PRAMUDJI HASTUTI

DEPARTMENT OF BIOCHEMISTRY
FACULTY OF MEDICINE, UGM
MINERAL ELEMENTS :

- MACRONUTRIENTS
- Ca, Mg, Na, K, P, S, Cl
(60 – 80% inorganic material in the body)

- MICRONUTRIENTS (TRACE ELEMENTS)

- essential
Fe, I, Cu, Zn, Mn, Co, Mo, Se, Cr, F
- possibly-essential
Ni, Tin, Va, Si
- non-essential
Al, B, Ge, Cd, As, Pb, Hg
PROBLEM :

-CHILDHOOD UNDERNUTRITION 
- altered immunity
- increased risk infectious disease & death
- reduced growth
- reduced cognitive development

CAUSES :
- deficiency micronutrients (minerals) &
vitamins
 IRON

-Total body content of Iron is 3-5 gm.

- 70% in Erythrocytes (in Hb)
- 5% in Myoglobin
- Remaining as other hemoproteins
Cytochromes, Catalase,xanthine oxidase
tryptophan pyrollase, peroxidase etc.
Non hemo proteins : transferrin, ferritin & Hemosiderin

Biochemical functions :

- Components of Hb & Mb : helps transport O2

- Components of cytochromes & non heme substances
:OXIDATIVE PHOSPHORYLATION
Peroxidase : phagocytosis
Daily requirement :

- Adult - 10 mg/day
- Menstruating women - 18 mg/day
- Pregnant & Lactating mother - 20-40 mg/day

Sources
Rich Source = Liver, heart, kidney, spleen
Good Sources = Spinach, bananas, apples, Egg yolk
Poor Sources = Milk, wheat
Absorption :

- Absorbed in Ferrous state

- In food stuff :in Ferric

converted to Fe++ by Ascorbic acid or cysteine.

- Factors affecting absorption :

Acidity : Ascorbic acid & cysteine levels
High phosphate diet, Phytic acid, Oxalates

Normal Serum Iron level

- 65 - 170 mg/100mL :
- maintained at the level of absorption only
- It is not excreted in Urine.
Disorders :

Iron deficiency = anemia

- Defect absorption
- Nutritional disorder
- Chronic blood loss
- Lead poisoning
- Hook worm
- Repeated Pregnancies
- Nephrosis
 CALSIUM

- Total content :1 - 1.5 kg

-Sources:
Good source : milk
Medium source : fish, egg
Poor source : Vegetables Cereals

-Daily requirement:- Adults = 500mg

- Children = 1200 mg
Pregnant & Lactating women =1500 mg

Normal Serum levels 9 -11 mg/dl

-Absorption: requires a carrier(calbindin)

- Factors increase absorption : Vitamin D (Calcitriol)

Parathyroid hormone, Acidity : Amino acids
(Lysine & Arginine)

-Factors decrease absorption : Phytic acid, Oxalates,

high phosphate content, Malabsorption

Functions :
1) Activation Enzymes Calmodulin and activates
- Glycogen synthase,
- glycerol
- 3- phosphate dehydrogenase
- Pyruvate dehydrogenase
2) Pancreatic lipase
3) enzymes in coagulation .
Function

- mediates excitation and contraction of Muscle fibres

- causes neuromuscular Irritability
- helps in transmission of nerve impulses
- Secretion of hormones
- Act as second Messenger in Signal transduction
- Decreases Vascular permeability
- factor in Coagulation
- In Myocardium : prolongs systole
- Bone & teeth

Factors regulate Blood Ca levels :

1) Vit D 2) PTH 3) Calcitonin

4) Phosphorus 5) Serum Protein 6) Kidney threshold
7) Alkalosis & Acidosis 8) Children & Pregnancy
- 99% in skeleton (bone, teeth)
- small in body fluids
= as blood coagulation
= maintain normal excitability heart,
muscles, nerves, membrane permeability

-Excess in serum/urine 
idiopathic hypercalcemia infant,
hyperparathyroidism, renal stones

- Metastatic calcification ≈ high intake Ca/

alkali (peptic ulcer)
ABSORPTION :

- Active
- regulated by 1,25-(OH)2 cholecalciferol
- facilitated by vit D, lactose, protein,
acid >>  soluble (><alkaline)
- Inhibited : substance that cause insoluble
(phytate, oxalates, phosphates, fatty acid)

METABOLISM
- Regulate by parathyroid & calcitonin
- in plasma 3 forms :
- protein-bound
- ionized
- complex
- [Ionized] ↘ → tetany
= in pH ↗, renal excretion >> (nephritis)
= absorption ↘
= parathyroid <<, retention phosphorus

-Ratio Ca : P = maintain
50 (children)  rickets ↘

DISEASES
-Hyperparathyroidism :
= Ca ↗, P ↘ (reabsorption ↘)
- to maintain [Ca : P]  bone decalcification

-Hypoparathyroidism :
= Ca↘  P ↗
OSTEOPOROSIS
- Not related with calcium intake/bone loss
- protein intake >>  calcium loss >>

RICKETS
- Vitamin D <<  Calcification bone fail
- Ca, P diet <<

RENAL RICKETS
- Familial hypophosphatemic rickets (X-link)
- Defect transport P
 PHOSPHORUS

= Total body content : 1kg

= an intracellular ion

Functions :
- Formation of bone & teeth
- Production of high energy phosphates
- Synthesis of coenzymes NAD, NADP
- Phosphorylation : DNA & RNA Synthesis, activation
- Regulates Acid Base balance

Daily requirement : 500 mg/day

Sources :
Good source : milk
Moderate source : Cereals, nuts & meat
Calcitriol Increases Phosphate absorption
Normal levels : 3-4 mg/dl in adults
5 - 6 mg/dl in children

A reciprocal relation with Phosphorus and Calcium

In Renal failure : Phosphorus excretion diminished

- Ca excretion Increase  low Ca levels,
high phosphorus level Tetany
 MAGNESIUM

-Total body magnesium ;=20 gm

75% in bones
25% in soft tissues & body fluids
-Mainly in Intracellular fluid

Daily requirement :
Men - 400 mg/day
Women- 300 mg/day

Sources : Cereals, beans, vegetables, milk & fruits

Absorption requires a specific carrier in intestinal cells

Normal Serum levels : 1.8 - 2.2 mg/dl

Functions :
= activator of enzymes requiring ATP.
= required for proper Neuromuscular function.
= role in Insulin Sentivity
= Bone formation

Disorders :
Hypo magnesemia :
Uncontrolled DM
Chronic alcoholism
Liver Cirrhosis
Protein energy Malnutrition
Neuromuscular: hyper irritability
Cardiac arrhythmias
Spasm
 SODIUM

= Total body = 4000 meq

- 50% in bones
- 40% in ECF
- 10% in Soft tissues
= It is the major Extracellular cation

Daily requirement = 5-10 gm/day

In Hypertensive = 1 gm/day is recommended

Sources : Table salt (NaCl) is the major source.

vegetables, nuts, eggs and milk.
Functions :

= regulates Osmotic pressure & and fluid balance

= Regulates Acid-base balance (NaHCO3)
= involved in absorption of Glucose, Galactose &
Aminoacids
= helps in cell permeability.

Absorption : readily absorbed in GIT

Normal Serum level : 135-145 meq/L

Excretion : Kidney
Around 800 gm/day is filtered by Glomerulus
99% is reabsorbed by tubules  controlled by
Aldosterone
Sweating : causes loss of sodium.
Disorders :

Hyponatremia
- Diarrhea, Vomiting
- Chronic renal failure
- Addisons disease (adreno cortical Insufficiency) - - Renal
tubular acidosis

Symptom :
Mild - head ache, muscle cramps
Moderate & severe - Low Blood pressure & Circulatory failure

Hypernatremia :
- Cushings syndrome
- Prolonged administration of steroid hormones (Cortisone,
ACTH/Sex hormones)
- Severe dehydration (only water) (Burns, Diabetes Insipidus)
- Increased Blood volume, HTN
 POTASSIUM

= Total body : 3500 meq

75% in skeletal muscle
= It is the major Intracellular cation

Daily requirement : 3-4 gm/day

Sources : Banana, Orange, Potato, beans, Liver etc.

Rich Source : Tender coconut water.

Functions:
= maintains Intracellular Osmotic pressure
= Involves in cardiac & skeletal muscle activities
= Mainly K+ for depolarization & contraction of Heart.
= Involved proper transmission of Nerve Impulses
= Pyruvate kinase needs K+ for biosynthesis of proteins
Normal Serum Potassium : 3.5 -5 meq/L

(Cell contain 100 -120 meq/L)

Excretion : urine

Disorders :
Hypokalemia : Serum K+ less than 3 meq/L
= Cushing syndrome
= Renal tubular acidosis
= Tubular necrosis
= Metabolic alkalosis
= Diarrhea & vomiting
= Diabetic coma treatment with Insulin & Glucose
= Diuretics Muscle weakness

Tachycardia Cardiac arrest

Hyperkalemia :

= Addisons disease
= Renal failure
= Increased hemolysis
= Tissue necrosis
= Metabolic acidosis
= Insulin deficiency
= Depression of central Nervous system
= Flacid paralysis
Bradycardia & Cardiac arrest
 Chlorine

= Intake, output & metabolism : parallel with Na+& Cl-

= Daily requirement : 5-10gm

= Sources : table salt, leafy vegetables, eggs & Milk.

Excretion is through urine as sodium

Functions :
= Regulates Acid Base balance
= Osmotic pressure
= fluid balance in relation with Na+ & K+ ,Cl-
= Necessary for HCl formation
Normal serum level : 96-106 meq/L
CSF level is 125 meq/L

Disorders :
Hyper chloremia :
= Dehydration
= Cushings syndrome
= Severe diarrhea
= Respiratory acidosis
= Renal tubular acidosis

Hypo Chloremia :
= Addisons disease
= Respiratory alkalosis
= Excessive vomiting
 COPPER

- Constituent : several proteins,

metallo-enzymes,
naturally pigments
- Function : Hb synthesis
normal bone formation
maintenance myelin (nerve)

Present :
- enzymes cytochrome-oxidase
- SOD  scavenges toxic superoxide ion
- amine oxidase, tyrosinase, uricase, dopamine
hydroxylase
- in plasma : >> firmly bound (ceruloplasmin)
<< loosely bound by albumin
DEFICIENCY
- In animal deficiency Cu  lose weight  die
Bone disorders (dogs)
- thin cortices, deficient trabeculae, wide
epiphysis
- fractures & deformities
- anemia, gray hair

WILSON DISEASE :
Liver & lenticular nucleus brain contain Cu >>
low level Cu & ceruloplasmin in plasma

Deposition Cu >> in liver  cirrhosis

in kidney  renal damage
 IODINE

Problems :
- ± 10 million babies born/y : mentally impaired
because of Iodine deficiency

Response : Iodinated salt

campaign : be smart, use iodized salt
- Function : maintain proper thyroid function
- Deficiency : goiter & hypothyroidism