It has been well known that the anemia readily appears in protein deficiency and that the grade of anemia is roughly proportionate to the grade of protein-deficiency. From studies in the author's laboratory, the acceleration of the erythrocyte destruction during protein deficiency was supposed to be a possible reason for this anemia.
In order to ascertain the mechanism of anemia due to protein-deficiency the author performed a long-term experiment of low protein intake with human subjects and examined morphologically and biochemically the time-course of changes in the erythrocytes.
Two weeks after the start of the low-protein diet (0.53-0.78 gram/kg/day protein) following a certain period of the standard diet (1.34-1.35 gram/kg/day protein), the anemic symptoms made their appearance; the number of erythrocytes, hemoglobin concentration and hematocrit were all decreased. Calculated from these measurements, color index and volume index were also decreased; in the 4th-5th week of the low-protein diet these values became the lowest, followed by an ascent towards recovery. Around this time the phase microscopic figure of the erythrocyte showed an increased thickness, and more or less “globular” form. Parenthetically, in 3rd-4th week of the low-protein diet, the mean corpuscular diameter became smaller and so became the osmotic resistance. As for the enzyme activity of the adenosine phosphate system which is possibly related to the energy metabolism of the erythrocyte, the activity was reduced during this period of the low protein regimen.
These observations suggest that the erythrocyte, like other organs such as the liver, has its enzyme activity reduced due to the reduced protein metabolism in protein deficiency.The reduction in the activity of ATP in erythrocyte presumably provokes the decrease of the enegry metabalism in erythrocyte membrane, which is closely related with the resistance, and consequently the maintenance of the shape of the erythrocyte. This may be the mechanism why the resistance of the erythrocyte cellwall is reduced in protein deficiency. The acceleration of the destruction of erythrocytes may follow this reduction of membrane resistance, thus leading anemia. As the material of regeneration of erythrocyte is also decreased due to protein deficiency, the restoration of anemia is retarded, thus a long continued anemia exists in protein deficiency.
View full abstract