Paraoxonase-1 (PON1) is a high-density lipoprotein (HDL) associated enzyme with three activities which are paraoxonase, arylesterase and dyazoxonase. We aimed to determine serum (a) paraoxonase and arylesterase activities and, lipid hydroperoxide (LOOH) levels in patients with iron deficiency anemia (IDA) (b) whether there is an association between the development of atherosclerosis and paraoxonase/arylesterase activities in patients with IDA. Twenty-five female with IDA and 22 healthy female as control were enrolled in the study. Serum basal/salt-stimulated paraoxonase and arylesterase activities were measured spectrophotometrically. LOOH levels were measured by ferrous oxidation with xylenol orange assay. Basal/salt-stimulated paraoxonase and arylesterase activities were significantly lower in patients with IDA than controls (p < 0.001; for all), while LOOH levels were significantly higher (p < 0.001). Our results show that paraoxonase and arylesterase activities, which have antiatherogenic capability, are decreased in patients with IDA. Reduced paraoxonase and arylesterase activities may play a role in pathogenesis of atherosclerosis through increased susceptibility to lipid peroxidation in patients with IDA. (c) 2006 Elsevier Ireland Ltd. All rights reserved.