Low serum zinc and short stature in children

Kadek Wini Mardewi; I Gusti Lanang Sidiartha; Eka Gunawijaya

doi:10.14238/pi56.3.2016.171-5

Kadek Wini Mardewi Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
I Gusti Lanang Sidiartha Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
Eka Gunawijaya Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali

DOI: https://doi.org/10.14238/pi56.3.2016.171-5

Keywords: zinc, short stature, children

Abstract

Background Short stature/stunting is common in developing countries, and has been used as an indicator of a nationâ€™s general health condition. Short stature increases the risk of metabolic disease, disturbances in cognitive development, infection prevalence, physical as well as functional deficits, and even death. Nutritional factors that frequently cause stunting are low intake of energy, protein, or micronutrients such as iron, vitamin A, and zinc. The role of zinc supplementation in children with short stature has not been well defined. In addition, zinc supplementation should be evaluated in the setting of specific conditions and regions.
Objective To assess the association between low serum zinc level and short stature in children.
Methods This cross-sectional study was done in a primary health care center at Klungkung I, Klungkung District, from August to September 2013. Children with short and normal stature (as reference group) were enrolled and their serum zinc level was measured, Other risk factors were inquired by questionnaire. Association between low serum zinc level (<65 Âµg/dL) and short stature was analyzed by stepwise multivariable regression analysis; degree of association was presented as odds ratio (OR) and its corresponding confidence interval.
Results The prevalence of low serum zinc level in our subjects was 71%. Low serum zinc level was significantly associated with short stature [adjusted OR 16.1; 95%CI 3.1 to 84.0; (P=0.001)]. In addition, the occurrence of low serum zinc was higher in the short stature group (88.5%) compared to the normal stature group (53.8%). We also found that low calorie intake was associated with short stature [adjusted OR 29.4; 95%CI 2.76 to 314.7; (P=0.001)].
Conclusion Low serum zinc level appears to be associated with short stature. [Paediatr Indones. 2016;56:171-5.].

References

1. Best CM, Sun K, de Pee S, Sari M, Bloem MW, Semba RD. Paternal smoking and increased risk of child malnutrition among families in rural Indonesia. Tob Control. 2008;17:38-45.
2. Mardewi KW, Sidiartha L. Breastfeeding duration and age at first complementary feeding in children age 6 months to 5 years. Paediatric Indones. 2012;52:S73.
3. Kimani-Murage EW, Kahn K, Pettifor JM, Tollman SM, Dunger DB, Gomez-Olive XF, et al. The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children. BMC Public Health. 2010;10:158. DOI: 10.1186/1471-2458-10-158.
4. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371:243-60.
5. Musthtaq MU, Gull S, Khurshid U, Shahid U, Shad MA, Siddiqui AM. Prevalence and socio-demographic correlates of stunting and thinness among Pakistani primary school children. BMC Public Health. 2011;11:790. DOI: 10.1186/1471-2458-11-790.
6. Senbanjo IO, Oshikoya KA, Odusanya OO, Njokanma OF. Prevalence and risk factors for stunting among school children and adolescents in Abeokuta, southwest Nigeria. J Health Popul Nutr. 2011;29:364-70.
7. Imdad A, Yakoob MY, Bhutta ZA. Impact of maternal education about complementary feeding and provision of complementary foods on child growth in developing countries. BMC Public Health. 2011;11:S25. DOI: 10.1186/1471-2458-11-S3-S25.
8. Wamani H, Astrom AN, Peterson S, Tumwine JK, Tylleskar T. Boys are more stunted than girls in Sub-Sahara Africa: a meta-analysis of 16 demographic and health surveys. BMC Paediatr. 2007;7:17. DOI: 10.1186/1471-2431-7-17.
9. Casapia M, Joseph SA, Nunez C, Rahme E, Gyorkos TW. Parasite risk factors for stunting in grade 5 students in a comunity of extreme poverty in Peru. Int J Parasitol. 2006;36:741-7.
10. Umeta M, West CE, Verhoef H, Haidar J, Hautvast JG. Factors associated with stunting in infants aged 5-11 months in the Dodota-Sire District, rural Ethiopia. J Nutr. 2003;133:1064-9.
11. Gibson RS, Manger MS, Krittaphol W, Pongcharoen T, Gowachirapant S, Bailey KB, et al. Does zinc deficiency play role in stunting among primary school children in NE Thailand? Br J Nutr. 2007;97:167-75.
12. Salgueiro MJ, Zubillaga MB, Lysionek AE, Caro RA, Weill R, Boccio R. The role of zinc in the growth and development of children. Nutrition. 2002;18:510-9.
13. Brown KH, Peerson JM, Rivera J, Allen LH. Effect of supplemental zinc on the growth and serum zinc concentration of prepubertal children: a meta-anlysis of randomized controlled trials. Am J Clin Nutr. 2002;75:1062-71.
14. Fischer-Walker CL, Black RE. Functional indicators for assessing zinc deficiency. Food Nutr Bull. 2007;28:454-79.
15. Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I, Purwanto SH. Perkiraan besar sampel. In: Sudigdo S, Ismael S, editors. Dasar-dasar metodologi klinis. 4th ed. 2011; Jakarta: Sagung Seto. p. 348-82.
16. Dehghani SM, Katibeh P, Haghighat M, Morajev H, Asadi S. Prevalence of zinc deficiency in 3-18 years old children in Shiraz-Iran. Iran Red Cresent Med J. 2011;13:4-8.
17. Ibeanu V, Okeke E, Onyechi U, Ejiofor U. Assessment of anthropometric indices, iron and zinc status of preschoolers in a peri-urban community in south east Nigeria. Int J Basic Appl Sci IJBAS-IJENS. 2012;12:31-7.
18. Gibson RS. Zinc: the missing link in combating micronutrient malnutrition in developing countries. Proc Nutr Soc. 2006;65:51-60.
19. Ruminingsih. Perbedaan pola konsumsi (energi, protein, seng dan vitamin A) dan frekuensi sakit pada anak balita dengan status gizi pendek dan normal di wilayah kerja UPT puskesmas Klungkung I kabupaten Klungkung [thesis]. [Denpasar]: Universitas Udayana; 2010.
20. Tresna AK. Perbedaan pertumbuhan linier (TB/U), kadar seng dan kadar C-reactive protein (CRP) pada anak balita dengan kadar serum retinol normal dan tidak normal [thesis]. [Surabaya]: Universitas Airlangga; 2008.
21. Rivera JA, Hotz C, Gonzalez-Cossio T, Neufeld L, Garcia-Guerra A. The effect of micronutrient deficiencies on child growth: a review of results from community-based supplementation trials. J Nutr. 2003;133:4010S-20S.
22. Hidayati SN. Defisiensi seng (zn). In: Sjarif DR, Lestari ED, Mexitalia M, Nasar SS, editors. Buku ajar nutrisi pediatrik dan penyakit metabolik. 1st ed. Jakarta: IDAI; 2011. p. 182-9.
23. Yakoob MY, Theodoratou E, Jabeen A, Imdad A, Eisele T, Ferguson J, et al. Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malaria. BMC Public Health. 2011;11:S23. DOI: 10.1186/1471-2458-11-S3-S23.