OBJECTIVES: This study examines the relationship between vitamin K2 (VK2) status and the occurrence of short stature in children. METHODS: A cross-sectional analysis was conducted between January 2021 and August 2022, involving 235 children with a clinical diagnosis of short stature at the Second Affiliated Hospital of Wenzhou Medical University (short stature group) and 454 children with average height (±1 SD) from the same period (healthy group). Serum VK2 levels were compared between the two groups. Multivariate logistic regression analysis was used to identify factors associated with short stature, and spearman correlation analysis was used to examine the relationship between VK2 status and age. RESULTS: Children in the short stature group exhibited lower VK2 levels (P = 0.019) and a significantly higher prevalence of VK2 deficiency (P = 0.011) compared to the healthy group. VK2 deficiency was identified as an independent risk factor for short stature (OR = 1.535, 95% CI = 1.061-2.222, P = 0.023) through multivariate logistic regression analysis. Furthermore, an inverse correlation was observed between serum VK2 levels and age in children aged 2 to 15 years (ρ = -0.133, P <
0.001). CONCLUSIONS: VK2 deficiency may be associated with an increased risk of short stature in children.