Zinc Deficiency and Subsequent Reduction in Insulin-like Growth Factor I Are Risk Factors for Stunting among School-Aged Children in the Gaza Strip, Palestine ^†

Abstract

Stunting is a major public health problem in low- and middle-income countries because of its association with increased risk of mortality during childhood. To investigate whether zinc deficiency and insulin-like growth factor I are associated with the prevalence of stunting among school-aged children, a cross-sectional study was conducted in which 141 pupils from the first grade were recruited through a multistage cluster sampling technique. The blood sample was drawn from the pupils to analyze zinc, insulin-like growth factor (IGF-1), hemoglobin (HG), albumin, and C-reactive protein (CRP). Height, weight, and body mass index (BMI) were measured whereas height for age Z-score was computed to assess stunting. The study revealed that the prevalence of stunting among the study population is 34% out of which 27.7% and 6.4% exhibit mild and moderate stunting, respectively. The prevalence of zinc deficiency is almost 5% among the pupils. There is a positive association between serum zinc and IGF-1 (p = 0.013), and the results of the Multiple Linear Regression (MLR) illustrate that as the serum zinc level increases by one unit, the IGF-1 level increases by 0.61 cm. In addition, the final model of the MLR analysis shows a negative correlation between being female and height. By investigating the direction of the association between age and IGF-1 and height, it was clear that a positive correlation exists (b = 0.20, 0.03), respectively. This study shows a higher rate of stunting among first-grade children in the Gaza Strip and might be attributed to many factors such as gender, age, household size, and IGF-1.