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Module 11: Trace Elements, Toxicology, and vitamins - Coggle Diagram

- - - - Fat soluble
      - Antioxidant, role in vision, gene expression, embryonic development, immune and reproductive functions
      - 900 in men 700 in women for needed intake (micrograms)
      - Liver, yellow/orange fruits, leafy veggies, fish, milk
      - Reference intervals:
        
        1–6 year: 20–40 μg/dL (0.70–1.40 μmol/L), 7–12 year: 26–49 μg/dL (0.91–1.71 μmol/L), 13–19 year: 26–72 μg/dL (0.91–2.51 μmol/L), >19 year: 30–80 μg/dL (1.05–2.80 μmol/L)
      - Nyctalopia (night blindness), Bitot spot, xerophthalmia, keratomalacia; common in infants and children, especially in less developed countries; due to fat malabsorption, cystic fibrosis and may occur due to retinol-binding protein deficiency as a results of protein malnutrition, liver disease, and zinc deficiency
      - tests for detection: HPLC, LC-MS/MS
    - - reference intervals
        
        1–6 year: 20–40 μg/dL (0.70–1.40 μmol/L), 7–12 year: 26–49 μg/dL (0.91–1.71 μmol/L), 13–19 year: 26–72 μg/dL (0.91–2.51 μmol/L), >19 year: 0.5–1.8 mg/dL (12–42 μmol/L)
      - Antioxidant (prevents the peroxidation of unsaturated fatty acids), role in gene transcription, immunity, inhibits platelet aggregation, recently been implicated in bone physiology
      - 15 mg needed for men and women
      - Fruits and vegetables, meats, vegetable oils, unprocessed cereals, nuts, and seeds
      - Lipid peroxidation, red blood cell fragility causing hemolytic anemia especially in premature infants; may occur due to fat malabsorption, cystic fibrosis
      - tests for detection: HPLC, LC-MS/MS
    - - in micrograms 120 for men and 90 in women
      - Fruits and vegetables, meats, vegetable oils, unprocessed cereals, nuts, and seeds
      - Coagulation, bone metabolism
      - reference interval
        
        0.2–2.2 nmol/mmol triglyceride
    - - Forms the coenzyme thiamine pyrophosphate (TPP) required for decarboxylation reactions involved in carbohydrate metabolism, and nerve function
      - reference intervals
        
        Erythrocyte transketolase activity: 0.75–1.30 U/g Hb (48.4–83.9 kU/mol Hb)
        
        Percent TPP effect (activation): Normal: 0%–15%, Marginal: 16%–25%, Deficient: >25%
        
        TPP concentration: 173–293 nmol/L or 280–590 ng/g Hb (erythrocytes); 90–140 nmol/L or 275–675 ng/g Hb (whole blood)
      - Brown rice, vegetables, potatoes, liver, eggs
      - in mg: 1.2 for men and 1.1 for women
    - - in mg its 1.3 needed for men and 1.1 for women
      - Vegetables such as green beans and asparagus, bananas, dairy products
      - Essential component of coenzymes involved in reduction-oxidation (redox) reactions in the body
      - reference interval
        
        Adequacy: 1.20, Marginal: 1.21–1.40,Deficiency: >1.41, plasma FAD: 101 [57–170] nmol/L, plasma, plasma FMN: 6.3 [3.3–14.1] nmol/L, plasma riboflavin: 11 [4–34] nmol/L, erythrocyte FAD: 1.9 [0.7–3.8] pmol/g Hb, erythrocyte FMN: 0.11 [0.04–0.44] pmol/g Hb, erythrocyte riboflavin: 0.02 [0.01–0.13] pmol/g Hb
      - Angular stomatitis, dermatitis, photophobia, riboflavin-dependent IOM
      - tests: Erythrocyte glutathione reductase, HPLC, LC-MS/MS
    - - Plasma PLP: 9.5–24 ng/mL (39–98 nmol/L).
        Erythrocyte PLP: 250–680 pmol/g Hb
      - The active form pyridoxal phosphate is required for synthesis, catabolism of various amino acids
      - in mg, 1.3 (men and women <50 year); 1.7 (men >50 year); 1.5 (women >50 year)
      - Meat, bananas, vegetables, nuts
    - - in micrograms: 2.4 is needed
      - Meat and animal product
      - Required for erythropoiesis, methylation processes necessary for DNA and cell metabolism, and is cofactor for various enzymes notably those involved in the metabolism of methylmalonic acid and homocysteine
      - concentration <203 ng/L (150 pmol/L) as deficient
    - - in mg 90 for men and 75 for women
      - Fruits especially citrus fruits and vegetables
      - 0.4 and 1.5 mg/dL (23–85 μmol/L) or 20–53 μg/108 leukocytes (1.14–3.01 fmol/leukocyte)
      - Connective tissue formation, antioxidant
      - tests: Spectrophotometric-enzymatic methods, HPLC
      - Scurvy, infantile scurvy (Barlow disease)
        Linked with osteoporosis, anemia, diabetes mellitus, cancer