Association between skeletal muscle index and the risk of short stature in school-age children

ZHAO Huijuan; ZHAO Lu; LI Chenyi; ZHOU Yi; WANG Yan; CAI Shizhong

doi:10.11852/zgetbjzz2025-0375

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (1) : 53-58. DOI: 10.11852/zgetbjzz2025-0375

Growth & Development

Association between skeletal muscle index and the risk of short stature in school-age children

ZHAO Huijuan, ZHAO Lu, LI Chenyi, ZHOU Yi, WANG Yan, CAI Shizhong

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Abstract

Objective To investigate the independent effect of skeletal muscle index (SMI) on the risk of short stature in school-age children, and to analyze the moderating effects of age and sex. Methods Based on health check-up data from the Children's Hospital of Soochow University (2016—2022), 1 324 children aged 6 - 12 years were included (331 with short stature and 993 controls).Body composition was measured using bioelectrical impedance analysis (BIA), and SMI was calculated as skeletal muscle mass/height².Multivariable logistic regression analysis was performed to assess the association between SMI and short stature risk, adjusting for age, sex, percentage of body fat (PBF), and BMI-for-age Z-score (BAZ).Sensitivity analysis was conducted using quartile grouping and restricted cubic splines (RCS) to examine the dose-response relationship.Subgroup analysis was performed to test the interaction effects of age and sex. Results For every 1-unit increase in SMI, the risk of short stature decreased by 78% (OR=0.22, 95%CI: 0.14 - 0.35).After full adjustment, the risk in the highest quartile (Q4) was 87% lower than that in the lowest quartile (Q1) (OR=0.13, 95%CI: 0.08 - 0.21), with a significant dose-response trend (P_{for trend}<0.001).RCS analysis revealed a linear negative correlation between SMI and short stature risk (P_nonlinear=0.307).Subgroup analysis indicated that the protective effect of SMI was significantly stronger in boys than in girls (P_for _interaction<0.01), while no significant moderating effect of age was observed (P_for _interaction＞0.05). Conclusions SMI is an independent protective factor against the risk of short stature in children, with its effect showing sex heterogeneity, suggesting the critical role of skeletal muscle mass in height growth, particularly in boys.This study supports the inclusion of SMI in the child growth assessment system, providing a basis for the early identification of high-risk populations and the implementation of sex-specific interventions.

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short stature / skeletal muscle index / body composition analysis / child health

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ZHAO Huijuan, ZHAO Lu, LI Chenyi, ZHOU Yi, WANG Yan, CAI Shizhong. Association between skeletal muscle index and the risk of short stature in school-age children[J]. Chinese Journal of Child Health Care. 2026, 34(1): 53-58 https://doi.org/10.11852/zgetbjzz2025-0375

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