TNF-α and IGF-1 levels in stunting children with chronic infection
Keywords:
Stunting, TNF-α, IGF-1, Chronic InfectionAbstract
Background and Objectives: Stunting is a frequent nutritional issue among children worldwide. Stunted children have a high risk of having an infection. Infection also causes an increase in pro-inflammatory cytokines such as TNF-α and impairs the linear growth rate in children, which involves a decrease of the IGF-1 hormone. This study aims to analyze IGF-1 and TNF-α levels in stunting and non-stunting children with chronic infection.
Methods: A cross-sectional study was conducted at Husada Utama Hospital, Surabaya, Indonesia, between September 2023 and February 2024. Samples were obtained using simple random sampling which comprised children aged ≤5 years with complaints of feeding difficulties, constant weight loss, and appearing short compared to peers, who had been diagnosed with having chronic infection by professional medical staff. Stunting was determined if the height-for-age z-score (HAZ) was below -2SD.
Results: total of 48 children, 20 boys and 28 girls, were enrolled. These were divided into two groups: a stunting (16 children) and a non-stunting group (32 children). The stunting children group was significantly younger than the non-stunting group. As expected, the stunting group had significantly less body height and HAZ, with significantly lower body weight, (WAZ) and (WHZ). The TNF-α and IGF-1 levels were significantly lower in the stunting children group compared to the control group. There was a significant correlation between stunting and IGF-1 (OR: 0.915, 95% CI: 0.841 – 0.996). The cut-off value of IGF-1 to determine stunting was <4.43 (sensitivity of 96.88%, specificity 43.75%). The cut-off value of TNF-α to determine stunting was >83.12 (sensitivity of 90.63%, specificity 92.50%).
Conclusion: The TNF-α and IGF-1 levels were significantly lower in stunting children. IGF-1 appeared to be a protective factor against stunting. There was no correlation between stunting and the TNF-α level
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