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These include (1) decreased availability of amino acids (malnutrition, maldigestion, and malabsorption), (2) catabolic states (hyperthyroidism, Cushings syndrome, burns, postsurgery recovery), (3) protein-losing states (nephrotic syndrome and protein-losing enteropathy), (4) actions of cytokines (decrease in transport proteins such as albumin, transferrin, and lipoproteins, but increase in inflammatory response modifiers such as 1 -antitrypsin, ceruloplasmin, and 2 -macroglobulin), (5) action of hormones (such as growth hormone, cortisol, estrogen, androgens, and thyroid hormones) to increase or decrease production of specific proteins, and (6) congenital deficiency states (Wilsons disease and 1 -antitrypsin deficiency)

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