ESPE Yearbook of Paediatric Endocrinology

Front Pediatr. 2025 Jan 20;13:1522060. PMID: 39902060 doi: 10.3389/fped.2025.1522060

Brief Summary: This cross-sectional study evaluated the prevalence of short stature in a clustered random sample of children in Hainan Province, China, and the factors associated with short stature in this population. Short stature was associated withlower birth weight, lower childhood body mass index z-score, lower maternal education, lower family income and lower protein intake.

Previous studies in China reported an average prevalence of short stature of 2.4% (defined by WHO Z-score <-2 SD) with some variation according to the specific population. Height is multifactorial, influenced by genetic, environmental, nutritional, social and other factors. To investigate the impact of non-genetic factors on short stature in children in Hainan Province, the authors conducted this large cross-sectional survey of children between the ages of 3 and 18 years through a staged, cluster random sampling method. The authors used a parent questionnaire that included height, weight, gender, birth weight, paternal/maternal education, family income, weekly intake frequencies of fruits, beans, meat and eggs, weekly intake frequencies of a variety of snacks, daily outdoor activity and daily electronic screen times.

Demographic and dietary questionnaires and measured height and weight in 26,189 children aged 3-18 years were analyzed. The prevalence of short stature (<-2SD) was 2.9% in boys and 3.1% in girls. Those with short stature had lower parental education and annual family income than other children, and less frequent intakes of beans, meat, eggs and fruit. Short stature children also had more low birth weight, gestational age < 37 weeks and low current weight. The prevalence of short stature among rural children was more than twice that in urban children (3.76% vs 1.71%).

Hainan Province lags behind other provinces in China in economic development and this study shows a higher prevalence of short stature in this province compared to the larger Chinese population (2.4%). This may be the result of socioeconomic and nutritional factors, as well as pregnancy related issues. Attention to these issues may result in improved growth and stature in this area of China.