DEFISIENSI DAN KELEBIHAN MINERAL Fe

KELOMPOK 9

ORIGENES BOY KAPITAN G851130111LIVIA RHEA ALVITA G851130131G JENI CHRISTI A G851130321

PENDAHULUAN

Fe

Defisiensi Fe Kelebihan Fe

Anemia Gangguan

fungsional tubuh

Keracunan

PEMBAHASANFUNGSI Fe Oxygen Transport & Storageo Hemoglobino Mioglobin

Transport Elektron & Metabolisme Energio Sitokrom o Protein Fe-S

Substrat Oksidasi & Reduksi – Tergantung Enzim Besi-

Ribonukleat reductaseAsam amino oxidaseAsam lemak desaturaseOksida nitrat sintasePeroksidase

Regulasi Intraseluler Besi

Flavoprotein

Hemeproteins

Fe-sulfurNzms

FeNzms lain

Other FeProteins

Fe-Containing

Proteins

Transferrin&

Others

Ferritin&

Hemosiderin

Nzms lainHemeFlavoprotein

Hemoglobin

Nzms lain

BesiMengaktifka

nNzms

2Fe-2S4Fe-4SNzms

Myoglobin Cytochromes Other Nzms

Fungsi Fe

DistributionCompoun

dMale

(mg/kg)Female (mg/kg)

Functional

Hemoglobin 31 26

Myoglobin 4 3Heme Nzm 1 1Nonheme Nzm 1 1Transferrin Iron 0.05 0.05

Total 37 (74%) 33 (87%)Storage Ferritin 9 4

Hemosiderin 4 1Total 13 (26%) 5 (13%)

Body Total mg/kg 50 38Handbook of Nutritionally Essential Mineral Elements

Distribution

Iron

Requ

irem

ent m

g/da

y 6

5

4

3

2

1Body Iron Loss

Fetus

Menstruation

MenstruationLactation

Red Cells

Non gravid 1st 2nd 3rd

Trimester

Postpartum

Absorption

Nonheme

1. Iron solublized and ionized by stomach acid2. Chelation with small molecularweight compounds and mucin

3. Iron chelates pass throughunstirred water layer bind to surface proteins and are internalized

4. Absorption all along the small intestine, but highest in duodenum

Heme

1. Protein digestion of hemoglobin and myoglobin releases heme

2. Heme transported as such into the cell

AbsorptionDuodenal Lumen Duodenal Mucosa Plasma

B2-microglobulin

HFE

DMT1

B3 integrin

MucinFe++

Fe++ Fe++

Fe2+

Fe3+

Mobilferritin

Heme-Protein

Heme+

Polypeptides

Heme

Biliverdin Bilirubin Bilirubin

Heme

Oxigenase CO CO

paraferritinFe2+ Fe2+

Fe3+

Transferritin

Ceruloplasmin

Ferroportin

Mineral Interactions

Mn

Fe

CuZn (-) (+)

(-)

Iron DeficiencySubtle symptoms unless anemia is severe (hemoglobin <70g/L)Mainly three identified (from least to most severe) Storage iron depletion

Only iron store is depleted Early functional iron deficiency

Iron store is depleted and functional iron is low but not low enough to cause measurable anemia

Iron deficiency anemiaImpaired tissue oxygenation, reduced work abilityResponsible for many maternal death at parturition

Impaired oxidative metabolism in muscleshift to gluconeogenesis and lactate utilization (acidosis)

Behavioral and Intellectual DefectsBody temperature regulation impaired

Deficiency Signs

Koilonychia“Spoon Nails”

Glossitis

Angular Stomatitis

Iron Excess & ToxicityAcute toxicity - overload transferrin, strong acids produced by Fe/HCl in stomach kill GI tract

Bloody vomit and stoolsSystemic effects from conversion of ferrous to ferric and release of protons

Iron Excess & ToxicityChronic Iron Toxicity

Hemosiderosis - excess iron in hemosiderinHemochromotosis - excess iron in fibrotic tissue damage

common causes = excess ingestion or transfusionGenetic hyper absorption - Hemochromatosis

3-4/100 of European descentCirrhosis, diabetes, heart failure, arthritis, sexual dysfunctionTransferrin saturation good screening test