying. Journal of Cosmetic Dermatology, 18(2), 665-670.‏
    9. ElFaramawy AAA, Hanna IS, Darweesh RM, et al., The degree of hair greying as an independent risk marker for coronary artery disease, a CT coronary angiography study. Egypt Heart J. 2018 Mar;70(1):15-19.
    10. Kocaman SA, Çetin M, Durakoğlugil ME, et al., The degree of premature hair greying as an independent risk marker for coronary artery disease: a predictor of biological age rather than chronological age. Anadolu Kardiyol Derg. 2012 Sep;12(6):457-63.
    11. Zayed AA, Shahait AD, Ayoub MN, et al., Smokers’ hair: does smoking cause premature hair greying? Indian Dermatol Online J.2013; 4, pp. 90-92
    12. Christoffersen M, Frikke-Schmidt R, Schnohr P, et al., Visible age-related signs and risk of ischemic heart disease in the general population: a prospective cohort study. Circulation. 2014 Mar 4;129(9):990-8.