Peer-reviewed article
Infections, Animal-Source Foods, and Micronutrient Status as Correlates of Serum IGF-1 in Children with Stunting: A Cross-sectional Study in Uganda.
Emma Madigan, Nynne Emilie Nielsen, Joseph Mbabazi, Rolland Mutumba, Christian Ritz et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined factors associated with serum IGF-1 (a growth hormone) in 750 stunted children aged 12-59 months in Uganda. Inflammation markers were strongly linked to lower IGF-1 levels, while milk intake and vitamin A status were positively associated with IGF-1. Malaria infection was associated with lower IGF-1, but this effect disappeared after accounting for inflammation. The findings suggest that nutrition, particularly milk and vitamin A, may support growth in stunted children.
Key points
- Inflammation markers were strong negative correlates of serum IGF-1 in stunted children
- Milk intake was associated with 3.9 μg/L higher serum IGF-1, but meat and eggs were not
- Low vitamin A status (serum retinol-binding protein <0.70 μmol/L) was associated with 14.3 μg/L lower serum IGF-1
- Positive malaria test was associated with lower IGF-1, but the association was explained by inflammation rather than malaria itself
- Serum IGF-1 was positively associated with height-for-age z-score and fat-free mass
Limitations
As a cross-sectional study, this work cannot establish causal relationships between the factors examined and IGF-1 levels. The findings are specific to stunted children in Uganda and may not generalise to other populations.
Abstract
BACKGROUND: Serum insulin-like growth factor-1 (serum IGF-1) is important for growth in childhood. Inflammation downregulates serum IGF-1, but the roles of intake of animal-source foods and micronutrient status are not well known. OBJECTIVES: We assessed the associations of infections, intake of animal-source foods, iron, B12, folate, and vitamin A status with serum IGF-1 among stunted children. METHODS: We conducted a cross-sectional study, using data from a nutrition trial among 12-59-mo-old stunted Ugandan children. Data on sociodemography, anthropometry, breastfeeding, dietary intake, and morbidity were collected. Serum IGF-1 and markers of micronutrient status and inflammation were determined. A rapid malaria test was done. Fat and fat-free mass were measured using bioimpedance. Tobit regression was used to assess correlates of serum IGF-1. RESULTS: Of 750 children, 45.1% (n = 338) were girls and 29.6% (n = 222) were <2 y. Serum IGF-1 was available on 98.7% (n = 740). Median (interquartile range) serum IGF-1 was 37.4 (24.2, 53.3) μg/L, 11.8 [95% confidence interval (CI): 8.8, 14.9] μg/L lower in males, and 0.6 (95% CI: 0.5, 0.6) μg/L higher per month higher age. Inflammation markers were strong negative correlates of serum IGF-1. Positive malaria test was associated with lower serum IGF-1 (-4.7 μg/L, 95% CI: -7.8, -1.6), but not after inflammation adjustment (1.3 μg/L, 95% CI: -1.9, 4.6). Serum IGF-1 was associated with height-for-age z and fat-free mass. Serum retinol-binding protein <0.70 and 0.70-1.05, compared with >1.05 μmol/L was associated with 14.3 (95% CI: 9.6, 19.1) and 6.1 (95% CI: 1.6, 10.6) μg/L lower serum IGF-1 after adjustments for age, sex, and inflammation. Markers of other micronutrients were not. Intake of milk, but not meat or eggs, was associated with 3.9 (95% CI: 0.7, 7.1) μg/L higher serum IGF-1. CONCLUSIONS: Milk intake and vitamin A status were positively associated with serum IGF-1. In contrast to milk, vitamin A has not consistently been associated with growth. This requires further investigation.