Trace Elements Flashcards by Isabelle Tchoungang

What are trace elements?

Inorganic micronutrients considered essential when deficiency in their intake causes impairmemt of function

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How is function restored and symptoms alleviated when these trace elements are deficient?

By supplying physiological amounts of the element

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What trace elements have specific biochemical functions and symptoms of deficiency in humans?

Cupper
Zinc
Iron
Fluoride
Iodine
Chromium
Selenium

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What is the most abundant trace element?

Iron (Fe)

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What trace elements have no clear biochemical functions but are symptomatic when deficient?

Cobalt

Boron

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What trace elements have a clear biochemical function but do not show symptoms in deficiency?

Manganese

Molybdenum

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How are clinically critical trace elements studied primarily?

Via indirect measurement

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Indirect measurement of iron

Hemoglobin/red blood cells appearance

Transferrin/ferritin binding/storage/transport proteins

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Indirect measurement of iodine

Thyroid hormone

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Indirect measurement of copper

Ceruloplasmin

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Indirect measurement for zinc

RBC protoporphyrin

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What percentage of dietary copper is absorbed?

50%

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What are the functions of copper?

Needed in many enzyme reactions
Role in regulation of iron metabolism, formation of connective tissue, energy production within cells, and nervous system

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Percentage of copper in liver

10%

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Percentage of copper in muscle, kidney, heart, brain

70%

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What protein carried copper?

Ceruloplasmin

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This a-2 globulin protein made in the liver is a copper-containing enzyme that plays a role in the body’s iron metabolism.

Ceruloplasmin

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What percentage of circulating copper is bound to ceruloplasmin?

~95%

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Why are preemies deficient of copper?

Cu stores in liver increase till the third trimester.

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What can cause cu deficiency in adults?

Malabsorption

Inborn error of cu absorption/metabolism

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What disease is deficiency of cu?

Menke’s syndrome

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What disease is cu overload?

Wilson’s disease

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What can cause cu overload?

Inborn errors of cu metabolism

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How is excess cu is usually discarded?

Excreted in bile to feces.

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What organ damage is seen in cu overload?

Hepatolenticular degeneration.

What is Menke's syndrome?

X-linked defect in intestinal absorption, transport and storage of cu

What is seen in MS?

Decreased cu in all compartments like hair, brain, blood, liver, kidney, skin, bone

What are the signs and symptoms in MS?

Low ATP, collagen, and melanin. From childhood; growth failure, mental impairment, vascular lesions, hair and skin changes.

What are the lab findings in MS?

Low tissue cu Low serum free cu Low ceruloplasmin

What is Wilson's disease?

Genetic defect in gene coding for enzyme responsible for cu excretion in bile/feces

What is the pathology seen in WD?

Too much cu accumulated in the body Cu deposition in liver, brain, cornea Mental status changes(Parkinson/dementia-like)

What lab findings are seen in WD?

``` High tissue cu High free serum cu Low ceruloplasmin High AST and ALT Kayser/fleischer ring in the eyes ```

Name other reasons for cu overload?

Increased synthesis of ceruloplasmin (during inflammation or consumption of oral contraceptives) Increased intake of cu water/food)

What is the antidote of cu overload?

Metal chelation agents (EDTA penicillamine, BAL) | Stomach pumping

In what products is chromium found?

In meats and whole grains

What are the functions of chromium?

Important in glucose and lipid metabolism Role in cardiovascular diseases and lipid homeostasis Potentiates insulin action, making it more efficient

How does chromium potentiate insulin's action?

By increasing insulin receptors and enhancing its binding to cells, increasing insulin sensitivity.

Chromium is transported bound to what beta globulin protein?

Transferrin

What is seen in chromium deficiency?

Cardiovascular disease Impaired lipid profile Impaired glucose tolerance and insulin resistance in some

What is seen in chromium toxicity?

Respiratory tract irritation, cancer (lungs, nasal and sinus), dermatitis/ulcers Hypoglycemia Liver, kidney, nerve damage

How is chromium toxicity contracted?

Occupational exposure (steelmaking, electroplating, leather tanning) Hip prostheses with Cr alloy Supplementation

What is fluoride necessary for?

To support mineralization of bone and teeth | Small doses help in osteoporosis

How does fluoride form fluorapatite in tooth enamel?

Fluoride ions replace hydroxyl groups in hydroxyapatite causing less susceptibility to acidic decay

What are the signs in excessive intake of fluoride (fluorosis)

Mottle or pitted teeth | Possible skeletal changes and crippling calcification of ligaments

What signs are seen in fluoride deficiency?

Tooth decay/dental caries | Possibly osteoporotic bone

Where is Se present in the body?

All tissues

With which vitamin is Se associated?

Vitamin E

What are the functions of Se?

Antioxidant in protecting cells from free radicals | Thyroid gland function

What disease is deficiency in Selenium?

Keshan's disease

What is Keshan's disease?

It is selenium deficiency with mutated coxsackievirus that has resulted in endemic cardiomyopathy

What signs are seen in se deficiency?

Cellular damage, immune disorder, hypothyroidism

What signs are seen in se toxicity?

Garlic smelling breath, hair less, nail damage, nausea/vomiting, nerve damage

In what type of food is zinc present?

All protein-rich foods

Zn is bound to

Albumin and a-2 macroglobulin.

This is an essential trace element in many metalloproteins and transcription factors like DNA/RNA polymerase, alcohol dehydrogenase, alkaline phosphatase

Zinc

What are zinc fingers?

Important structures that interact with DNA in proteins to regulate gene expression

What is the role of zn fingers?

Protein synthesis, stabilization of nucleic acids and organelles

What are other functions of zinc?

In prostate gland for sperm function | Supplementation in sickle cell disease can improve lifespan of RBC and reduce vascular obstruction

What causes zinc deficiency?

Decreased nutritional intake Pregnancy (increased fetal demand) Chronic alcoholism Gi disease

What are the signs in zinc deficiency?

Growth retardation, dermatitis, poor wound health, alopecia

What causes zinc toxicity?

Acidic drinks in a zinc-coated container

What are the signs of zinc toxicity?

Nausea, vomiting, diarrhea, anemia, impaired immune function.

This an autosomal recessive disorder in which there is defective gene of a zinc transporter protein in the gut resulting in zinc deficiency

Acrodermatitis enteropathica

What are the symptoms of AE?

Slow growth, hypogonadism, dermatological lesions, diarrhea.

Function of Manganese

Enzyme activator, growth, carb and lipid metabolism

This trace element's only known function is its part in cobalamin/vitamin B12

Cobalt