The relationship between malnutrition and TH 2 immune markers: a study in school-aged children of different socio-economic backgrounds in Makassar, Indonesia.

Abstract

ObjectiveThe burden of underweight remains a major problem in Indonesia, and at the same time, the prevalence of overweight is increasing. Malnutrition is a major determinant of health and has been linked to allergic disorders in children. We examined the relationship between malnutrition and TH2 immune markers in school‐aged children in Makassar, Indonesia.MethodsA cross‐sectional study was performed in five schools where socio‐demographic characteristics were recorded. Children’s standardised z‐scores of body mass index (z‐BMI) and age‐standardised z‐scores of height (z‐HA) were assessed using WHO child growth standards. Skin prick test (SPT) reactivity was determined to house dust mite allergens. Helminth infection status, (growth) hormones including insulin‐like growth factor (IGF‐1) and TH2 immune markers were measured.ResultsIn total, 954 children were included of whom 21.6% were underweight and 14.8% overweight. After controlling for confounders, overweight was positively associated with leptin (GMR 3.55, 95% CI: 2.99–4.23) and IGF‐1 (GMR 1.45, 95% CI: 1.15–1.82), whereas underweight was negatively associated (respectively GMR 0.57, 95% CI: 0.49–0.66 and GMR 0.78, 95% CI: 0.63–0.97). Underweight was associated with a lower eosinophil count (GMR 0.79, 95% CI: 0.64–0.97) but not with total IgE levels or SPT reactivity. Overweight was positively associated with SPT reactivity (adjusted OR 2.68, 95% CI: 1.50–4.78) but no relationship was found with the other TH2 immune markers.ConclusionMalnutrition is prominent in school‐aged children in Makassar, with overweight associated with increased SPT reactivity. Therefore, interventions should focus on undernutrition, but also on overweight to prevent the increase of allergic disorders in Indonesia.