Immune response in IGF-1 and growth parameters among infected children

Ardianah, Eva
Widjaja, Nur Aisiyah
Indriani, Diah
Melaniani, Soenarnatalina
Kuntoro
Wibowo, Arief
Notobroto, Hari Basuki
Purnomo, Windhu
Indawati, Rachmah
Saputro, Sigit Ari
Santoso, Febrina Mustika
Puspitasari, Ria
Pebriaini, Prisma Andita
Nurfidaus, Yasmine
Irawan, Roedi
Hidayat, Boerhan
Hidayati, Siti Nurul
Hanindita, Meta Herdiana

Berita Kedokteran Masyarakat
Vol 41 No 08 (2025)

Purpose: Infections in children can affect weight gain and linear growth by influencing metabolism and nutrition. Chronic inflammation results in growth failure mediated by pro-inflammatory cytokines and poor nutritional intake, which affects the GH/IGF-1 axis. This study aimed to investigate the impact of the inflammatory response on children's anthropometry, particularly HAZ, and the role of IGF-1. Methods: An observational study with a cross-sectional design was conducted from September 2021 to July 2022. The study involved children diagnosed with infections. The subjects had undergone a physical and laboratory investigation, which included a thorax photo, urine culture, Mantoux test, and complete blood test in a hospital setting. A complete medical history was obtained from the pediatrician. Results: The prevalence of undernutrition was 37.33%; the prevalence of underweight/severely underweight, stunted/severely stunted, and wasted/severely wasted was 25.33%, 30.66%, and 14.67% respectively. Stunted/severely stunted was more prevalent in subjects under 2 years old, compared to subjects more than 2 years old (22/41 vs. 7/34, p=0.014). SEM analysis revealed that the inflammatory response affected IGF-1 levels (r=0.850, p=0.000), while IGF-1 affected body composition (r=0.245, p=0.025), and then affected HAZ (r=1.000, p=0.000). The effect of IGF-1 on HAZ appears to be indirect, acting through body composition. Parental height has a weak, albeit significant, effect on body composition (r=0.101, p=0.025) and HAZ (r=0.192, p=0.040). Univariate analysis revealed strong correlations between IL-6 and IL-10 and IGF-1 (r=0.870, p=0.000 and 0.876, p=0.000, respectively). In contrast, parental height showed a correlation with HAZ/LAZ (r=0.319, p=0.000). Maternal height was correlated positively with WAZ (r=0.320, p=0.044). Conclusion: The prevalence of stunting among children under two years of age indicates that early childhood constitutes a critical period for intervention in growth and development. Inflammatory response has been demonstrated to influence IGF-1 levels in children. The role of IGF-1 on HAZ was mediated by body composition.