DYSPROTEINEMIA DURING TOTAL FASTING

The starvation diet has become a widely adopted method of treating obesity. Unfortunately, it leads to occasionally serious complications in about 8% of the patients thus treated.15 There is consequently an urgent need for systematic analyses of the metabolic changes occurring in the course of such cures. Hitherto, influence of fasting on the plasma microprotein spectrum has not been studied to any great extent. In a series of patients treated by Fateh, a decrease in the serum concentrations of C3, transferrin, and haptoglobin and a slight increase in the plasma concentrations of IgA and IgM were observed during treatment; the coeruloplasmin levels had already been elevated at the beginning of fasting. The serum concentrations of total protein, albumin, α2-macroglobulin, IgG, IgE, and α1-foetoprotein were not significantly affected by starvation.4 By contrast, Ditschuneit had the impression that the concentrations of IgA, IgG, IgM, C3, albumin, and total protein decreased.3 In view of these partially contradictory results and of the limited spectrum of individual proteins analyzed, we determined the following protein components of the plasma in a series of 12 obese patients who were placed on a starvation diet for a period of 4 wk: total protein, albumin, α2-macroglobulin, transferrin, haptoglobin, coeruloplasmin, prealbumin, retinol-binding protein, α2-HS-Glycoprotein, acid α1-glycoprotein, Gc-globulin, β2-microglobulin, IgG, IgM, IgA, Clq, C3, C3-activator, C4, and properdin. In addition, since proteinuria is known to occur in rats as a result of starvation,21 we measured the urinary concentrations of the proteins characteristic of glomerular proteinuria, i.e., α2-macroglobulin, transferrin, haptoglobin, and albumin, and of those indicative of tubular damage, i.e., prealbumin, α2-HS-glycoprotein, acid α1-glycoprotein, and Gc-globulin. © 1979.