Causes of Protein and Amino Acid Deficiency

Causes

Although the main cause of protein deficiency is a protein-deficient diet, the disorder can commonly occur in a variety of pathologic states. In particular, the disorder can be seen in the general context of starvation (although the deficits may be both protein and energy) or in disorders where there are specific protein losses from the body as in nephrotic syndrome or after burns.

Secondary protein deficiencies can be ascribed to six causes:

1. Irregular food habits and starvation states; this may be seen in both developed and developing countries in a variety of pathological states.

2. Inability to digest and absorb the protein that is consumed; this occurs in patients with chronic gastrointestinal disorders such as celiac disease, persistent diarrhea, or protein-losing enteropathy.

3. A disturbed protein metabolism, which may exist in patients with cirrhosis of the liver, but also in patients with hormonal disorders or in some cases of diabetes.

4. A continuous loss of protein; this predominates in patients with disease such as chronic renal disease, bleeding, or exudative gastroenteropa-thy. High losses of albumin into the urine are indicators of the nephrotic syndrome.

5. Increased protein turnover, which is characteristic in cases of systemic infection or fever. In many instances this may be subclinical and associated with protein diversion due to immunostimulation.

6. Enhanced catabolism of protein, with increased nitrogen losses, seen in patients with severe injuries, especially burns, or in postoperative stress.

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