Muttaquina Hossain, Baitun Nahar, Md. Ahshanul Haque, Nurun Nahar Naila, Md. Amran Gazi, Md. Mehedi Hasan, Nur Muhammad Shahedul Haque, Dinesh Mondal, Rashidul Haque, Michael B Arndt, Judd L Walson, Mustafa Mahfuz, Tahmeed Ahmed
OBJECTIVE: Growth in young children is controlled through the release of several hormonal signals. Stunting is clearly a growth disorder; yet limited evidence exists documenting the relationship between the plasma adipokines, human growth factors, and cytokines in stunted children. The study aimed to explore the association between these biomarkers and stunting in a cohort of Bangladeshi children. METHOD: A quasi-experimental study was conducted among 50 stunted (length-for-age Z score (LAZ) <-2SD) and 50 control (LAZ ? -2SD) children, aged 12-18 months residing in a slum in Dhaka, Bangladesh. Length and weight were measured monthly for 6 months. Fasting blood and fecal biomarkers were measured at enrolment and at 6 months using commercial enzyme-linked immunoassays. RESULT: At enrolment, stunted children were significantly more underweight (weight for age Z-score -2.09 vs. -1.03) and wasted (weight for length Z-score -1.2 vs. 0.66) than controls (p<0.0001 respectively). All biomarkers levels were similar in both groups except for oxyntomodulin (60.8 vs. 42.3, p=0.02) at enrolment. Serum leptin level significantly increased (p<0.001) in stunted children from enrolment to 6 months, but remained lower than in controls. Leptin (adjusted odds ratio, aOR) 4.0, 95% CI: 1.4, 11.3), leptin:adiponectin (aOR 5.07E+08, 95% CI: 813.04, 3.16E+14), insulin like growth factor-1 (IGF-1) (aOR 1.02, 95% CI: 1.0, 1.04) and gamma interferon (IFN-?) (aOR 0.92, 95% CI: 0.85, 0.98) levels were independently associated with stunting at enrolment. Both leptin and leptin:adiponectin significantly increased, while IFN-? levels significantly decreased among stunted children over the study period, as compared to controls. None of the measured biomarkers was significantly associated with length or BMI change from enrolment in either group. CONCLUSION: Fasting plasma leptin, leptin:adiponectin, IGF-1 and IFN-? were independently associated with stunting among under-2 Bangladeshi children living in a slum of Dhaka city. This trial is registered at ClinicalTrials.gov as NCT2839148.