Lower IGF-1, calcium, phosphorus, and magnesium levels link to short stature in underweight children

Child short stature, defined as height-for-age Z-score below -2 standard deviations, affects millions globally and is a key indicator of chronic undernutrition. Linear bone growth, driven by endochondral ossification, relies on a complex interplay of genetic, endocrine, and nutritional factors. Key players include insulin-like growth factor-1 (IGF-1), 25-hydroxyvitamin D [vitamin 25(OH)D], and essential bone minerals like calcium (Ca), phosphorus (Ph), and magnesium (Mg). Current understanding of how these biomarkers vary across different growth phenotypes, particularly in the context of concurrent undernutrition, remains incomplete, hindering targeted interventions.

This cross-sectional analytical study investigated 225 children aged 24-59 months residing in Bandung District, Indonesia. Data and stored biological specimens (SBS) were collected between May and August 2021. The cohort was divided into three groups: 84 underweight children with short stature, 70 normal-weight children with short stature, and 71 children with normal weight and stature. SBS were preserved at -80 °C. Researchers employed appropriate statistical tests, post-hoc analyses, and multivariable logistic regression to compare biomarker levels and examine their associations with short stature across these distinct growth phenotypes.

Significant differences in IGF-1, 25(OH)D, calcium, phosphorus, and magnesium levels were observed across the three growth groups (all p < 0.05). Post-hoc analysis revealed that these differences were specifically confined to comparisons between the underweight short stature group and the normal-weight normal stature group, with no significant differences involving the normal-weight short stature group. Multivariable analysis further demonstrated that lower levels of IGF-1, calcium, phosphorus, and magnesium were independently associated with short stature.

These associations were largely attributable to the underweight subgroup, while remaining non-significant among children with normal-weight short stature.