Nutritional Elements and Clinical Biochemistry

ISBN-13: 9781461331704 / Angielski / Miękka / 2011 / 464 str.

Marge A. Brewster; Marge A. Brewster

Opis

The important role that the nutritional status exerts in determining the course of life from birth to death in the human being and especially its impact in disease states is only par- tially appreciated at this time. Nutritional deficiencies are usually considered to be major problems only in under-privileged or developing populations, except for those occurring in specific diseases. This attitude is incorrect as indicated by reports of Bestrian et al (1974, 1976) and Merritt and Suskin (1979) and others who found evidence of nutritional depletion in as much as 50% of the patients in varied groups of hospitalized patients in the United States. Other studies, some of which are included in this book, emphasized the existence of deficiencies of certain specific nutrients. Despite evidence of nutritional deficiencies occurring more frequently than previously appreciated, there is no well established protocol of laboratory studies that the clinical chemist or scientist should provide to help the physician detect lack of essential nutrients before extensive and possibly irreparable damage has occurred to the individual patient. Considerable research data are needed to determine the best biologic material (i.e., erythrocytes, leucocytes, plasma, serum, urine, cerebrospinal fluid, lymph) for analysis to determine accurately at an early stage metabolic deficiencies due to a specific nutritional element. Improved techniques for analysis of key metabolites and nutrients are available in the research labora- tory and many of them can be adapted to the clinical laboratory.

Spis treści

Clinical Correlates in Nutritional Disease.- 1. Fetal Growth.- 1.1 Vascular Factors.- 1.2 Hormonal Factors.- 1.3 Nutrition.- 1.4 Classification of Altered Fetal Growth.- 2. Postnatal Growth.- 3. References.- Clinical Significance of Riboflavin Deficiency.- 1. Structure and Chemical-Physical Properties.- 2. Metabolism and Functions.- 3. Requirements.- 4. Assessment of Riboflavin Status.- 5. Occurrence of Riboflavin Deficiency.- 6. Causes of Deficiency.- 7. Effects of Riboflavin Deficiency.- 8. References.- Role of Vitamin C in Health and Disease.- 1. Synthesis.- 2. Catabolism.- 3. Physiology.- 4. Recommended Daily Allowances.- 5. Toxic Effects of Large Vitamin C Intake.- 6. Vitamin C Deficiency.- 7. Methods of Assessing Vitamin C Adequacy.- 8. References.- Vitamin A and Retinol Binding Protein Alterations in Disease.- 1. Vitamin A Chemistry, Metabolism and function.- 2. Retinol Binding Proteins.- 3. Vitamin A and Retinol Binding Proteins in Cancer.- 4. References.- Vitamin D - Its Excessive Use in the U.S.A..- 1. History of Development of Knowledge of Vitamin D Requirements.- 2. Vitamin D Concentration in Foods.- 3. Absorption, Turnover and Storage of Vitamin D.- 4. Toxicity of Excess Vitamin D.- 5. References.- The Clinical Implications of Lipid Antioxidant Nutrition.- 1. Background.- 2. Vitamin E as a Free Radical Trap.- 3. Vitamin E Deficiency and Anemias.- 4. Vitamin E Insufficiency in the Adult.- 5. Relationship of Vitamin E Dietary Levels to Vitamin E Concentration.- 6. Forms of Vitamin E and Their Biologic Activity.- 7. The Measurement of Serum Vitamin E Concentrations.- 8. Liver Necrosis, Vitamin E and Selenium Deficiencies.- 9. References.- Vitamin B12 and Folic Acid: Clinical and Pathophysiological Considerations.- 1. Historical Aspects.- 2. Characteristics of Megaloblastic Anemias.- 3. Vitamin B12 Deficiency.- 4. Folic Acid Deficiency.- 5. Inborn Errors of Metabolism Resulting in Megaloblastic Anemia and Megaloblastic Anemia in Children.- 6. References.- Trace Metals in Health and Disease.- 1. Chromium.- 2. Cobalt.- 3. Copper.- 4. Fluorine.- 5. Iodine.- 6. Iron.- 7. Manganese.- 8. Molybdenum.- 9. Nickel.- 10. Silicon.- 11. Selenium.- 12. Tin.- 13. Vanadium.- 14. Zinc.- 15. References.- Role of Specific Nutritional Components on Plasma Lipids, Lipoproteins and Coronary Heart Disease.- 1. Coronary Heart Disease.- 2. Effects of Specific Nutritional Substances on Serum Lipid Concentrations.- 3. Nutritional Modification for the Prevention and Treatment of Hyperlipidemia and Dyslipoproteinemia.- 4. Role of the Physician, Clinical Biochemist, and Dietician in Dietary Management.- 5. References.- Dietary Management of Hyperlipidemia: the Prudent Polyunsaturated Fat Diet.- 1. Rationale of the Diet Parameters.- 2. Development of the Therapeutic Diet.- 3. Practical Considerations.- 4. Modifications of the Prudent Polyunsaturated Fat Diet.- 5. Patient Adherence.- 6. Summary and Sample Menus.- 7. References.- Effects of Hypoproteinemia on Serum Lipoprotein Composition of Dogs and Rats.- 1. Introduction.- 2. Methods.- 3. Results.- 4. Discussion.- 5. References.- Dietary Fiber and Disease.- 1. Atherosclerosis.- 2. Colon Carcinogenesis.- 3. Diabetes Mellitus.- 4. References.- Some Manifestations of Malabsorption in Disease.- 1. Review of Assimilation of Nutrients.- 2. Abnormalities Associated with Malabsorption.- 3. Activity of Intestinal Microflora.- 4. References.- Amino Acids in Health and Disease.- 1. Protein Requirements.- 2. Factors Affecting Plasma Amino Acid Concentrations.- 2.1 Methodology.- 2.2 Intermediary Metabolism.- 2.3 Genetics.- 3. References.- Aminograms in Various Types of Liver Disease.- 1. Introduction.- 2. Materials.- 3. Methods.- 4. Results.- 5. Discussion.- 6. References.- The Role of Erythrocyte Amino Acids in Energy Metabolism.- 1. Introduction.- 1.1 Amino Acid Content of Erythrocytes and Plasma.- 1.2 Effects of Exercise on Amino Acid Concentrations.- 2. Utilization of Amino Acids by the Liver and Kidney for Gluconeogenesis.- 2.1 The Glucose-Alanine Cycle and Energy Production.- 2.2 Energy Production from Amino Acids Other than Alanine.- 3. Transport of Amino Acids for Gluconeogenesis.- 3.1 Active Transport of Amino Acids by the Blood.- 3.2 Developmental Changes in Blood Cell Amino Acid Transport.- 4. References.- Contributors.