SlideShare a Scribd company logo
1 of 32
VITAMIN D
Prof.(Dr) Viyatprajna
Acharya
M.D., PhD
WHAT WILL WE KNOW?
 History
 Chemistry
 Metabolism
 Biochemical functions
 Deficiency manifestations
 DRA
 Sources of Vitamin D
 Hypervitaminosis
GENERAL FORMAT
Vitamin
(Synonym
if any)
Chemistry Metabolic
functions
Dietary
source
RDA Deficiency
manifestations
Hypervitaminosis Other
HISTORY
 Reports on rickets- 2nd century AD
 1650- Glisson gave a classical feature of
infantile rickets
 1919- Mc Collum induced rickets in rats
by making them dietary deficient
 1931- Angus & team found D3
 Structure- Otto diels & Kurt Alder
VITAMIN D- CHEMISTRY
 Group of sterols
 Hormone-like
 Active molecule- 1,25-
dihydroxycholecalciferol
SYNTHESIS (SKIN)
7-dehydrocholesterol
↓UV ray (290-315 nm)
Secosterol (Ring B opens; cis
double bond between 5th & 6th C atom)
↓
Cholecalciferol (trans double
bond; rotation on 6th C atom)
88%- Bound to Vitamin D binding protein and
circulates
0.03%- Circulate free
Rest- circulate binding to albumin
Major
storage form
Most potent
form
Regulation of synthesis of
1,25-DHCC
1. ↓ Phosphate level-
stimulates 1-hydroxylase
activity
2. ↓ Calcium level- ↑ PTH
3. Feedback inhibition by
1,25 DHCC
4. Inhibition by 24-
hydroxylase- increased
calcitriol stimulates its
secretion and inhibits its
own synthesis
BIOCHEMICAL FUNCTIONS
OTHER FUNCTIONS
 Secretion of insulin
 Secretion of PTH and Thyroid hormones
 Inhibition of production of interleukin by
activated T-Lymphocytes
 Inhibition of Ab production by B-
lymphocytes
 Differentiation of monocyte precursor
cells
 Modulation of cell proliferation
CALCIUM PHOSPHOROUS HOMEOSTATSIS
 Ca :P 1:4- 4:1
 Maintained by calcitriol, ALP, PTH, Calcitonin
 Regulation of calcitriol- Ca, P, PTH
andcalcitriol itself
 Synthesis and target organs are different
 Different target organs
 Acts through nuclear receptors like steroid
hormones
 Structure and mechanism of action similar
to steroid hormones-sterol ring
 Synthesis is feedback regulated
 Acts in conjunction with other hormones-
calcitonin & PTH
 T1/2 is short- 10 hrs; in circulation it is 2-3
weeks though.
 Plant source- ergot-
commercial preparation
 Animal source- fatty fish, fish
liver oil, egg yolk etc.
 Milk is a moderate source
D/R
 Pre-school- 10 μg/ day
 Children & adults- 5-10 μg/ day
 Pregnancy & lactation – 10 μg/ day
 > 60 yrs- 15 μg/ day
little role in osteoporosis !
WHY DEFICIENCY OCCURS?
 Around 1- 1&1/2 years
 Bones become soft and pliable
 Craniotabes- softening of skull
bones- delayed closure of ant.
fontanelle
 Frontal bossing
 Bow legs, Knock knee
 Rickety rosary
 Pigeon chest
 Kyphoscoliosis
 Harrison’s sulcus
 Visceroptosis
 Biochemical findings- Ca & P are
low normal ; ↑↑ ALP
 Rickets- under mineralization
 Osteomalacia- demineralization
 Hypophosphatemic rickets- defective P
reabsorption at renal tubules
 Vit D resistant rickets- Fanconi’s
syndrome
↓ renal reabsorption of HCO3, PO4, Glucose, AA
 Renal rickets- calcitriol is not
synthesised
 End-organ refractoriness- abnormal or
 Insufficient mineralization
 Aged population
 Rarefication of bone
 Ca- slightly low; P- low; ↑↑ ALP
 ↑susceptibility to fractures
 Vit D deficiency never causes
hypocalcemia !!!
 With Vit A cures cold and flu
 Gives good effect in COVID tt too !
 Modulatory effect on immunohemopoietic
system- helps in differentiation of cells
 Corrects anemia
 Associated with insulin resistance & DM
 Reduces risk of cancer
 Reduces risk of CVD
 Beneficial effects observed in AIDS
patients
VITAMIN D FORTIFIED FOODS
CLINICAL CASE DISCUSSION
An 18 month old boy was brought to the
pediatrician with a complain of frequent diarrhoea
and stunted growth. The mother gave history that
the stool was somewhat sticky. The child was not
eating well and was late in walking. Mother also
gave history of frequent falls while walking and
swelling of forehead probably due to falls.
On examination: There were rachitic features.
Mother gave history of photosensitive rashes.
The pediatrician ordered for some tests. Serum
Calcium- normal, Phosphate- low, ALP- mildly
elevated
X-ray: Cupping of distal radius and distal femur,
More PPT on Medical Biochemistry on my
website
www.vpacharya.com

More Related Content

What's hot

Calcium & phosphate metabolism
Calcium & phosphate metabolismCalcium & phosphate metabolism
Calcium & phosphate metabolismdr neetu singh
 
Calcium Metabolism
Calcium MetabolismCalcium Metabolism
Calcium MetabolismAayush Gupta
 
Ca po4 metabolism 1 parasf /dental courses
Ca po4 metabolism 1 parasf /dental coursesCa po4 metabolism 1 parasf /dental courses
Ca po4 metabolism 1 parasf /dental coursesIndian dental academy
 
Calcium metabolism
Calcium metabolism Calcium metabolism
Calcium metabolism Sapna Vadera
 
Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...
Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...
Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...Indian dental academy
 
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...Indian dental academy
 
Calcium and phosphate metabolism
Calcium and phosphate metabolismCalcium and phosphate metabolism
Calcium and phosphate metabolismJanani Rangaswamy
 
Calcium and phosphorus metabolism /dental courses
Calcium and phosphorus metabolism /dental coursesCalcium and phosphorus metabolism /dental courses
Calcium and phosphorus metabolism /dental coursesIndian dental academy
 
Calcium metabolism
Calcium metabolismCalcium metabolism
Calcium metabolismVernon Pashi
 
Calcium metabolism
Calcium metabolismCalcium metabolism
Calcium metabolismKCMCOT
 
Lecture pharmacology of calcium metabolism
Lecture pharmacology of calcium metabolismLecture pharmacology of calcium metabolism
Lecture pharmacology of calcium metabolismGyanendra Raj Joshi
 
Calcium and Phosphorous Metabolism
Calcium and Phosphorous MetabolismCalcium and Phosphorous Metabolism
Calcium and Phosphorous Metabolismdrmadhubilla
 
calcium homeostasis and viamin D
calcium homeostasis and viamin D calcium homeostasis and viamin D
calcium homeostasis and viamin D Dr VARUN RAGHAVAN
 
Hormonal control of Calcium Metabolism
Hormonal control of Calcium MetabolismHormonal control of Calcium Metabolism
Hormonal control of Calcium MetabolismAnbarasi rajkumar
 

What's hot (20)

Calcium & phosphate metabolism
Calcium & phosphate metabolismCalcium & phosphate metabolism
Calcium & phosphate metabolism
 
Calcium Metabolism
Calcium MetabolismCalcium Metabolism
Calcium Metabolism
 
Ca po4 metabolism 1 parasf /dental courses
Ca po4 metabolism 1 parasf /dental coursesCa po4 metabolism 1 parasf /dental courses
Ca po4 metabolism 1 parasf /dental courses
 
Calcium metabolism
Calcium metabolism Calcium metabolism
Calcium metabolism
 
Calcium
CalciumCalcium
Calcium
 
Calcium metabolism
Calcium  metabolismCalcium  metabolism
Calcium metabolism
 
Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...
Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...
Calcium metabolism/ oral surgery courses /certified fixed orthodontic courses...
 
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
 
Calcium and phosphate metabolism
Calcium and phosphate metabolismCalcium and phosphate metabolism
Calcium and phosphate metabolism
 
Calcium and phosphorus metabolism /dental courses
Calcium and phosphorus metabolism /dental coursesCalcium and phosphorus metabolism /dental courses
Calcium and phosphorus metabolism /dental courses
 
Calcium metabolism
Calcium metabolismCalcium metabolism
Calcium metabolism
 
Calcium
CalciumCalcium
Calcium
 
Calcium
CalciumCalcium
Calcium
 
Calcium metabolism
Calcium metabolismCalcium metabolism
Calcium metabolism
 
Lecture pharmacology of calcium metabolism
Lecture pharmacology of calcium metabolismLecture pharmacology of calcium metabolism
Lecture pharmacology of calcium metabolism
 
Calcium and Phosphorous Metabolism
Calcium and Phosphorous MetabolismCalcium and Phosphorous Metabolism
Calcium and Phosphorous Metabolism
 
calcium homeostasis and viamin D
calcium homeostasis and viamin D calcium homeostasis and viamin D
calcium homeostasis and viamin D
 
Hormonal control of Calcium Metabolism
Hormonal control of Calcium MetabolismHormonal control of Calcium Metabolism
Hormonal control of Calcium Metabolism
 
Calcium homeostasis
Calcium homeostasisCalcium homeostasis
Calcium homeostasis
 
Calcium and phosphorous metabolism
Calcium and phosphorous metabolismCalcium and phosphorous metabolism
Calcium and phosphorous metabolism
 

Similar to Vitamin D-edited on 22.07.21

Similar to Vitamin D-edited on 22.07.21 (20)

Vitamin D
Vitamin DVitamin D
Vitamin D
 
CLINICAL BIOCHEMISTRY OF BONE
CLINICAL BIOCHEMISTRY OF BONECLINICAL BIOCHEMISTRY OF BONE
CLINICAL BIOCHEMISTRY OF BONE
 
Vitamin D - sources, receptors, functions, deficiency, toxicity
Vitamin D - sources, receptors, functions, deficiency, toxicityVitamin D - sources, receptors, functions, deficiency, toxicity
Vitamin D - sources, receptors, functions, deficiency, toxicity
 
2009外文讲义1
2009外文讲义12009外文讲义1
2009外文讲义1
 
Vit d
Vit dVit d
Vit d
 
Rickets
RicketsRickets
Rickets
 
RICKETS.pptx
RICKETS.pptxRICKETS.pptx
RICKETS.pptx
 
Vitamin d3
Vitamin d3Vitamin d3
Vitamin d3
 
Rickets
RicketsRickets
Rickets
 
Rickets & osteomalacia
Rickets & osteomalaciaRickets & osteomalacia
Rickets & osteomalacia
 
Rickets a brief outlook
Rickets a brief outlookRickets a brief outlook
Rickets a brief outlook
 
Calcium
CalciumCalcium
Calcium
 
Calcium metabolism, rickets and osteomalacia
Calcium metabolism, rickets and osteomalaciaCalcium metabolism, rickets and osteomalacia
Calcium metabolism, rickets and osteomalacia
 
CM & R.pptx
CM & R.pptxCM & R.pptx
CM & R.pptx
 
Rickets
RicketsRickets
Rickets
 
Rickets & osteomalacia
Rickets & osteomalaciaRickets & osteomalacia
Rickets & osteomalacia
 
Clinical approach to rickets with special reference to renal rickets- by Dr u...
Clinical approach to rickets with special reference to renal rickets- by Dr u...Clinical approach to rickets with special reference to renal rickets- by Dr u...
Clinical approach to rickets with special reference to renal rickets- by Dr u...
 
Metabolic bone diseases
Metabolic bone diseasesMetabolic bone diseases
Metabolic bone diseases
 
Vitamin D 1.ppt
Vitamin D 1.pptVitamin D 1.ppt
Vitamin D 1.ppt
 
Calcium
CalciumCalcium
Calcium
 

More from Prof Viyatprajna Acharya

Test for ketone bodies, bile salts and.pptx
Test for ketone bodies, bile salts and.pptxTest for ketone bodies, bile salts and.pptx
Test for ketone bodies, bile salts and.pptxProf Viyatprajna Acharya
 
Talk on Cancer awareness on World cancer day-at JCI Talcher meet
Talk on Cancer awareness on World cancer day-at JCI Talcher meetTalk on Cancer awareness on World cancer day-at JCI Talcher meet
Talk on Cancer awareness on World cancer day-at JCI Talcher meetProf Viyatprajna Acharya
 
Cancer-an overview by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Cancer-an overview by Prof Viyatprajna Acharya, KIMS, BhubaneswarCancer-an overview by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Cancer-an overview by Prof Viyatprajna Acharya, KIMS, BhubaneswarProf Viyatprajna Acharya
 
Regulation of gene expression by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Regulation of gene expression by Prof Viyatprajna Acharya, KIMS, BhubaneswarRegulation of gene expression by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Regulation of gene expression by Prof Viyatprajna Acharya, KIMS, BhubaneswarProf Viyatprajna Acharya
 
Post translational modification by Prof Viyatprajna Acharya
Post translational modification by Prof Viyatprajna AcharyaPost translational modification by Prof Viyatprajna Acharya
Post translational modification by Prof Viyatprajna AcharyaProf Viyatprajna Acharya
 
Genetic code and Translation by Prof Viyatprajna Acharya, KIMS Bhubaneswar
Genetic code and Translation by Prof Viyatprajna Acharya, KIMS BhubaneswarGenetic code and Translation by Prof Viyatprajna Acharya, KIMS Bhubaneswar
Genetic code and Translation by Prof Viyatprajna Acharya, KIMS BhubaneswarProf Viyatprajna Acharya
 
Mutation by Prof V P Acharya, Biochemistry, KIMS Bhubaneswar
Mutation by Prof V P Acharya, Biochemistry, KIMS BhubaneswarMutation by Prof V P Acharya, Biochemistry, KIMS Bhubaneswar
Mutation by Prof V P Acharya, Biochemistry, KIMS BhubaneswarProf Viyatprajna Acharya
 

More from Prof Viyatprajna Acharya (20)

Colorimetry.pptx
Colorimetry.pptxColorimetry.pptx
Colorimetry.pptx
 
Test for ketone bodies, bile salts and.pptx
Test for ketone bodies, bile salts and.pptxTest for ketone bodies, bile salts and.pptx
Test for ketone bodies, bile salts and.pptx
 
Thyroid Function Test.pptx
Thyroid Function Test.pptxThyroid Function Test.pptx
Thyroid Function Test.pptx
 
Environmental Biochemistry.pptx
Environmental Biochemistry.pptxEnvironmental Biochemistry.pptx
Environmental Biochemistry.pptx
 
XENOBIOTICS.pptx
XENOBIOTICS.pptxXENOBIOTICS.pptx
XENOBIOTICS.pptx
 
Talk on Cancer awareness on World cancer day-at JCI Talcher meet
Talk on Cancer awareness on World cancer day-at JCI Talcher meetTalk on Cancer awareness on World cancer day-at JCI Talcher meet
Talk on Cancer awareness on World cancer day-at JCI Talcher meet
 
Digestion and absorption of lipids
Digestion and absorption of lipidsDigestion and absorption of lipids
Digestion and absorption of lipids
 
Cancer-an overview by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Cancer-an overview by Prof Viyatprajna Acharya, KIMS, BhubaneswarCancer-an overview by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Cancer-an overview by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
 
Regulation of gene expression by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Regulation of gene expression by Prof Viyatprajna Acharya, KIMS, BhubaneswarRegulation of gene expression by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
Regulation of gene expression by Prof Viyatprajna Acharya, KIMS, Bhubaneswar
 
Post translational modification by Prof Viyatprajna Acharya
Post translational modification by Prof Viyatprajna AcharyaPost translational modification by Prof Viyatprajna Acharya
Post translational modification by Prof Viyatprajna Acharya
 
Genetic code and Translation by Prof Viyatprajna Acharya, KIMS Bhubaneswar
Genetic code and Translation by Prof Viyatprajna Acharya, KIMS BhubaneswarGenetic code and Translation by Prof Viyatprajna Acharya, KIMS Bhubaneswar
Genetic code and Translation by Prof Viyatprajna Acharya, KIMS Bhubaneswar
 
Mutation by Prof V P Acharya, Biochemistry, KIMS Bhubaneswar
Mutation by Prof V P Acharya, Biochemistry, KIMS BhubaneswarMutation by Prof V P Acharya, Biochemistry, KIMS Bhubaneswar
Mutation by Prof V P Acharya, Biochemistry, KIMS Bhubaneswar
 
Types of RNA
Types of RNATypes of RNA
Types of RNA
 
RNA Metabolism
RNA MetabolismRNA Metabolism
RNA Metabolism
 
DNA metabolism
DNA metabolismDNA metabolism
DNA metabolism
 
6 dna organisation ii
6 dna organisation ii6 dna organisation ii
6 dna organisation ii
 
5 Nucleic acids & DNA organization-I
5 Nucleic acids & DNA organization-I5 Nucleic acids & DNA organization-I
5 Nucleic acids & DNA organization-I
 
1 introduction to molecular biology
1 introduction to molecular biology1 introduction to molecular biology
1 introduction to molecular biology
 
Metabolism of alanine
Metabolism of alanineMetabolism of alanine
Metabolism of alanine
 
Glycine metabolism
Glycine metabolismGlycine metabolism
Glycine metabolism
 

Recently uploaded

Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Miss joya
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girlsnehamumbai
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...narwatsonia7
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...Taniya Sharma
 
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...narwatsonia7
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Miss joya
 
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...Miss joya
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on DeliveryCall Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Deliverynehamumbai
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiAlinaDevecerski
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiNehru place Escorts
 
Call Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night Enjoy
Call Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night EnjoyCall Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night Enjoy
Call Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night Enjoybabeytanya
 
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls ServiceCall Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Servicenarwatsonia7
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.MiadAlsulami
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliRewAs ALI
 
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safenarwatsonia7
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...
Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...
Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...Call girls in Ahmedabad High profile
 

Recently uploaded (20)

Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
 
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCREscort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
 
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
 
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on DeliveryCall Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
 
Call Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night Enjoy
Call Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night EnjoyCall Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night Enjoy
Call Girl Number in Panvel Mumbai📲 9833363713 💞 Full Night Enjoy
 
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls ServiceCall Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas Ali
 
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...
Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...
Call Girls Service Navi Mumbai Samaira 8617697112 Independent Escort Service ...
 

Vitamin D-edited on 22.07.21

  • 2.
  • 3. WHAT WILL WE KNOW?  History  Chemistry  Metabolism  Biochemical functions  Deficiency manifestations  DRA  Sources of Vitamin D  Hypervitaminosis
  • 4. GENERAL FORMAT Vitamin (Synonym if any) Chemistry Metabolic functions Dietary source RDA Deficiency manifestations Hypervitaminosis Other
  • 5. HISTORY  Reports on rickets- 2nd century AD  1650- Glisson gave a classical feature of infantile rickets  1919- Mc Collum induced rickets in rats by making them dietary deficient  1931- Angus & team found D3  Structure- Otto diels & Kurt Alder
  • 6. VITAMIN D- CHEMISTRY  Group of sterols  Hormone-like  Active molecule- 1,25- dihydroxycholecalciferol
  • 7.
  • 8. SYNTHESIS (SKIN) 7-dehydrocholesterol ↓UV ray (290-315 nm) Secosterol (Ring B opens; cis double bond between 5th & 6th C atom) ↓ Cholecalciferol (trans double bond; rotation on 6th C atom)
  • 9.
  • 10. 88%- Bound to Vitamin D binding protein and circulates 0.03%- Circulate free Rest- circulate binding to albumin
  • 12.
  • 13.
  • 14. Regulation of synthesis of 1,25-DHCC 1. ↓ Phosphate level- stimulates 1-hydroxylase activity 2. ↓ Calcium level- ↑ PTH 3. Feedback inhibition by 1,25 DHCC 4. Inhibition by 24- hydroxylase- increased calcitriol stimulates its secretion and inhibits its own synthesis
  • 16.
  • 17. OTHER FUNCTIONS  Secretion of insulin  Secretion of PTH and Thyroid hormones  Inhibition of production of interleukin by activated T-Lymphocytes  Inhibition of Ab production by B- lymphocytes  Differentiation of monocyte precursor cells  Modulation of cell proliferation
  • 18. CALCIUM PHOSPHOROUS HOMEOSTATSIS  Ca :P 1:4- 4:1  Maintained by calcitriol, ALP, PTH, Calcitonin  Regulation of calcitriol- Ca, P, PTH andcalcitriol itself
  • 19.  Synthesis and target organs are different  Different target organs  Acts through nuclear receptors like steroid hormones  Structure and mechanism of action similar to steroid hormones-sterol ring  Synthesis is feedback regulated  Acts in conjunction with other hormones- calcitonin & PTH  T1/2 is short- 10 hrs; in circulation it is 2-3 weeks though.
  • 20.  Plant source- ergot- commercial preparation  Animal source- fatty fish, fish liver oil, egg yolk etc.  Milk is a moderate source
  • 21.
  • 22. D/R  Pre-school- 10 μg/ day  Children & adults- 5-10 μg/ day  Pregnancy & lactation – 10 μg/ day  > 60 yrs- 15 μg/ day little role in osteoporosis !
  • 24.
  • 25.  Around 1- 1&1/2 years  Bones become soft and pliable  Craniotabes- softening of skull bones- delayed closure of ant. fontanelle  Frontal bossing  Bow legs, Knock knee  Rickety rosary  Pigeon chest  Kyphoscoliosis  Harrison’s sulcus  Visceroptosis  Biochemical findings- Ca & P are low normal ; ↑↑ ALP
  • 26.  Rickets- under mineralization  Osteomalacia- demineralization  Hypophosphatemic rickets- defective P reabsorption at renal tubules  Vit D resistant rickets- Fanconi’s syndrome ↓ renal reabsorption of HCO3, PO4, Glucose, AA  Renal rickets- calcitriol is not synthesised  End-organ refractoriness- abnormal or
  • 27.  Insufficient mineralization  Aged population  Rarefication of bone  Ca- slightly low; P- low; ↑↑ ALP  ↑susceptibility to fractures  Vit D deficiency never causes hypocalcemia !!!
  • 28.  With Vit A cures cold and flu  Gives good effect in COVID tt too !  Modulatory effect on immunohemopoietic system- helps in differentiation of cells  Corrects anemia  Associated with insulin resistance & DM  Reduces risk of cancer  Reduces risk of CVD  Beneficial effects observed in AIDS patients
  • 30.
  • 31. CLINICAL CASE DISCUSSION An 18 month old boy was brought to the pediatrician with a complain of frequent diarrhoea and stunted growth. The mother gave history that the stool was somewhat sticky. The child was not eating well and was late in walking. Mother also gave history of frequent falls while walking and swelling of forehead probably due to falls. On examination: There were rachitic features. Mother gave history of photosensitive rashes. The pediatrician ordered for some tests. Serum Calcium- normal, Phosphate- low, ALP- mildly elevated X-ray: Cupping of distal radius and distal femur,
  • 32. More PPT on Medical Biochemistry on my website www.vpacharya.com