Related Experiment Video
Updated: Aug 16, 2026
Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
Published on: August 22, 2012
Elevated acute-phase protein in stunted Nepali children reporting low morbidity: different rural and urban profiles
C Panter-Brick1, P G Lunn, R Baker
1Department of Anthropology, University of Durham, Durham DH1 3HN, UK. Catherine.Panter-Brick@durham.ac.uk
Insights
Severe stunting in Nepali village boys is linked to high alpha1-antichymotrypsin (ACT) levels, despite reporting less illness. This highlights inflammation
Area of Science:
- Pediatric Nutrition and Growth
- Biochemistry and Inflammation
- Global Health Disparities
Background:
- Childhood stunting remains a significant global health issue, particularly in low-income settings.
- Plasma protein concentrations can serve as indicators of nutritional status and inflammatory processes.
- Contrasting socio-ecological environments may influence growth, health, and biochemical markers in children.
Purpose of the Study:
- To investigate the relationship between stunting severity, plasma protein levels (albumin and alpha1-antichymotrypsin), and reported morbidity in Nepali boys.
- To compare these parameters across diverse environments: remote village, urban poor squatters, homeless street children, and middle-class schoolchildren.
- To explore potential mechanisms linking inflammation, growth faltering, and perceived illness burden.
Main Methods:
- Cross-sectional study involving 104 Nepali boys aged 10-14 years.
- Measurement of height-for-age z-scores to assess stunting severity.
- Analysis of plasma concentrations of albumin and alpha1-antichymotrypsin (ACT).
- Collection of self-reported morbidity data.
Main Results:
- Severe stunting was prevalent in village, squatter, and street children, with village boys exhibiting the most significant growth retardation (mean z-score -2.97).
- Higher stunting severity was associated with elevated plasma ACT levels and reduced albumin levels.
- Village children, despite severe stunting and abnormal plasma proteins, reported the lowest disease burden.
Conclusions:
- High plasma ACT levels and stunting are strikingly prevalent in the rural Nepali sample, suggesting underlying inflammation.
- The discrepancy between severe stunting/abnormal proteins and low reported morbidity may indicate sub-clinical infections or adaptation to illness.
- Findings caution against using uncorroborated morbidity reports across diverse socio-ecological contexts and highlight the need to consider inflammation in growth faltering.
Abstract:
This study examined the associations between severity of stunting, plasma protein concentrations and morbidity of 104 Nepali boys, aged 10-14 years, living in contrasting environments. Boys from a remote village were compared with three similarly aged urban groups: poor squatters, homeless street children, and middle-class schoolchildren. All but the middle-class group were stunted, particularly village boys whose mean height-for-age z-score (-2.97, SD 0.82) indicates severe growth retardation. Stunting was significantly associated with increased plasma levels of the acute-phase protein alpha1-antichymotrypsin itself inversely related to plasma levels of albumin. Plasma ACT levels of village children (mean 1.52 g/l, SD 0.43) were three to four times higher than those of squatters and homeless street children, and five times higher than those of middle-class boys. Despite being the most severely stunted and having the most abnormal plasma protein values, village children reported the lowest burden of disease, a contradiction which may reflect exposure to sub-clinical infections or habituation to illness and low expectation of treatment. This study draws attention to the strikingly high levels of ACT and of stunting in the rural sample, and cautions on the use of uncorroborated morbidity reports across different epidemiological and socio-ecological environments. Possible mechanisms to explain the impact of illness and inflammation on growth faltering are discussed.
