Is Urinary Pyridinium Crosslinks Associated with Stunting in Stunting Children in Indonesia

Abstract

The objective of this study was to analyze the correlation between pyridinium crosslinks (Pyd) urine and stunting among children. We also determined the effect of nutritional intervention on the Pyd content in urine among stunting children. The study was a cross-sectional involving 173 children in Pekanbaru and Kabupaten Lima Puluh Kota, Indonesia in 2014 (children aged 0-3 days: n = 32), in 2017 (children aged 4-6 years: n = 80), in 2018 (children 4-6 years old: n = 25), and in 2020 (children 12-15 years old: n = 36). Height gauges, family socio-economic questionnaires, pot urine and Pyd kit were utilized to gather the data. As nutritional interventions, milk was given to children aged 4-6 years old for 4 months (as additional energy; 20% of the recommended dietary allowance); brunch meals and milk were given to children 12-15 years old for 34 days (as additional energy; 30% recommended dietary allowance). Pyd and height were used as parameter indicators in this study. Pearson correlation and t-test (significance p< 0.05 and p<0.01) were applied for statistical analysis. The Pyd content of stunted children aged in 0-3 days, 3-5 years, 4-6 years, and 12-15 years were discovered to be 982, 16.4, 16.9 and 9.6 nmol/mmol creatinine, respectively. The Pyd content of stunted children aged 4-6 and 12-15 years before and after nutritional intervention were 16.9 vs 15.3 and 9.81 vs 5.33 nmol/mmol creatinine, respectively. Stunting neonatal urine Pyd content was found to be different from normal neonatal urine Pyd content (p <0.01). There was a correlation revealed between urine Pyd content and height of children aged 4-6 years (p <0.05) and r = -0.242. A difference was observed in the urine Pyd content of children 4-6 years before nutrition intervention (p <0.01) as well as in urine Pyd content of children aged 12-15 years before and after nutritional intervention (p <0.05); as many as 19.4% of the subjects increased their nutritional status from stunting to normal. The urine Pyd is expected to be a marker of the efficacy of nutritional care in bone growth disorders associated with bone resorption in stunting children.