Stunted and ferritin levels in children aged 0-24 months: Does gender influence the incidence?

Background and aim: Stunted remains a global nutritional problem in developing countries, such as Indonesia. Iron deficiency is common among stunted individuals due to the depletion of iron reserves, which induces hypoxia in hepatic cells and inhibits protein synthesis, including insulin-like growth factor 1 (IGF-1). Serum ferritin, the storage form of iron, is a sensitive marker for detecting iron reserves. This study aims to assess growth faltering, stunted, and ferritin levels in children under two years old. Methods: This study used a cross-sectional approach using secondary data from medical records of children under two years old who visited the Nutrition and Metabolic Diseases outpatient clinic at Husada Utama Hospital between July 2018 and June 2020. Data were analyzed using SPSS version 21.0 (IBM, UK), including normality and homogeneity tests, independent sample t-test (or Mann-Whitney U test), chi-squared test, and Fischer’s exact test. Bivariate analysis was conducted to determine relationships between variables. Results: Among the subjects, 52 children (44.83%) were undernourished. The incidence of stunted or severe stunted was higher in males than in females (44.83% or 26 children vs. 25.86% or 15 children). Ferritin levels were significantly lower in males compared to females (29.69 + 24.80 µg/dl vs. 53.38 + 95.36 µg/dl, p = 0.011). A weak negative correlation was observed between low ferritin levels and male sex (r = -0.184, p = 0.048). Male children had a 2.450-fold higher risk of low ferritin levels (95% CI [0.994-6.042], p = 0.052) and a 2.329-fold higher risk of stunted (95% CI [1.064-5.097], p = 0.034). However, no significant correlation was observed between stunted and low ferritin levels (r = 0.066, p = 0.478). Conclusions: A correlation was found between sex and low ferritin levels, with males at a higher risk for both low ferritin levels and stunted among children aged 0-24 months old.