The Integrating Precision Genomic Strategies and Islamic Ethical Perspectives in Stunting Prevention: Focus on the Growth Hormone-IGF-1 Pathway
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Page: 1132-1144
Abstract
Stunting remains one of the major chronic nutritional problems in Indonesia. The national prevalence of stunting has decreased from 37.2% in 2013 to 19.8% in 2024; however, this figure is still above the World Health Organization threshold (<20%) and has not yet reached the national target of 14%. The interaction of nutritional, environmental, and genetic factors influences stunting. Genetic variations within the Growth Hormone–Insulin-like Growth Factor One pathway play a significant role in regulating linear growth in children; disruptions in this pathway can increase vulnerability to stunting. In addition, the majority of Indonesia's population adheres to Islam, making religious values a strategic potential for strengthening health interventions. This review article examines the integration of scientific approaches, focusing on genetics and Islamic values, in stunting prevention by highlighting polymorphisms in the IGF1, IGF1R, and GHR genes and their relevance to the principles of maqāsid al-sharī‘ah, particularly hifz al-nasl (protection of lineage). The analysis is conducted using a descriptive-analytical approach based on recent scientific literature and Islamic references, including the Qur’an, prophetic traditions, and scholarly exegesis. The findings indicate a strong alignment between scientific approaches and Islamic teachings, including the importance of adequate nutrition during pregnancy, exclusive breastfeeding, consumption of lawful, nutritious food, genetic screening efforts consistent with the values of divine decree, and vitamin D supplementation to support Insulin-like Growth Factor One levels. This integration has the potential to enhance community acceptance of stunting-prevention programs, strengthen moral and spiritual motivation, and support the achievement of national stunting-reduction targets. Thus, an approach that combines precise genomics and Islamic values may serve as a contextual and sustainable strategy in shaping a generation that is healthy, intelligent, and spiritually resilient.
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References
Apriastini NKT, Adnyani NPT, Selvyani PO, Setiawan KH. Stunting: Faktor Risiko, Diagnosis, Tatalaksana, Dan Prognosis. Ganesha Medicine 2024;4:17–23. https://doi.org/10.23887/gm.v4i1.77137.
Witdiawati W, Purnama D, Rosidin U, Shalahuddin I, Sumarni N. Pendidikan Kesehatan tentang Peran Remaja dalam Pencegahan Stunting. Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) 2024;7:1744–51. https://doi.org/10.33024/jkpm.v7i4.13904.
Sagala R, Malik A, Mustofa MB. Pencegahan Stunting Pada Anak Dalam Persepektif Islam Di Kota Bandar Lampung. AKM: Aksi Kepada Masyarakat 2023; 4:109–22. https://doi.org/ 10.36908/akm.v4i1.708.
Ridwan R, Faruq U Al, Setyobudi T, Masykuroh UF, Fitriyah YN. Integration of Islamic Values in Stunting Prevention in Indonesia: Analysis of Surah An-Nisa’ Verse 9 as the Foundation for a Holistic Approach. Integrasi Nilai-Nilai Islam dalam Pencegahan Stunting di Indonesia: Analisis Surah An-Nisa’ Ayat 9 sebagai Landasan Pendekatan Holistik. Al Huwiyah: Journal of Women and Children Studies 2024;4. https://doi.org/10.24042/jwcs.v4i2.24264.
Heriawita, Sulastri D. Analisis faktor genetik terhadap stunting: sebuah tinjauan sistematis. Journal of Social and Economic Research 2023;5:44–52. https://doi.org/10.54783/jser.v5i2.101.
Setiyaningrum IP, Alfiani T, Rochana S. Patofisiologi Stunting: Literature Review. Jurnal Kesehatan Tambusai 2024;5:13773–83. https://doi.org/10.31004/jkt.v5i4.40010.
Fikri AM, Malau J, Kasasiah A, Ramadhan WN, Safitri NA, Debora PC, et al. Determinants of stunting among under-five children in Indonesia: considering the role of GHSR gene polymorphism. Nutrire 2025;50:60. https://doi.org/10.1186/s41110-025-00364-0.
Del Tredici AL, Malhotra A, Dedek M, Espin F, Roach D, Zhu G, et al. Frequency of CYP2D6 Alleles Including Structural Variants in the United States. Frontiers in Pharmacology 2018;9. https://doi.org/10.3389/fphar.2018.00305.
Indratno SHA, Malau J, Kasasiah A. Genetic Studies On The GHSR and IGF1R and Their Relationship With Stunting: A Systematic Literature Review. Jurnal Pembelajaran Dan Biologi Nukleus 2024;10:632–46. https://doi.org/10.36987/jpbn.v10i2.5731.
Zaitoon H, Yackobovitch-Gavan M, Midlej E, Uretzky A, Laurian I, Dorfman A, et al. The role of IGF1 in determining body composition in children and adolescents with growth hormone deficiency and those with idiopathic short stature. Endocrine 2024;86:1110–20. https://doi.org/10.1007/s12020-024-03992-0.
Afni N, Riana H. Science Midwifery. Malnutrition in children is associated with low insulin-like growth factor-1 (IGF-1) levels. vol. 12. Online; 2024. https://doi.org/https://doi.org/10.35335/midwifery.v12i5.1753.
Puaprasert K, Chu C, Saralamba N, Day NPJ, Nosten F, White NJ, et al. Real-time PCR detection of common CYP2D6 genetic variants and their application in a Karen population study. Malaria Journal 2018;17:427. https://doi.org/10.1186/s12936-018-2579-8.
García-Alegría AM, Anduro-Corona I, Pérez-Martínez CJ, Guadalupe Corella-Madueño MA, Rascón-Durán ML, Astiazaran-Garcia H. Quantification of DNA through the NanoDrop Spectrophotometer: Methodological Validation Using Standard Reference Material and Sprague Dawley Rat and Human DNA. International Journal of Analytical Chemistry 2020;2020:1–9. https://doi.org/10.1155/2020/8896738.
Melia G, Irman S, Susandra E, Pendidikan S, Islam A, Tarbiyah F, et al. Pengembangan Program Pendidikan Kesehatan Mental Berbasis Agama Untuk Meningkatkan Kesejahteraan Siswa. Jurnal Ilmiah Bimbingan Dan Konseling Islam 2025;5:79–88. https://doi.org/https://doi.org/10.53888/muhafadzah.v6i1.
Jannah NLR. Harmonization Of Healthy Living Guidelines Based On The Teachings Of The Rasulullah (Religion) And Based On Healthy Science. Averroes: Journal for Science and Religious Studies 2024;1:135–48. https://doi.org/10.62446/averroes.010301.
Samad SAA, Samad M, Ramli S, HR S, Ilyas I. Islamic Educational Approaches To Stunting Prevention And Child Protection. Jurnal Pendidikan Islam 2024;10:163–74. https://doi.org/10.15575/jpi.v0i0.38432.
Baker JL, Bjerregaard LG. Advancing precision public health for childhood obesity. Reviews in Endocrine and Metabolic Disorders 2023;24:1003–10. https://doi.org/10.1007/s11154-023-09802-8.
Mehta NH, Huey SL, Kuriyan R, Peña-Rosas JP, Finkelstein JL, Kashyap S, et al. Potential Mechanisms of Precision Nutrition-Based Interventions for Managing Obesity. Advances in Nutrition 2024;15:100186. https://doi.org/10.1016/j.advnut.2024.100186.
Bidlingmaier M, Gleeson H, Latronico A-C, Savage MO. Applying precision medicine to the diagnosis and management of endocrine disorders. Endocrine Connections 2022;11. https://doi.org/10.1530/EC-22-0177.
Carter-Su C, Schwartz J, Argetsinger LS. Growth hormone signaling pathways. Growth Hormone & IGF Research 2016;28:11–5. https://doi.org/10.1016/j.ghir.2015.09.002.
Lu M, Flanagan JU, Langley RJ, Hay MP, Perry JK. Targeting growth hormone function: strategies and therapeutic applications. Signal Transduction and Targeted Therapy 2019;4:3. https://doi.org/10.1038/s41392-019-0036-y.
Galal MA, Alouch SS, Alsultan BS, Dahman H, Alyabis NA, Alammar SA, et al. Insulin Receptor Isoforms and Insulin Growth Factor-like Receptors: Implications in Cell Signaling, Carcinogenesis, and Chemoresistance. International Journal of Molecular Sciences 2023;24:15006. https://doi.org/10.3390/ijms241915006.
Hakuno F, Takahashi S-I. 40 YEARS OF IGF1: IGF1 receptor signaling pathways. Journal of Molecular Endocrinology 2018;61:T69–86. https://doi.org/10.1530/JME-17-0311.
Werner H. The IGF1 Signaling Pathway: From Basic Concepts to Therapeutic Opportunities. International Journal of Molecular Sciences 2023;24:14882. https://doi.org/10.3390/ijms241914882.
Forbes BE, Blyth AJ, Wit JM. Disorders of IGFs and IGF-1R signaling pathways. Molecular and Cellular Endocrinology 2020;518:111035. https://doi.org/10.1016/j.mce.2020.111035.
Fruman DA, Chiu H, Hopkins BD, Bagrodia S, Cantley LC, Abraham RT. The PI3K Pathway in Human Disease. Cell 2017;170:605–35. https://doi.org/10.1016/j.cell.2017.07.029.
Savage MO, Storr HL. GH Resistance Is a Component of Idiopathic Short Stature: Implications for rhGH Therapy. Frontiers in Endocrinology 2021;12. https://doi.org/10.3389/fendo.2021.781044.
Tamburrino F, Gibertoni D, Rossi C, Scarano E, Perri A, Montanari F, et al. Response to long‐term growth hormone therapy in patients affected by RASopathies and growth hormone deficiency: Patterns of growth, puberty, and final height data. American Journal of Medical Genetics Part A 2015;167:2786–94. https://doi.org/10.1002/ajmg.a.37260.
Hossain MA, Adithan A, Alam MJ, Kopalli SR, Kim B, Kang C-W, et al. IGF-1 Facilitates Cartilage Reconstruction by Regulating PI3K/AKT, MAPK, and NF-kB Signaling in Rabbit Osteoarthritis. Journal of Inflammation Research 2021; Volume 14:3555–68. https://doi.org/10.2147/JIR.S316756.
Qin Y, Di J, Guo Z, Chen S, Xiang C. Association of organs-crosstalk with the pathogenesis of osteoarthritis: cartilage as a key player. Frontiers in Endocrinology 2025;16. https://doi.org/10.3389/fendo.2025.1593658.
Liu H-J, Wang L-H, Chen L. Evaluation of Safety and Efficacy of Growth Hormone Therapy by IGF-1 Z Score in Children with Short Stature. Advances in Therapy 2019;36:2374–83. https://doi.org/10.1007/s12325-019-01021-5.
Nuryandari S, Widjaja NA, Husada D. TNF-α and IGF-1 levels in stunting children with chronic infection. Acta Biomedica 2024;95. https://doi.org/10.23750/abm.v95i6.16382.
Majewska KA, Kedzia A, Kontowicz P, Prauzinska M, Szydlowski J, Switonski M, et al. Polymorphism of the growth hormone gene GH1 in Polish children and adolescents with short stature. Endocrine 2020;69:157–64. https://doi.org/10.1007/s12020-020-02305-5.
Rohman A, Ghazali MAB, Windarsih A, Irnawati I, Riyanto S, Yusof FM, et al. Comprehensive Review on Application of FTIR Spectroscopy Coupled with Chemometrics for Authentication Analysis of Fats and Oils in the Food Products. Molecules 2020;25:5485. https://doi.org/10.3390/molecules25225485.
Taib WRW, Ismail I. Evidence of stunting genes in Asian countries: A review. Meta Gene 2021;30:100970. https://doi.org/10.1016/j.mgene.2021.100970.
Muhammad HFL. Obesity as the Sequel of Childhood Stunting: Ghrelin and GHSR Gene Polymorphism Explained. Acta Medica Indonesiana 2018;50:159–64.
Dias C, Giordano M, Frechette R, Bellone S, Polychronakos C, Legault L, et al. Genetic variations at the human growth hormone receptor (GHR) gene locus are associated with idiopathic short stature. Journal of Cellular and Molecular Medicine 2017;21:2985–99. https://doi.org/10.1111/jcmm.13210.
Husni Pasarela, Andri Soemitra, Zuhrinal M Nawawi. Halal Tourism Development Strategy in Indonesia. Konfrontasi: Jurnal Kultural, Ekonomi Dan Perubahan Sosial 2022;9:14–26. https://doi.org/10.33258/konfrontasi2.v9i1.188.
Aha Putra JN, Mutawakkil MochA. Qada’ dan Qadar Perspektif Al-Qur’an, Hadits, dan Implikasinya terhadap Pendidikan Agama Islam. J-PAI: Jurnal Pendidikan Agama Islam 2020;7. https://doi.org/10.18860/jpai.v7i1.11232.
Lee C-L, Chuang C-K, Chiu H-C, Chang Y-H, Tu Y-R, Lo Y-T, et al. Understanding Genetic Screening: Harnessing Health Information to Prevent Disease Risks. International Journal of Medical Sciences 2025;22:903–19. https://doi.org/10.7150/ijms.101219.
Manickam K, Buchanan AH, Schwartz MLB, Hallquist MLG, Williams JL, Rahm AK, et al. Exome Sequencing–Based Screening for BRCA1/2 Expected Pathogenic Variants Among Adult Biobank Participants. JAMA Network Open 2018;1:e182140. https://doi.org/10.1001/jamanetworkopen.2018.2140.
Kord-Varkaneh H, Rinaldi G, Hekmatdoost A, Fatahi S, Tan SC, Shadnoush M, et al. Reply to “Double-counting of effect sizes and inappropriate exclusion of studies in “The influence of vitamin D supplementation on IGF-1 levels in humans: A systematic review and meta-analysis.” Ageing Research Reviews 2021;66:101239. https://doi.org/10.1016/j.arr.2020.101239.
Siti Pandanwangi, Akrom, Nurkhasanah, Zuniarto AA, Hidayati T, Tsai ML. A Relationship Between Nutritional Status And Insulin-Like Growth Factor-1 Levels In Stunted Children In Cirebon Regency. Window of Health : Jurnal Kesehatan 2024:329–38. https://doi.org/10.33096/woh.v7i2.1299.
Hikmahrachim HG, Rohsiswatmo R, Ronoatmodjo S. Efek ASI eksklusif terhadap stunting pada anak usia 6-59 bulan di Kabupaten Bogor tahun 2019. Jurnal Epidemiologi Kesehatan Indonesia 2020;3. https://doi.org/10.7454/epidkes.v3i2.3425.
Yuliana A, Fatma Kumala T, Farida S. Correlation of Exclusive Breastfeeding with Stunting Incidence in Toddlers Age 24-60 Months in the Work Area of Mojolaban Health Center, Sukoharjo. Proceedings of the International Conference on Science, Health, And Technology 2022:293–302. https://doi.org/10.47701/icohetech.v3i1.2271.
Haryani VM, Putriana D, Hidayati RW. Animal-Based Protein Intake is Associated with Stunting in Children in Primary Health Care of Minggir. Amerta Nutrition 2023;7:139–46. https://doi.org/10.20473/amnt.v7i2SP.2023.139-146.
Headey D, Hirvonen K, Hoddinott J. Animal Sourced Foods and Child Stunting. American Journal of Agricultural Economics 2018;100:1302–19. https://doi.org/10.1093/ajae/aay053.
Lowe C, Kelly M, Sarma H, Richardson A, Kurscheid JM, Laksono B, et al. The double burden of malnutrition and dietary patterns in rural Central Java, Indonesia. The Lancet Regional Health - Western Pacific 2021;14:100205. https://doi.org/10.1016/j.lanwpc.2021.100205.
Rachmi CN, Agho KE, Li M, Baur LA. Stunting, Underweight and Overweight in Children Aged 2.0–4.9 Years in Indonesia: Prevalence Trends and Associated Risk Factors. PLOS ONE 2016;11:e0154756. https://doi.org/10.1371/journal.pone.0154756.
Ningsih AD, Yuswatiningsih E, Prasetyaningati D. Exploring the relationship between maternal parenting styles and stunting prevention behaviors in children aged 3-5 years. Healthcare in Low-Resource Settings 2024. https://doi.org/10.4081/hls.2024.12054.
Saleh A, Syahrul S, Hadju V, Andriani I, Restika I. Role of Maternal in Preventing Stunting: a Systematic Review. Gaceta Sanitaria 2021;35:S576–82. https://doi.org/10.1016/j.gaceta.2021.10.087.
Kasprzak A. Insulin-Like Growth Factor 1 (IGF-1) Signaling in Glucose Metabolism in Colorectal Cancer. International Journal of Molecular Sciences 2021;22:6434. https://doi.org/10.3390/ijms22126434.