title: Stunting, adiposity, and low-grade inflammation in African adolescents from a township high school.
abstract: OBJECTIVE
  The objective of this study was to compare the inflammatory status of children with differences in nutritional status.
  
  
  METHODS
  This was a cross-sectional study of 184 African children aged 13-18 y from a low socioeconomic background that compared stunted with non-stunted and lean with over-fat (percentage of body fat above normal cutoff points) children. Fasting serum tumor necrosis factor-alpha, interleukin-6, C-reactive protein, and insulin were measured using high-sensitivity methods. Body composition was assessed using anthropometry and air-displacement plethysmography. T tests for parametric data and the Mann-Whitney test for non-parametric data were used to compare groups. Regression analyses and principal components analyses were done to assess relations between body composition and biochemical variables.
  
  
  RESULTS
  Of all participants 18% were stunted. Serum tumor necrosis factor-alpha of stunted girls was higher than in non-stunted girls. More of the stunted boys were over-fat compared with their non-stunted counterparts. Regression analyses showed that insulin resistance, diastolic blood pressure, and C-reactive protein contributed significantly to interleukin-6 in boys. Serum C-reactive protein, waist circumference, and body mass index clustered together in factor analysis in boys. Serum interleukin-6, waist-hip ratio, and tumor necrosis factor-alpha clustered together in factor analysis in girls.
  
  
  CONCLUSIONS
  An association between adiposity and stunting and between adiposity low-grade inflammation was found in this study. Interventions for stunted children focus mainly on correction of undernutrition by providing feeding schemes. Attention should, however, also be paid to changes in body composition over time to prevent excessive abdominal fat accumulation and risk for cardiovascular diseases later in life.
authors.affiliation: School of Physiology, Nutrition and Consumer Science, North-West University, Potchefstroom, South Africa. salome.kruger@nwu.ac.za
authors.forename: Herculina Salome
authors.initials: HS
authors.lastname: Kruger
authors.forename: Rachelle
authors.initials: R
authors.lastname: Pretorius
authors.forename: Aletta E
authors.initials: AE
authors.lastname: Schutte
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000378:metabolism*; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D010991:Plethysmography; D012016:Reference Values; D012574:Schools; D012737:Sex Factors; D012923:Social Class; D013019:South Africa / Q000453:epidemiology; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein