International Journal of Trichology

: 2020  |  Volume : 12  |  Issue : 3  |  Page : 137-

A study of association of premature graying of hair and osteopenia in North Indian Population

Mahmood Dhahir Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
P.O.Box 55302, Baghdad Post Office, Baghdad

How to cite this article:
Al-Mendalawi MD. A study of association of premature graying of hair and osteopenia in North Indian Population.Int J Trichol 2020;12:137-137

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Al-Mendalawi MD. A study of association of premature graying of hair and osteopenia in North Indian Population. Int J Trichol [serial online] 2020 [cited 2023 Jan 29 ];12:137-137
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I refer to the interesting case–control study published by Agarwal et al.[1] in March–April 2020 issue of the International Journal of Trichology. On using ultrasound bone densitometer to estimate bone mineral density (BMD), the authors compared the grade of osteopenia in individuals with premature graying of hair (PGH) and those without PGH. They found that the mean BMD in the case group was 0.76 ± 1.00 compared to 0.68 ± 1.11 in the control group with no statistically significant difference (P = 0.649).[1] They concluded that was no significant correlation between PGH and steopenia.[1] I presume that due to the following methodological limitation, the study results ought to be cautiously interpreted. In the study methodology, the authors stated that BMD was assessed based on the World Health Organization (WHO) criteria in which T-score of BMD between 1.0 and 2.5 was regarded as osteopenia.[1] The impact of that limitation could be addressed in dual aspects.

First, it is noteworthy that WHO definition criteria of osteopenia using T-scores were introduced in 1994. Certain concerns have been raised on the correctness of the use of the WHO T-score thresholds for defining osteopenia which might be attributed to the inappropriateness of these definition criteria at skeletal sites other than the forearm, hip, and spine, or when other tools, such as quantitative ultrasound are utilized.[2]

Second, it is obvious that BMD normative data (BMDND) are controlled by different determinants, such as age, gender, weight, and race.[3] Based on these determinants, BMDND have been formulated for certain populations to be employed in the researches centers and clinical settings.[4],[5] Since population in India has its unique characteristics, there is a need to construct national BMDND. Employing local standard is expected to yield a better idea on the association between steopenia and PGH.

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Conflicts of interest

There are no conflicts of interest.


1Agarwal S, Choudhary A, Kumar A, Zaidi A, Mohanty S, Yadav S. A study of association of premature graying of hair and osteopenia in North Indian population. Int J Trichol 2020;12:75-8.
2Knapp KM, Blake GM, Spector TD, Fogelman I. Can the WHO definition of osteoporosis be applied to multi-site axial transmission quantitative ultrasound? Osteoporos Int 2004;15:367-74.
3Wu Q, Lefante JJ, Rice JC, Magnus JH. Age, race, weight, and gender impact normative values of bone mineral density. Gend Med 2011;8:189-201.
4Alwis G, Rosengren B, Nilsson JA, Stenevi-Lundgren S, Sundberg M, Sernbo I, et al. Normative calcaneal quantitative ultrasound data as an estimation of skeletal development in Swedish children and adolescents. Calcif Tissue Int 2010;87:493-506.
5Zhang ZQ, Ho SC, Chen ZQ, Zhang CX, Chen YM. Reference values of bone mineral density and prevalence of osteoporosis in Chinese adults. Osteoporos Int 2014;25:497-507.