14 Min & trace elements for clinical chemistry .ppt

14 Min & trace elements for clinical chemistry

1. Minerals and trace
elements
Mr. Hussein Hassan Mohamud

2. Seven Food Substances
Food Substances
Carbohydrates
Proteins
Water
Dietary Fibre Minerals
Vitamins
Fats

3. Minerals
Approximately 50 chemical elements are
identified
Important for Growth, Development , regulation
of vital functions
Major : calcium, Phosphorous, Sodium,
Potassium, Magnesium
Minor: Required less than a few milligram per
day. Ex. Iron, Iodine, Fluorine, Zinc, Copper,
Cobalt, Chromium, Manganese, Molybdenum,
Selenium, Nickel, Tin, Silicon, Vanadium

4. Trace elements
 A naturally occurring, homogeneous, inorganic
substance required in humans in amounts less
than 100 mg/day
Excess amounts are important to health

5. Iron
Adult human body contains 3-4 Gm
60-70% is present in Blood and rest in storage form.
Each Gm of Hb contains 3.34mg of Iron.
Requirement :
1 mg per day for Male
2.5 mg for Females
3.5 mg for Females in Physiological stress
conditions

6. Functions of iron
Iron is a part of all cells and has many different
functions
Hb Carries oxygen to the tissues
Brain development along with Folic acid
Myoglobin Facilitates oxygen use and storage in
muscles
An integral part of enzyme reactions in various tissues
( Cyotchromes, Catalases, etc)
Regulation of body temperature
Catecholamine metabolism
Susceptibility to infection

7. Iron loss
In adults – 1 mg per day
Menstruating women – 2 mg per day
Hemorrhages are common causes
Stored in Liver, Spleen, Bone marrow,
Kidneys

8. Iron Deficiency
Occurs in 3 stages:
First Stage: Decreased storage
without any other detectable
abnormalities
Second Stage: stores are exhausted,
serum Ferritin level decreases.
Third Stage: Decrease in Hemoglobin

9. Iron
Signs of iron deficiency anemia include:
Fatigue
Headache
Cardiovascular stress
Poor tolerance to heavy blood loss

10. Evaluation of iron status
1.Hemoglobin Concentration: relative index
of iron deficiency. ( early Anemia if Hb is
10-11g% & marked anemia Hb is < 10g
%).
2.Serum Iron concentration: useful index
( Normal 0.8 to 1.8mg /L)
3.Serum Ferritin level: Gold standard &
sensitive tool for evaluation and reflects the
size of the iron status ( < 10Micrgms/L)
4.Serum Transferrin Saturation: 16% - 30%

11. Iodine
Essential Micronutrient
Body normally has 20-30 mg of iodine and more than
75% is in the thyroid gland,
rest is in the mammary gland, gastric mucosa, and blood
it’s only function is related to thyroid Hormone
Required for synthesis of thyroid hormone
 Thyroxin (T4) – 4 atoms of iodine per molecule
 Triiodothyronine (T3) – 3 atoms of iodine per molecule
Requirement per day is 150 micrograms

12. Iodine
Food Sources – 90% intake
Foods of origin (sea-foods), processed foods,
iodized salt
Fresh Water – small & Variable
Small amounts in Milk, meat, Vegetables, Cereals
etc.

13. Iodine - Absorption and Excretion
Iodine is absorbed in the form of iodide
occurs both as free and protein-bound iodine in
circulation
iodine is stored in the thyroid where it is used for
the synthesis of T3 and T4
hormone is degraded in target cells and in the
liver and the iodine is conserved if needed
excretion is primarily via urine
small amounts from bile are excreted in the feces

14. Iodine - deficiency
Goitre—enlargement of the thyroid gland, goiters are more
prevalent in women and with increased age
deficiency may be absolute—in areas of deficiency,
or relative—adolescence, pregnancy, lactation
Iodine deficiency is the world’s most prevalent cause of brain
damage
Serious iodine deficiency during pregnancy may result in
stillbirths, abortions and cretinism
 the less visible, more pervasive form of iron & iodine
deficiency that lowers intellectual performance at home and
school may have far greater global and economic impact

15. Fluorine
It is found in combined forms
96% of fluorides in the body found in bone and teeth.
An essential for normal mineralisation of bones and
formation of dental enamel
Source:
Drinking water : Fluorine in the drinking water is
0.5 mg per ltr. Excess of fl > 3mg causes flourosis.
Foods: Sea fish, cheese, Tea
It is a two edged sword ( deficiency or excess)

16. Zinc
Adult body contains 1.4 to 2.3 gms of Zinc
Plasma level- 96Microgm per 100 ml ( adults), 89
Microgram per 100 ml (children)
Functions are;
Active role in metabolism of glucose and proteins
Synthesis of insulin by pancreas
Immunity functions
Food sources :
 meat, milk, fish
Plant sources have low bioavailability

17. Zinc
One of the ten biggest factors contributing to
diseases related to nutrition in developing countries
 Zinc interventions could reduce child deaths
globally by 63%
 South East Asia and Sub-Saharan Africa highest
risk of zinc deficiency:
 Inadequate intake – 1/3 of the population
 40% of pre-school children
Zinc used as a (part of) curative intervention for
severe malnutrition and diarrhea

18. Zinc deficiency
 Growth failure
Sexual infantility in adolescents, loss of taste, delayed
wound healing, decrease in immuno synthesis.
Spontaneous abortions, stillbirths, congenital
malformations.
LBW, Intra Uterine deaths, premature labour.
Daily Requirement
is 15mg for men
 12 mg for women, 10mg for children