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Mineral metabolism a) b) Minerals are classified into: Principal elements: which exist in the body in large amounts. e.g. Na, K, Ca, Mg, P, S, Cl and Fe. Trace elements: which exist in the body in small amounts. e.g. Cu, Co, I2, Mn, F, Mo, Se, Al, Zn and Cr. A) Principal elements 1) Calcium Calcium is present in the body in larger amounts than any other cation. The amount of calcium in the body of adults is about 1400 g. 99% of the body calcium is in the skeleton (bones and teeth) and the other 1% is present in other tissues and body fluids. A) Principal elements 1) Calcium Importance of Calcium 1. 2. 3. 4. Essential for formation of bone and teeth. Necessary for muscle contraction. It plays an important role in the transmission of nerve impulses. Activation of certain enzymes. A) Principal elements 1) Calcium Absorption of Calcium 1. 2. About 30% of dietary calcium is absorbed. Absorption of calcium is affected by the following factors: Concentration of calcium in diet: The higher the concentration, the more the absorption of calcium. pH: Calcium salts are soluble in acid solutions, so, acidity increases the absorption. A) Principal elements 1) Calcium Absorption of Calcium Requirements of the body. Ca:P ratio: The optimum ratio for absorption of both elements is about 1:1 or 1:2 Amount of magnesium in diet: Excess magnesium in diet inhibits calcium absorption as magnesium competes with calcium for absorption. A) Principal elements 1) Calcium Absorption of Calcium 6. Amount of proteins in diet: Amino acids form soluble complexes with calcium, so, high protein diet favors the absorption of calcium. Vitamin D: 1,25 dihydroxy vit. D induces the formation of a carrier protein that is important for the transfer of calcium across the intestinal mucosal epithelium. Parathormone: Involved in the conversion of Vit. D to 1,25 dihydroxy vit. D, so, it helps calcium absorption. A) Principal elements 1) Calcium Calcium Blood Level 1. 2. Plasma normally contains 9 – 11 mg / 100 ml of calcium. 45% of which is non-diffusible )bound to plasma albumin). The diffusible calcium (55%) is classified into: Ionisable (50%): active form. Non-ionisable (5%): Calcium citrate. Erythrocytes almost contain no calcium. A) Principal elements 1) Calcium 1. a) b) 2. a) b) c) Factors affecting plasma calcium level: Vitamin D: It increases calcium level as: It increases absorption of calcium from the intestine. It increases reabsorption of calcium by renal tubules. Parathyroid hormone (parathormone): It increases calcium level by increasing: Absorption of calcium from the intestine. Reabsorption of calcium by renal tubules. Mobilization of calcium from bones. A) Principal elements 1) Calcium 3. 4. 5. Factors affecting plasma calcium level: Calcitonin (secreted by the thyroid gland): It lowers calcium blood level by inhibiting mobilization of calcium from bones. Plasma phosphate: Increase of plasma phosphates leads to a decrease of plasma calcium and vice versa. Plasma proteins: Decrease in plasma proteins → decrease of the non-diffusible form of calcium → decrease of total plasma calcium. A) Principal elements 1) Calcium Sources Cheese and milk (rich sources). Fruits, vegetables, egg yolk and legumes (small amounts). Requirements For normal adults: 0.8 g/day. For pregnant and lactating women: 1.2 g/day. Excretion 1. 2. In feces: 80% In urine: 20% A) Principal elements 2) Phosphorus Total body phosphorus is about 800 g. 80% in the skeleton and 20% in other tissues and body fluids. Phosphorus is present in every cell of the body. A) Principal elements 2) Phosphorus Importance of Phosphorus 1. 2. 3. 4. 5. Formation of bones and teeth. Formation of nucleic acids and nucleotides. e.g. ATP, ADP and cAMP. Formation of phospholipids, phosphoproteins, hexose, pentose and triose phosphates. Formation of many coenzymes as TPP, CoA-SH, NAD, NADP, FMN, FAD, UDP-G and pyridoxal phosphate. Formation of buffers. A) Principal elements 2) Phosphorus Absorption of Phosphorus Phosphorus is absorbed from the intestine in the form of phosphates. Only about 70% of food phosphates are absorbed. Factors which help the absorption of calcium will secondarily help the absorption of phosphate as unabsorbed calcium inhibits the absorption of phosphate. The best Ca/P ratio for the proper absorption of both calcium and phosphate is 1:1 (1:2 to 2:1). A) Principal elements 2) Phosphorus Blood Phosphorus 1. a) b) In plasma: Inorganic phosphates: 3.5 mg/100 ml. Organic phosphates: mostly phospholipids. A) Principal elements 2) Phosphorus Factors affecting plasma inorganic phosphate I. II. III. Renal function: Renal failure → failure of excretion in urine → ↑ plasma inorganic phosphate. Parathyroid hormone: It inhibits renal tubular reabsorption of phosphate → ↑ phosphate excretion in urine → ↓ plasma phosphate. Vitamin D: Plasma inorganic phosphate decreases in rickets. A) Principal elements 2) Phosphorus Blood Phosphorus 2. a) b) In RBCs: Inorganic phosphates: Potassium monohydrogen phosphate K2HPO4 and potassium dihydrogen phosphate KH2PO4. Organic phosphates: mainly in the form of hexose, pentose, triose phosphates and ATP. A) Principal elements 2) Phosphorus Sources Cheese, milk, liver, kidney, heart, meats and fishes. Requirements For normal adults: 0.8 – 1 g/day. For pregnant and lactating women: 1.2 g/day. Excretion 1. 2. In urine: 60% In feces: 40% A) Principal elements 3) Magnesium The total body magnesium is about 21 g. 70% in the skeleton and 30% in the other tissues and body fluids, mostly intracellular. Magnesium in muscle cells is about 10 times that in plasma. A) Principal elements 3) Magnesium Importance of Magnesium 1. 2. 3. 4. Magnesium is important for: Normal contraction of muscles. Formation of bones and teeth. Normal transmission of nerve impulses. Activation of kinases, phosphorylases and transketolases. A) Principal elements 3) Magnesium Absorption of Magnesium About 40% of the ingested magnesium is absorbed. Factors affecting absorption of magnesium are the same affecting calcium absorption. A) Principal elements 3) Magnesium Blood Magnesium Plasma magnesium is normally 2.2 mg/ 100 ml. Magnesium in RBCs is about 2 – 3 times its amount in plasma. A) Principal elements 3) Magnesium Factors affecting plasma magnesium 1. 2. 3. Renal function: Renal failure → ↓ excretion of magnesium → hypermagnesemia. Aldosterone → ↑ renal clearance → ↓ plasma magnesium. Parathyroid hormone → ↑ mobilization of magnesium from bones → ↑ magnesium in blood. A) Principal elements 3) Magnesium Sources Vegetables (chlorophyll), legumes, meats, fish, liver, kidney and heart. Requirement For normal adults: 0.3 g/day. Excretion 1. 2. In feces: 70% In urine: 30% A) Principal elements 4) Sodium, Potassium and Chloride One third of the total sodium, potassium and chloride content of the body is present in the skeleton. The remaining two thirds are present in other tissues and body fluids. Sodium and chloride are chiefly extracellular and potassium is chiefly intracellular. A) Principal elements 4) Sodium, Potassium and Chloride Importance of Sodium, Potassium and Chloride 1. Maintenance of fluid volumes and osmotic pressure. 2. Formation of buffers. 3. Transmission of nerve impulses. 4. Contraction of muscles. 5. Chloride activates amylase enzyme. 6. Chloride is important for formation of gastric HCl. A) Principal elements 4) Sodium, Potassium and Chloride Sources of Sodium, Potassium and Chloride 1. 2. Table salt (NaCl). Potassium is present in potatoes, fruits, meats, fishes, vegetables and legumes. A) Principal elements 4) Sodium, Potassium and Chloride Requirements for normal adults 10 – 15 g/day NaCl 3 – 5 g/day KCl Excretion Excretion is mainly controlled by aldosterone hormone. 95% in urine. Small amounts in feces and sweat. A) Principal elements 5) Sulphur I. II. a) b) c) d) Sulphur containing compounds in the body are classified into: Inorganic compounds: Sulphate, thiosulphate and tiocyanate. Organic compounds: Amino acids: Cysteine, cystine, methionine and homocysteine. Proteins: Keratin, hormones (insulin, parathyroid hormone, ACTH and MSH). Vitamins: Thiamine, Biotin and Lipoic acid. Other compounds: e.g. CoA-SH, glutathione, ergothionine, heparin, adenosine and urochrome. A) Principal elements 5) Sulphur N.B.) Ergothionine and glutathione are present in RBCs. Requirements of sulphur are attained by adequate proteins in the diet. Excretion of sulphur is mainly through urine and feces. Other routes of excretion include hairs, nails and skin. A) Principal elements 6) Iron 1. 2. 3. 4. 5. The total body iron is about 4 g. Iron is present in the following compounds: Hemoglobin (70% of iron). Myoglobin (5% of iron). Respiratory enzymes (5%): Cytochrome a, b and c, catalase and peroxidase. Transferrin and ferritin. Hemosederin. A) Principal elements 6) Iron Absorption of Iron Iron is only absorbed in an inorganic form. Ferric (Fe+3) must be converted to ferrous (Fe+2) before absorption. This is helped by reducing substances in food as cysteine and vitamin C. In the plasma ferrous is oxidized rapidly to the ferric state to be carried by transferrin. Oxidation is catalyzed by ceruloplasmin (a copper-containing protein). A) Principal elements 6) Iron Sources Animal sources: Liver, kidney, spleen, heart, red meats and egg yolk. Plant sources: Dates, legumes, vegetables and cereals. Requirements For normal adults: 10 – 15 mg/day. For pregnant and lactating women: 20 mg/day. A) Principal elements 6) Iron Excretion Iron is never excreted in urine as it is carried on a β-globulin. (Proteins are not passed through the glomeruli). In feces: 90 – 95% In sweat: 5% In menstruation and milk: 5% B) Trace elements 1) Copper Copper is present in most tissues such as liver, muscles, bones….etc. Liver is the storage site for copper. The total body copper normally ranges between 100 and 150 mg. B) Trace elements 1) Copper Importance of Copper 1. 2. 3. 4. Hemopoiesis: Copper helps the absorption of iron from the intestine and helps mobilization of iron from its stores. Copper is an essential component of cytochrome oxidase and superoxide dismutase. It is important for the formation of myelin sheath. Hemocyanin is a cupro-protein which function as an oxygen carrier in the blood of some invertebrates (instead of hemoglobin). B) Trace elements 1) Copper Blood Copper Copper is present in plasma bound to a globulin fraction forming ceruloplasmin. Copper is also present in RBCs in the form of erythrocuprein. B) Trace elements 1) Copper Wilson’s Disease 1. 2. 3. 4. It is a congenital disease characterized by: Low plasma ceruloplasmin. Increased copper bound to albumin. Accumulation of large amounts of copper in the liver → liver cirrhosis. Accumulation of large amiunts of copper in brain → parkinsonism. Excretion Copper is excreted mainly in feces. B) Trace elements 2) Iodine 1. 2. The total body iodine is 25 – 50 mg. Iodine is present in: Thyroid gland (30%). Other tissues and body fluids (70%). Functions Iodine enters in the formation of thyroid hormones. B) Trace elements 2) Iodine Sources Sea water, sea fishes, see weeds, vegetables and fruits grown on the sea board are rich sources of iodine. Absorption Iodine and sodium iodide are readily absorbed from the skin, lungs and intestine. Excretion Urine: 70% Feces: 30% Small amounts are excreted through sweat, lungs and milk. B) Trace elements 3) Manganese 1. a) b) c) d) 2. Manganese is important for: Growth. Normal bone structure. Normal functions of CNS. Spermatogenesis and ovulation. Manganese is an essential component of some enzymes such as: arginase, cholinesterase, carboxylases and some decarboxylases. B) Trace elements 4) Zinc 1. a) b) c) d) 2. Zinc is important for: Normal taste and appetite. Normal growth and healing of wounds. Development of gonads. Mobilization of vitamin A from its stores. Zinc acts as a component of insulin and some enzymes such as carbonic anhydrase and carboxypeptidase. Deficiency of zinc causes testicular degeneration by the testicular proteolytic enzyme which is normally inhibited by zinc. B) Trace elements 5) Flourine 1. 2. Flourine is present in many tissues such as bones, teeth, thyroid gland and skin. Flourine is absorbed from intestine and excreted in urine, milk and sweat. Intake of 1 – 1.5 part per million of flourine in the drinking water increases resistance of teeth to dental caries due to: Formation of flouroapatite in teeth. Inhibition of fermentation of carbohydrates by the oral bacteria because flouride inhibits enolase enzyme. B) Trace elements 5) Flourine 1. 2. Excess flourine leads to flourosis which is characterized by: Teeth become brittle and mottled with whitish patches. Bones become denser with calcification at the point if insertion of muscles. B) Trace elements 6) Chromium 1. 2. Chromium is essential for: Proper utilization of glucose by tissues. Normal growth. B) Trace elements 7) Cobalt Cobalt is important for formation of vitamin B12 which is important in hemopoiesis. Over administration of cobalt leads to polycythemia. B) Trace elements 8) Selenium Selenium is a component of the enzyme glutathione peroxidase which protects hemoglobin, polyunsaturated fatty acids and cell membranes against oxidative damage by H2O2 B) Trace elements 9) Molybdenum Molybdenum is an essential component of some flavoprotein enzymes such as: Sulphite oxidase, aldehyde oxidase and xanthine oxidase.