The Higher C-Reactive Protein Levels as a Risk Factor of Stunting in Children with Acyanotic Congenital Heart Disease
DOI:
https://doi.org/10.3889/oamjms.2022.9551Keywords:
C-reactive protein, Congenital heart disease, StuntingAbstract
BACKGROUND: Children with acyanotic congenital heart disease (CHD) had a high risk of stunting. In addition to inadequate nutrition, chronic inflammatory process also plays an important role. An increase in serum c-reactive protein (CRP) suppresses insulin like growth factor 1 (IGF-1) production, causing disorder in child growth.
AIM: The objective f the study was to prove that higher CRP levels as a risk factor of stunting in children with acyanotic CHD aged 6–24 months old.
METHODS: This study is an observational analytic study with a case–control design, to assess higher CRP levels as a risk factor of stunting in children with acyanotic CHD aged 6–24 months old. This research was conducted at the Pediatric Cardiology Polyclinic, Sanglah Hospital from May to December 2021 with the consecutive sampling method. Data analysis was performed using the Chi-square test or Fisher’s absolute test. Multivariate analysis with binary logistic regression was performed on all variables. Significance level was p < 0.05.
RESULTS: This study involved 60 subjects, consisting of 30 subjects with stunting and 30 subjects with no stunting. Children with stunting had higher mean CRP levels, 2.4 (±3.7) and 1.2 (±0.6). CRP level ≥3 mg/dL (p = 0.031; aOR 22.89; 95% CI 1.32–395.39) was a risk factor of stunting in children with acyanotic CHD. Other risk factors that significant are male, living in rural areas, low birth weight, and under-nutrition.
CONCLUSION: Higher CRP levels as a risk factor of stunting in children with acyanotic CHD. Other significant risk factors include males, living in rural areas, low birth weight, and under-nutrition.Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Ulfah DA, Lestari ED, Salimo H, Lilijanti S, Artiko B. The effect of cyanotic and acyanotic congenital heart disease on children’s growth velocity. Paediatr Indones. 2017;57(3):159-62. https://doi.org/10.14238/pi57.3.2017.160-3
Rahman MA, Utamayasa IK, Hidayat T, Irawan R, Elizabeth R. Anthropometric profile of children with cyanotic and noncyanotic congenital heart disease. J Media Gizi Indones. 2020;15(1):1-6. https://doi.org/10.20473/mgi.v15i1.1-6
Pulungan AB. Height Below the Third Percentile or Z-score Below the Second Standard Deviation: Short or Stunting?. Med Edu Pediatric Health Sci. 2015;69:60-9.
World Health Organization. WHO Global Nutrition Targets 2025: Stunting Policy Brief. Geneva: World Health Organization. Available from: https://www.who.int/nutrition/piblication/globaltargets2025_policybrief_stunting/en/. 2014a. [Last accessed 2022 Jan 01].
Wanner C. C-reactive protein risk prediction: Adding cardiac hypertrophy to the list. Am J Kidney Dis. 2002;40(6):1340-1. https://doi.org/10.1053/ajkd.2002.37389 PMid:12460058
Upadhyay RK. Emerging biomarkers of congenital heart diseases and disorders. Stem Cell Res Ther. 2016;1(3):108-15. https://dor.org/10.15406/jsrt.2016.01.00021
Utama D. Diagnostic Test of C-Reactive Protein, Leukocytes, Total Neutrophil Value and Temperature in Feverish Children with Unknown Causes. Sari Pediatri. 2012;13(6):412-9. https://doi.org/10.14238/sp13.6.2012.412-9
Syed S, Manji K, McDonald C, Kisenge R, Aboud S, Sudfeld C, et al. Biomarkers of systemic inflammation and growth in early infancy associated with stunting in young Tanzanian children. Nutrients. 2018;10(9):1158. https://doi.org/10.3390/nu10091158 PMid:30149537
Mbuya MN, Chideme M, Chasekwa B, Mishra V. Biological, Social, and Environmental Determinants of Low Birth Weight and Stunting among Infants and Young Children in Zimbabwe. Vol. 1. Zimbabwe Working Paper; 2010. p. 1-39.
Ahasmi L, Nugroho HW, Salimo H . Association of C-Reactive Protein Levels with Stunting Aged 2-5 Years in Pucangsawit, Surakarta. Sari Pediatr. 2020;22(3):176-81. https://doi.org/10.14238/sp22.3.2020.176-81
Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health. 2014;34(4):250-65. https://doi.org/10.1179/2046905514Y.0000000158 PMid:25310000
Singh PK, Chaudhuri PK, Kumar A, Chaudhary. Incidence of congenital heart disease in children with recurrent respiratory tract infection in tertiary hospital. IOSR J Dent Med Sci. 2017;16(9):42-4.
World Health Organization. C-reactive Protein Concentrations as a Marker of Inflammation or Infection for Interpreting Biomarkers of Micronutrient Status. Geneva: World Health Organization, VMNIS; 2014b. p. 1-4.
Chandler PD, Scott JB, Drake BF, Ng K, Manson JE, Rifai N. Impact of Vitamin D supplementation on inflammatory markers in African Americans: Results of a four-arm, randomized, placebo-controlled trial. Cancer Prev Res (Phila). 2014;7(2):218-25. https://doi.org/10.1158/1940-6207.CAPR-13-0338-T PMid:24327720
Jutomo L, Wirjatmadi B, Irawan R. The role of omega-3 fatty acid supplementation on change in CRP levels and the frequency of illness in stunting children ages 12-36 months. Int J Sci Res. 2018;9(1):299-302.
Safabakhsh M, Emami M, Khosroshahi M, Asbaghi O, Khodayari S, Khorshidi, et al. Vitamin C supplementation and C-reactive protein levels: Findings from a systematic review and meta-analysis of clinical trials. J Complement Integr Med. 2020;17(4):1-12. https://doi.org/10.1515/jcim-2019-0151
Titaley CR, Ariawan I, Hapsari D, Muasyaroh A, Dibley MJ. Determinants of the stunting of children under two years old in Indonesia: A multilevel analysis Indonesia basic health survey. Nutrients. 2019;11(5):1106. https://doi.org/10.3390/nu11051106 PMid:31109058
Coulibaly NT, Rocquelin G, Eymard-Duvernay S, Zougmore ON, Traore SA. Effects of early extra fluid and food intake on breast milk consumption and infant nutritional status at 5 months of age in an urban and a rural area of Burkina Faso. Eur J Clin Nutr. 2004;58(8):80-9. https://doi.org/10.1038/sj.ejcn.1601752 PMid:14679371
Derso T, Tariku A, Biks GA, Wassie MM. Stunting, wasting and associated factors among children aged 6-24 months in Dabat health and demographic surveillance system site: A community based cross sectional study in Ethiopia. BMC Pediatr. 2017;17(1):96. https://doi.org/10.1186/s12887-017-0848-2 PMid:28376746
Akombi BJ, Agho KE, Hall JJ, Wali N, Renzaho AM, Merom D. Stunting, wasting and underweight in Sub-Saharan Africa: A systematic review. Int J Environ Res Public Health. 2017;14(8):863. https://doi.org/10.3390/ijerph14080863 PMid:28788108
Cruz LM, Azpeitia GG, Súarez DR, Rodríguez AS, Ferrer JF, Seria-Majem L. Factors associated with stunting among children aged 0 to 59 months from the central region of Mozambique. Nutrients. 2017;9(5):491. https://doi.org/10.3390/nu9050491 PMid:28498315
Rufaida FD, Raharjo AM, Handoko A. The correlation of family and household factors on the incidence of stunting on toddlers in three villages Sumber baru health center work area of Jember. J Agromed Med Sci. 2020;6(1):1-6. https://doi.org/10.19184/ams.v6i1.9541
Lestari W, Kristiana L, Paramita A. Stunting: A Study of the Social Construction of Rural and Urban Communities Related to Nutrition and Parenting Patterns of Toddlers in Jember Regency. Aspiration. 2018;9(1):17-33. https://doi.org/10.22212/aspirasi.v9i1.985
Adisena A, Eldrian F, Hasni D. Development of stunted toddlers aged 24-59 months using prescreening developmental questionnaire (PDQ) in air dingin public health center, Padang 2019: An overview. J Health Sci. 2021;14(1):27-31. https://doi.org/10.33086/jhs.v14i1.1447
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 Niluh Putu Wida Pangestika, I Gusti Ngurah Sanjaya Putra, I Gusti Lanang Sidiartha, I Gusti Ayu Trisna Windiani, Eka Gunawijaya, Dewi Sutriani Mahalini, Made Sukmawati (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0
