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VITAMIN C or
ASCORBIC ACID
• Functions
• Clinical features & morphology of scurvy
Vitamin C
• Water soluble vitamin
• 70 percentage of vitamin C is lost in the
process of cooking
• Most animals & plants can synthesize ascorbic
acid from glucose
• Man, higher primates, guineapigs & bats
cannot synthesize ascorbic acid
Dietary sources of vitamin C
• Amla ( Indian gooseberry- 700 mg/100 g)
• Guava, lime, lemon
• Green leafy vegetables
• Milk &
• Animal products like liver & fish
Functions of vitamin C
1. It can change between ascorbic acid &
dehydroascorbic acid
• Most physiological properties of vitamin are
explained by this redox system
2 . Ascorbic acid is necessary for the post
transilational hydroxylation of proline & lysine
residues
lHydroxy proline & hydroxy lysine form cross links
in collagen- gives tensile strength to fibers
lThis process is necessary for the normal
production of supporting tissues like osteoid,
collagen, and intercellular cement substances of
capillaries
3 . Tryptophan metabolism
l Hydroxylation of tryptophan to 5-hydroxy
tryptophan- formation of serotonin
4 . Tyrosine metabolism
lOxydation of parahydroxyphenylpyruvate to
homogenitisic acid
5 . Iron metabolism
lVit C reduces ferric iron to ferrous state, which
is preferentially absorbed from intestine
6 . Hemoglobin metabolism
lReconversion of met-hemoglobin to
hemoglobin
7 . Folic acid metabolism
lHelps the enzyme folate reductase to reduce
foluc acid to tetrahydrofolic acid
lThus helps in maturation of RBC
8 . Steroid synthesis
lHas some role in adrenal steroidogenesis
lVit C is present in adrenal cortex- depleted by
ACTH stimulation
9 . Stimulates phagocytic action of WBC
10 . Vit C is concentrated in the lens of eye
Regular intake of vit C reduces risk of
cataract formation
11 . Antioxidant property
lAbility to scavenge free radicals directly
lParticipate in metaboluc reactions that
regenerate antioxidant form of vit E
CLINICAL FEATURES &
MORPHOLOGY OF
SCURVY
lGross deficiency of vit C
lCharacterised by bone diseases in growing
children & by hemorrhages & healing defects
in both children & adults
SYMPTOMS OF SCURVY
• Symptoms of scurvy generally develop after 3
months of severe or total vit C deficiency, they
include;
lWekness & fatigue
lBruising easily & bleeding from weakened blood
vessels, conn: tissue & bones due to collagen loss
lHair & teeth loss
lGingivitis: gums become painful, swollen &
spongy
• Infantile scurvy (Barlow's disease): infants
have pain when they move & lose their
appetite.
• Infants do not gain weight as they normally do
• In infants & children bone growth is impaired
& bleeding & anemia may occur
• In infants between 6 to 12 months of age diet
should be supplemented with vitamin C
sources
• Hemorrhagic tendency: collagen is abnormal
& intercellular cement substance is brittle. So
capillaries are fragile, bleed under minor
pressure
• Subcutaneous hemorrhage manifested as
petechiae in mild deficiency & as ecchymoses
or hematoma in severe conditions
• In severe cases hemorrhage may occur in the
conjunctiva & retina.
• In bones, deficiency results in failure of
osteoblast to form the intercellular ground
substance osteoid
• The resulting scorbutic bone is weak &
fractures easily
• Hemorrhage into joint cavity lead to painful
swelling of the joint
• Microcytic hypochromic anemia is seen
• Poikilocytosis & anisocytosis are also common
• Reason for anemia may be:
• -loss of blood by hemorrhage
• -decreased iron absorption
• -decreased THFA
OBESITY
Obesity
• Pathogenesis
• Metabolic changes
• Obesity is defined as a state of increased body
weight, due to adipose tissue accumulation, that
is of sufficient magnitude to produce adverse
health effects
• One method to measure fat accumulation is to
find the Body Mass Index(BMI)
• BMI- (wt in kg)/ (height in meters)2
• Normal range- 18 to 25 kg/m2
• 25-30-overweight, greater than 30 kg/m2-obesity
• Obesity results when-
• -calorie intake exceeds utilisation
• -lnactivity & sedentary lifestyle
• -genetic predisposition
• -diseases like hypothyroidism & cushing's
disease
PATHOGENESIS
• Adipose mass is increased due to enlargement
of adipose cells due to excess lipid deposition
& increase in number of adipocytes
• Excess consumption of nutrients
MORPHOLOGIC FEATURES
• Increased adipose stores in subcutaneous
tissues, skeletal muscles & internal organs like
kidneys, heart, liver & omentum
• Fatty liver is more common
MATABOLIC CHANGES
1 . Hyperinsulinemia
Hyperglycemia due to a state of insulin
resistance
2 . Type 2 DM
Obesity exacerbate the diabetic state
3 . Hypertension
Due to increased blood volume
4 . Hyperlipoproteinemia
Normally plasma cholesterol circulates in
blood as LDL
Obesity associated with VLDL & mildly with
LDL
5 . Atherosclerosis
Risk of MI & stroke
6 . Nonalcoholic fatty liver
May progress to cirrhosis
7 . Cholilithiasis
8 . Hypoventilation syndrome (pickwickian
syndrome)
9 . Osteoarthritis
Due to wear & tear following trauma to joints
10 . Cancer
THANK YOU

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Vitamin c

  • 2. • Functions • Clinical features & morphology of scurvy Vitamin C
  • 3. • Water soluble vitamin • 70 percentage of vitamin C is lost in the process of cooking • Most animals & plants can synthesize ascorbic acid from glucose • Man, higher primates, guineapigs & bats cannot synthesize ascorbic acid
  • 4. Dietary sources of vitamin C • Amla ( Indian gooseberry- 700 mg/100 g) • Guava, lime, lemon • Green leafy vegetables • Milk & • Animal products like liver & fish
  • 6. 1. It can change between ascorbic acid & dehydroascorbic acid • Most physiological properties of vitamin are explained by this redox system
  • 7. 2 . Ascorbic acid is necessary for the post transilational hydroxylation of proline & lysine residues lHydroxy proline & hydroxy lysine form cross links in collagen- gives tensile strength to fibers lThis process is necessary for the normal production of supporting tissues like osteoid, collagen, and intercellular cement substances of capillaries
  • 8. 3 . Tryptophan metabolism l Hydroxylation of tryptophan to 5-hydroxy tryptophan- formation of serotonin
  • 9. 4 . Tyrosine metabolism lOxydation of parahydroxyphenylpyruvate to homogenitisic acid
  • 10. 5 . Iron metabolism lVit C reduces ferric iron to ferrous state, which is preferentially absorbed from intestine
  • 11. 6 . Hemoglobin metabolism lReconversion of met-hemoglobin to hemoglobin
  • 12. 7 . Folic acid metabolism lHelps the enzyme folate reductase to reduce foluc acid to tetrahydrofolic acid lThus helps in maturation of RBC
  • 13. 8 . Steroid synthesis lHas some role in adrenal steroidogenesis lVit C is present in adrenal cortex- depleted by ACTH stimulation
  • 14. 9 . Stimulates phagocytic action of WBC
  • 15. 10 . Vit C is concentrated in the lens of eye Regular intake of vit C reduces risk of cataract formation
  • 16. 11 . Antioxidant property lAbility to scavenge free radicals directly lParticipate in metaboluc reactions that regenerate antioxidant form of vit E
  • 18. lGross deficiency of vit C lCharacterised by bone diseases in growing children & by hemorrhages & healing defects in both children & adults
  • 19. SYMPTOMS OF SCURVY • Symptoms of scurvy generally develop after 3 months of severe or total vit C deficiency, they include; lWekness & fatigue lBruising easily & bleeding from weakened blood vessels, conn: tissue & bones due to collagen loss lHair & teeth loss lGingivitis: gums become painful, swollen & spongy
  • 20. • Infantile scurvy (Barlow's disease): infants have pain when they move & lose their appetite. • Infants do not gain weight as they normally do • In infants & children bone growth is impaired & bleeding & anemia may occur • In infants between 6 to 12 months of age diet should be supplemented with vitamin C sources
  • 21. • Hemorrhagic tendency: collagen is abnormal & intercellular cement substance is brittle. So capillaries are fragile, bleed under minor pressure • Subcutaneous hemorrhage manifested as petechiae in mild deficiency & as ecchymoses or hematoma in severe conditions • In severe cases hemorrhage may occur in the conjunctiva & retina.
  • 22. • In bones, deficiency results in failure of osteoblast to form the intercellular ground substance osteoid • The resulting scorbutic bone is weak & fractures easily • Hemorrhage into joint cavity lead to painful swelling of the joint
  • 23. • Microcytic hypochromic anemia is seen • Poikilocytosis & anisocytosis are also common • Reason for anemia may be: • -loss of blood by hemorrhage • -decreased iron absorption • -decreased THFA
  • 24.
  • 25.
  • 28. • Obesity is defined as a state of increased body weight, due to adipose tissue accumulation, that is of sufficient magnitude to produce adverse health effects • One method to measure fat accumulation is to find the Body Mass Index(BMI) • BMI- (wt in kg)/ (height in meters)2 • Normal range- 18 to 25 kg/m2 • 25-30-overweight, greater than 30 kg/m2-obesity
  • 29. • Obesity results when- • -calorie intake exceeds utilisation • -lnactivity & sedentary lifestyle • -genetic predisposition • -diseases like hypothyroidism & cushing's disease
  • 30. PATHOGENESIS • Adipose mass is increased due to enlargement of adipose cells due to excess lipid deposition & increase in number of adipocytes • Excess consumption of nutrients
  • 31. MORPHOLOGIC FEATURES • Increased adipose stores in subcutaneous tissues, skeletal muscles & internal organs like kidneys, heart, liver & omentum • Fatty liver is more common
  • 32. MATABOLIC CHANGES 1 . Hyperinsulinemia Hyperglycemia due to a state of insulin resistance 2 . Type 2 DM Obesity exacerbate the diabetic state
  • 33. 3 . Hypertension Due to increased blood volume 4 . Hyperlipoproteinemia Normally plasma cholesterol circulates in blood as LDL Obesity associated with VLDL & mildly with LDL
  • 34. 5 . Atherosclerosis Risk of MI & stroke 6 . Nonalcoholic fatty liver May progress to cirrhosis 7 . Cholilithiasis 8 . Hypoventilation syndrome (pickwickian syndrome)
  • 35. 9 . Osteoarthritis Due to wear & tear following trauma to joints 10 . Cancer