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Randomized Controlled Trial
. 2023 May 31;15(11):2590.
doi: 10.3390/nu15112590.

Insulin-like Growth Factor 1 (IGF1), IGF Binding Protein-3 (IGFBP3) and Growth Response to Daily Zinc Supplementation: A Randomized Trial in Rural Laotian Children

Maxwell A Barffour  1   2   3 , Robin M Bernstein  4   5 , Guy-Marino Hinnouho  1   6 , K Ryan Wessells  1 , Charles D Arnold  1 , Sengchanh Kounnavong  7 , Sonja Y Hess  1
Affiliations
Randomized Controlled Trial

Insulin-like Growth Factor 1 (IGF1), IGF Binding Protein-3 (IGFBP3) and Growth Response to Daily Zinc Supplementation: A Randomized Trial in Rural Laotian Children

Maxwell A Barffour et al. Nutrients. .

Abstract

Objectives: To assess (a) the impact of daily preventive zinc tablets (7 mg; PZ), zinc-containing multiple micronutrient powder (10 mg zinc, and 13 other micronutrients; MNP) or placebo, delivered for 9 months, on Insulin-like Growth Factor 1 (IGF1) and IGF Binding Protein 3 (IGFBP3) among Laotian children 6-23 months, and (b) whether the effects of PZ and MNP on length-for-age z-scores (LAZ) and weight-for-age z-scores (WAZ) are modified by baseline IGF1 and IGFBP3.

Design: A double-blind, placebo-controlled trial (N = 419).

Methods: Plasma IGF1 and IGFBP3 concentrations at baseline and 36 weeks were analyzed by automated chemiluminescent assay. Anthropometry was assessed at baseline, at 18 and 36 weeks. Intervention effects were estimated using ANCOVA.

Results: At 36 weeks, geometric mean IGF1 (~39.0-39.2 ng/mL; p = 0.99) and IGFBP3 (2038-2076 ng/mL; p = 0.83) did not differ by group. At 18 weeks (but not at 36 weeks), LAZ in the PZ group (-1.45) was higher than the MNP (-1.70) and control (-1.55) groups (p = 0.01) among children in the highest baseline IGF1 tertile (p for interaction = 0.006). At 36 weeks (but not at 18 weeks), WAZ in the PZ group (-1.55) was significantly higher than the MNP (-1.75) and control (-1.65) groups (p = 0.03), among children in the lowest baseline IGFBP3 tertile (p for interactions = 0.06).

Conclusions: Although IGF1 and IGFBP3 did not respond to PZ and MNP, baseline IGF1 and IGFBP3 significantly modified the impact of PZ on linear and ponderal growth, suggesting that IGF1 bioavailability may drive catch-up growth in zinc-supplemented children.

Keywords: IGF1; IGFBP3; multiple micronutrient powder; physical growth; zinc supplementation.

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Conflict of interest statement

The Spouse of S.Y.H. worked for the Bill and Melinda Gates Foundation. None of the other authors have a conflict of interest to declare. The sponsors had no involvement in the study implementation, data analyses and manuscript writing.

Figures

Figure 1
Figure 1
CONSORT Diagram indicating the selection of children into growth biomarker sub-study. Detailed CONSORT including an explanation of exclusions is published elsewhere [24,25].
Figure 2
Figure 2
Effect-modification by baseline IGF1 of the response in length-for-age z-score (LAZ) at 18 weeks to zinc-alone or zinc-containing MNP in rural Laotian children. Bars with different letters are significantly different (p-value < 0.05).
Figure 3
Figure 3
Effect-modification by baseline IGFBP3 of the response in weight for-age z-score (WAZ) after 36 weeks to zinc-alone or zinc-containing MNP in rural Laotian children. Bars with different letters are significantly different (p-value ≤ 0.05).
Figure 4
Figure 4
Association between baseline length-for-age z-scores and IGF1 concentrations.
Figure 5
Figure 5
Distributions of IGF1, IGFBP3, and molar IGF1:IGFBP3 ratio at baseline and 36 weeks later in rural Laotian children.
See this image and copyright information in PMC

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References

    1. Black R.E., Victora C.G., Walker S.P., Bhutta Z.A., Christian P., de Onis M., Ezzati M., Grantham-McGregor S., Katz J., Martorell R., et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:427–451. doi: 10.1016/S0140-6736(13)60937-X. - DOI - PubMed
    1. Cousins R.J. Metal elements and gene expression. Annu. Rev. Nutr. 1994;14:449–469. doi: 10.1146/annurev.nu.14.070194.002313. - DOI - PubMed
    1. Imdad A., Bhutta Z.A. Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: A meta-analysis of studies for input to the lives saved tool. BMC Public Health. 2011;11:S22. doi: 10.1186/1471-2458-11-S3-S22. - DOI - PMC - PubMed
    1. Mayo-Wilson E., Junior J.A., Imdad A., Dean S., Chan X.H.S., Chan E.S., Jaswal A., Bhutta Z.A. Zinc supplementation for preventing mortality, morbidity, and growth failure in children aged 6 months to 12 years of age. Cochrane Database Syst. Rev. 2014;5:CD009384. doi: 10.1002/14651858.CD009384.pub2. - DOI - PubMed
    1. Brown K.H., Peerson J.M., Baker S.K., Hess S. Preventive Zinc Supplementation among Infants, Preschoolers, and Older Prepubertal Children. Food Nutr. Bull. 2009;30:S12–S40. doi: 10.1177/15648265090301S103. - DOI - PubMed

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