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Damion Francis MSc. TMRI-ERU Chemical elements required by living organisms other than C, H, O, N Naturally occurring in foods and must be taken in the diet Comprise of 4% of the body weight Classified according to the amount needed by the body Macrominerals- required in large proportions by the body (≥100mg) Includes: calcium, phosphorus, magnesium, etc. Microminerals (Trace elements)- required in relatively small amount by the body These include iron, zinc, cobalt and manganese BONE Bone is made up of an inorganic mass of minerals with a protein matrix (collagen) Major component is calcium and phosphate along with a other minerals and trace minerals Concurring with biological theory increase in fruit and vegetable intakes was associated with stronger bones in several studies The exchange of Ca and P between the extracellular matrix and body fluids are regulated by the parathyroid hormone (PTH) and vitamin D Bone has two growth phases: Formation of a protein matrix (collagen produced by osteoblasts) which can be calcified Calcification (calcium phosphate is precipitated from serum) Remodeling involves the building of bone by osteoblasts which are then broken down by osteoclasts Subsequently rebuilt by osteoblast mainly through the production of hydroxyapatite (Ca10(PO4)6OH2), the primary inorganic constituent of bone and teeth The apatites develops and mature into calcified crystals increasing bone density Teeth Mineralization of cementum and dentin is similar to bone Calcification of enamel differs from the above mentioned Mineralization and matrix formation occur alongside enamel development Mineral content of enamel is 95-97% with only a trace of organic matrix Enamel development begins with the differentiation of cells of the oral epithelium Thickens to form a protruded inner enamel epithelium Results in formation of ameloblasts which secretes enamel proteins such as amelogenin Also involved in transport of calcium and phosphate in enamel matrix Enamel proteins such as amelogenin mediate the formation of hydroxyapatite crystals from calcium and phosphate through enamel biomineralization Protein fraction in developing enamel is an aggregate of small proteins most of which are phosphoproteins Once enamel is completely mineralized only phosphopeptides remain (phosphorus and 1 or 2 aa) Adult body contains 1-1.5kg of ca Function Deposit in soft tissue to harden them Plays part in controlling heart action, skeletal muscle & excitability of the nerve Has role in blood clotting (prothrombin & thrombin) Enzyme cofactor (pancreatic lipase) Chromosomal movement before meiosis Metabolism Absorbed mainly in upper small intestine Facilitated by vit. D, proteins, acid pH Reduced by phytic acid, oxalic acid Transported as free ion or bound to albumin Blood levels are regulated by PTH, calcitonin (thyroid gland), and active vit. D storage deposit of calcium is bone trabuculae in long bones Bones are metabolically active but can calcium can be withdrawn when needed Approximately 250 – 1000mg of calcium enters and leave the bone daily Homeostasis is maintained from dynamism between blood levels and bone Diet and resorption contributes to the blood levels which act as a reserve Osteoid formation is directly regulated by amount of calcium from diet Calcium balance is obtained when there is sufficient calcium absorbed to meet body requirements for growth and tissue regeneration Negative balance when insufficient consumed and body mobilize calcium from bone to maintain necessary blood levels THREE HORMONE AND THREE ORGANS PTH ACTIVATED VITAMIN D CALCITONIN BONE KIDNEY SMALL INTESTINE principal regulator of [Ca] in ECF by [Ca] and [Pi] If blood levels of iCa 0.1 mg/dl, secretion of PTH is Kidney reacts quickly to changes in PTH minute to minute adjustments of blood Ca PTH acts on distal nephron to urinary excretion of Ca steroid hormone regulate specific gene expression following interaction with its intracellular receptor biologically active form is 1,25-dihydroxy vitamin D3 (1,25-(OH)2D3, also termed calcitriol) calcitriol functions primarily to regulate calcium and phosphorous homeostasis Parafollicular cells of thyroid gland in response of hypercalcaemia Decrease osteoclast activity Stimulating a distal tubular - mediated calciuresis Other hormones affect Ca balance - including prostaglandins that mobilize Ca, various growth factors, growth hormone, somatomedins, thyroid hormones (decrease skeletal mass), sex steroids which help maintain bone mass, adrenal cortical hormones Sources dairy product, fortified flour, egg,leafy vegetable, fish, cabbage, broccoli Requirement Adult 500mg/day, Pregnancy 1200mg/day excreted in urine and feces Deficiency Rickets in children & Osteomalacia in adult Food Calcium Small Intestine Body need Acid pH Vitamin C Vitamin D Lactose Certain amino acids Unabsorbed calcium Alkaline pH Oxalic acid Phytic Acid Some Fibers Laxatives Blood Calcitonin (thyroid hormone) Sufficient Vitamin D Weight-bearing exercise Teeth Positive calcium balance Feces Parathyroid hormone Inadequate/ excess vit. D Bone immobilization Bones Urine Negative calcium balance Inadequate intake, impaired absorption and increased loss include: Incomplete calcification of teeth Tooth and bone malformations Increased susceptibility to dental caries Excessive periodontal bone resorption Increased tooth mobility and premature tooth loss Increased risk of hemorrhage Less than 500mg calcium associated with higher risk of gingival detachment Decreased bone mineral density (cementum and dentin)