Digit ratio (2D:4D) in Klinefelter's syndrome

Effects of an App-Based Mindfulness Intervention during Pregnancy on the Infant's Prenatal Androgen Exposure: A Randomized Controlled Pilot Trial

Prenatal androgen exposure modulates the development of the brain, with lasting effects on its function and behavior over the infant's life span. Environmental factors during pregnancy, in particular maternal stress, have been shown to influence the androgen load of the unborn child. We here addressed the research gap on whether a mindfulness intervention or a pregnancy education administered to pregnant women more affects the androgen exposure of the unborn child (quantified by the proxies of second-to-fourth digit length ratio (2D:4D) and anogenital distance assessed one year after delivery and at delivery, respectively). Moreover, we tested the mindfulness intervention's effects on maternal perceived stress, anxiety, depressiveness, and mindfulness. Pregnant women (gestation weeks 8-14) were randomized to a 15-week app-based mindfulness-oriented intervention (N = 72) or a pregnancy education intervention (control condition; N = 74). The mindfulness-oriented group did not significantly differ from the pregnancy education group in infants' 2D:4D or anogenital distance (partial η2 ≤ 0.01) or in maternal stress, anxiety, depressiveness, or mindfulness. However, the descriptive results indicate that across pregnancy, stress and anxiety decreased and mindfulness increased in both groups. Overall, this study did not show that the mindfulness intervention (relative to the pregnancy education) reduced the prenatal androgen exposure of the unborn children or improved the maternal outcomes significantly.

Sex-specific association between prenatal androgenization (second-to-fourth digit length ratio) and frontal brain volumes in adolescents

Prenatal androgenization associates sex-dependently with behavior and mental health in adolescence and adulthood, including risk-taking, emotionality, substance use, and depression. However, still little is known on how it affects underlying neural correlates, like frontal brain control regions. Thus, we tested whether prenatal androgen load is sex-dependently related to frontal cortex volumes in a sex-balanced adolescent sample. In a cross-sectional magnetic resonance imaging study, we examined 61 adolescents (28 males, 33 females; aged 14 or 16 years) and analyzed associations of frontal brain region volumes with the second-to-fourth digit length ratio (2D:4D), an established marker for prenatal androgenization, using voxel-based morphometry in a region-of-interest approach. Lower 2D:4D (indicative of higher prenatal androgen load) correlated significantly with smaller volumes of the right anterior cingulate cortex (r-ACC; β = 0.45) in male adolescents and with larger volumes of the left inferior frontal gyrus orbital part (l-IFGorb; β = - 0.38) in female adolescents. The regression slopes of 2D:4D on the r-ACC also differed significantly between males and females. The study provides novel evidence that prenatal androgenization may influence the development of the frontal brain in a sex- and frontal brain region-specific manner. These effects might contribute to the well-known sex differences in risk-taking, emotionality, substance use, and depression. Future research is needed to elucidate the role of prenatal androgenization within the biopsychosocial model.

Are sex differences in blood cell count and hemoglobin moderated by the 2D:4D ratio? A cross-sectional study in a Ghanaian population

Background and Aims

There are sex differences in blood cell count and hemoglobin (HGB) in adulthood due to differences in the levels of circulating sex hormones. The second-to-fourth digit ratio (2D:4D) is the putative marker of prenatal hormone exposure. The 2D:4D or the right-left difference (Dr-l) are sexually dimorphic and are correlates of sex hormones in adulthood. The study sought to determine whether sex differences in adult blood cell count and HGB can be partly explained by the 2D:4D or Dr-l.

Methods

The study was cross-sectional between June and December 2021 at the University for Development Studies. The study involved 207 healthy participants (females = 113) aged from 18 to 32 years. The right-hand (2D:4DR), and the left-hand (2D:4DL) digit ratio and their difference (Dr-l) were measured using Computer-assisted analysis. Blood cell count, HGB, testosterone, and estradiol were measured from venous blood samples using an automated HGB analyzer and ELIZA technique.

Results

The platelet count was inversely related to the 2D:4DR in the total sample with the 2D:4DR accounting for about 0.2% (adjR 2 = 0.002) of the variability in platelet count. However, there was a sex difference as indicated by the significant interaction between sex and the 2D:4DR on platelet count (p = 0.03). The relationship between platelet count and the 2D:4DR was negative in females but positive in males. Also, there was a positive relationship between HGB concentration and the Dr-l in the total study sample, where the Dr-l accounted for about 0.6% (adjR 2 = 0.006) of the variability in HGB concentration. Sex interacted significantly with the Dr-l on HGB concentration (p = 0.01) such that the relationship between HGB and the Dr-l was positive in females but negative in males.

Conclusion

Prenatal hormone exposure, as indexed by the 2D:4D ratio, may partly account for the observed sex differences in platelet count and HGB levels in adulthood.

Digit Ratio (2D:4D) Is Not Associated with Alzheimer's Disease in the Elderly

The development of Alzheimer's disease (AD) is influenced by sex hormones-estrogens and androgens in particular. However, the impact of prenatal sex hormone exposure is less clear; very few investigations have examined the relationship between the second-to-fourth digit length ratio (2D:4D), a putative proxy for the ratio of prenatal estrogens to androgens, and AD, with inconsistent results among the few that have. Therefore, we aimed to investigate this relationship using methodologically robust metrics. In a 2 (sex) × 4 (group) MANOVA incorporating 108 participants (30 AD patients, 19 patients with tauopathy but no amyloidopathy, 31 clinical and 28 healthy age- and education-matched controls), the effects of sex and group on the dependent variables right and left 2D:4D were examined. We also explored the association between 2D:4D and the severity of AD symptoms assessed via neuropsychological examination. We did not find any significant differences in the right- and left-hand 2D:4D between patients with AD and the other groups; no significant associations between 2D:4D and neuropsychological task performances were found in the dementia groups. The 2D:4D of healthy women was significantly lower than that of depressed women without AD, i.e., clinical controls, but not significantly different from depressed female patients with AD. This investigation does not support the role of 2D:4D in the development or severity of AD in general, but suggests a potential role of 2D:4D for depression in women. Future studies are warranted to clarify whether 2D:4D can distinguish between early- and late-onset depression in women.

The ratio of 2nd to 4th digit length and reproductive function of infertile male patients

Purpose

To investigate the relationship between the ratio of index to ring finger lengths (2D:4D ratio), reflecting androgen exposure in utero, and reproductive function among men.

Methods

Male patients (N = 180) who consulted for fertility issues participated in the study. The palms of both hands were scanned, and the 2D:4D ratio was calculated. Data on semen volume, sperm concentration and total motility, total and motile sperm counts, and serum hormone concentrations were obtained. Spearman correlation coefficients between the 2D:4D ratio and hormone and semen quality parameters were calculated.

Results

The total sperm count was significantly negatively correlated with the 2D:4D ratio of the left hand (r = -0.154, p  = 0.039) but not with that of the right hand (r = -0.045, p  = 0.548). Testosterone showed weak negative correlations with the 2D:4D ratio in the left (r = -0.142, p  = 0.058) and right (r = - 0.149, p  = 0.046) hands. Follicle-stimulating hormone levels were negatively correlated with the 2D:4D ratios of the left (r = -0.173, p  = 0.020) and right (r = -0.164, p  = 0.027) hands. Other semen quality parameters or luteinizing hormone levels showed no significant correlation with the 2D:4D ratios.

Conclusions

No clear associations were observed between the 2D:4D ratios and reproductive function.

The association of prenatal amniotic sex hormones and digit ratio (2D:4D) in children aged 5 to 70 months: A longitudinal study

The sex difference of the 2D:4D digit ratio (female > male)-a proposed marker for prenatal testosterone exposure-is well established. Studies suggest it already exists in utero and is of moderate effect size in adulthood. However, evidence for the claim that 2D:4D reflects prenatal androgen action is limited, and the sex difference may exhibit lability during childhood. In the present study, 244 mothers were recruited in the course of an amniocentesis examination (performed between gestational weeks 14 and 18). Prenatal testosterone (T) and estradiol (E) levels were determined from amniotic fluid for boys and girls. The majority (97.4%, n = 114) of available female T levels (n = 117) were found below the level of quantification. Therefore, only male amniotic fluid data (n = 117) could be included for the analysis of associations between amniotic sex hormones (T levels and T to E ratio (T/E)) and 2D:4D. The families were then invited to each of the five consecutive follow-ups (ages: 5, 9, 20, 40, and 70 months) where children's 2D:4D was measured for both hands. The alternative marker D[r-l] reflects the directional asymmetry of 2D:4D (right subtracted by left 2D:4D) and was subsequently calculated as an additional measure for prenatal T exposure. No significant correlations between amniotic T or the T/E ratio (measured between week 14 and 18 of gestation) with 2D:4D respectively D[r-l] were observed for any time point. There was a significant sex difference (females > males) and a significant age effect with moderate correlations of 2D:4D between time points. 2D:4D increased between 20 and 40 months and between 40 and 70 months of age. The findings raise questions regarding the applicability of 2D:4D as a marker for prenatal androgen action and are discussed in terms of the reliability of obtained digit ratio data as well as in terms of the developmental timing of amniocentesis.

Relationships of the Ulna-to-fibula Ratio to Baseline and Reactive Steroid Hormone Levels: An Exploratory Study

Objective

Organizational hormone effects on the human brain and behavior are often retrospectively assessed via morphological markers of prenatal (e.g., 2D:4D digit ratio) or pubertal (e.g., facial width-to-height ratio, fWHR) hormone exposure. It has been argued that markers should relate to circulating hormones particularly in challenging, dominance/status-relevant situations. However, meta-analytic research indicates that fWHR, a frequently used pubertal marker, is neither reliably sex-dimorphic nor related to steroid hormones. This casts doubt on fWHR’s validity for reflecting hormone levels. Ulna-to-fibula ratio (UFR), an alternative, long-bone-length-based pubertal marker, is sex-dimorphic and associated with dominance motivation. However, its hormonal associations were never tested before. We therefore explored UFR’s relationships to baseline and reactive hormone levels.

Methods

We measured ulna and fibula length as well as shoulder/waist/hip circumference of 81 participants (49 women; after exclusions) via anthropometry. Salivary hormone levels (estradiol, testosterone) at baseline and after a gross-motor one-on-one balancing contest were measured via radioimmunoassay.

Results

We replicated UFR’s dimorphism, unrelatedness to height, and correlations to other putative markers of organizational hormone effects. On an exploratory basis, we found UFR to be related to overall baseline testosterone and to competition-induced reactive surges in steroid hormones (estradiol, testosterone) overall and in women.

Conclusions

Our results hint at UFR’s relationship to baseline testosterone and may indicate functional connections between outcomes of pubertal organizational hormone effects and contest-induced steroid reactivity. Pubertal organizational hormone effects may prepare the endocrine system for dominance and status contests. However, the small sample and the exploratory nature of our research demands replication.

Digit ratio (2D:4D) and maternal testosterone-to-estradiol ratio measured in early pregnancy

The ratio of index to ring finger (2D:4D) has been hypothesised to indicate prenatal androgen exposure, yet evidence for its validity is lacking. We report the first pre-registered study to investigate mothers' early pregnancy sex hormone concentrations in relation to their children's digit ratios measured at 18-22-month follow-up. Although the testosterone (T) to estradiol (E) ratio correlated negatively with right hand digit ratio (R2D:4D) and directional asymmetry (right-minus-left) in digit ratio (D_[R-L]), neither effect remained statistically significant once demographic and obstetric covariates were controlled for. Nevertheless, the multivariate level of analysis did reveal that T correlated positively with left hand digit ratio (L2D:4D) and negatively with D_[R-L]. However, the first of these effects is in the opposite direction to that predicted by theory. Taken together, the results of our study suggest research with larger samples is required to determine whether digit ratios are valid proxies for maternal sex hormone exposure.

Influence of gonadal steroids on cortical surface area in infancy

Sex differences in the human brain emerge as early as mid-gestation and have been linked to sex hormones, particularly testosterone. Here, we analyzed the influence of markers of early sex hormone exposure (polygenic risk score (PRS) for testosterone, salivary testosterone, number of CAG repeats, digit ratios, and PRS for estradiol) on the growth pattern of cortical surface area in a longitudinal cohort of 722 infants. We found PRS for testosterone and right-hand digit ratio to be significantly associated with surface area, but only in females. PRS for testosterone at the most stringent P value threshold was positively associated with surface area development over time. Higher right-hand digit ratio, which is indicative of low prenatal testosterone levels, was negatively related to surface area in females. The current work suggests that variation in testosterone levels during both the prenatal and postnatal period may contribute to cortical surface area development in female infants.

Anthropometric measures do not explain the 2D:4D ratio sexual dimorphism in 7-year-old children

Objectives

Digit ratio (2D:4D) might reflect prenatal testosterone exposure and has been used as a putative marker for androgen related outcomes. However, such associations might be inflicted by confounders. Application of 2D:4D in epidemiological research motivate identification of biological background determinants.

We examined sex, anthropometric measures, and maternal factors as determinants of 2D:4D in Swedish 7‐year‐old children.

Methods

The study was embedded in the Swedish Environmental, Longitudinal, Mother and Child, Asthma and Allergy (SELMA) pregnancy cohort. A total of 870 pre‐pubertal children, median 7.5 years of age, were studied.

A single assessor performed digit measurements from scanned photocopies using computer software. Child anthropometric measurements investigated were hand size, birthweight, recumbent birth length, standing height, weight, BMI, body fat percentage, and waist/hip circumference. Maternal factors included age, pregnancy length, parity, and education.

Results

We found a significant sexual dimorphism regarding digit lengths and 2D:4D, boys on average presenting a lower 2D:4D than girls also after adjustment for summed finger lengths and body fatness. In crude analyses, maternal age correlated with 2D:4D across the whole population and in females but not in adjusted models. No other study variables were associated with 2D:4D.

Conclusion

Digit ratio showed sexual dimorphism at the age of seven and seems to represent a true sex difference rather than an artifact and bias from hand size, body size or body fat content. Among the rest of our investigated variables, we found no determinants constituting important confounders in future research on 2D:4D ratio.

Evidence for Perinatal Steroid Influence on Human Sexual Orientation and Gendered Behavior

In laboratory animals, exposure to gonadal steroid hormones before and immediately after birth can exert permanent effects on many behaviors, particularly reproductive behaviors. The extent to which such effects occur in humans remains an open question, but several lines of evidence indicate that perinatal levels of both androgens and estrogens may affect adult human psychology and behavior, including sexual orientation and gender nonconformity. Some putative indicators of prenatal androgen exposure, including the ratio of the length of the index finger to that of the ring finger (2D:4D), have repeatedly indicated that lesbians, on average, were exposed to more prenatal androgens than straight women, suggesting that sufficient fetal androgen exposure predisposes a fetus to gynephilia (attraction to women) at maturity. The digit ratios of gay men do not differ from those of straight men, suggesting that prenatal androgen levels are not responsible for their androphilia (attraction to men). However, evidence that gay men who prefer an insertive anal sex role (ASR) have more masculine digit ratios than those preferring a receptive ASR suggests that early androgens influence some sexual preferences in men. Furthermore, digit ratios among gay men have been found to correlate with recalled childhood gender nonconformity (CGN). People with isolated gonadotropin-releasing hormone (GnRH) deficiency (IGD) offer further insight into the effects of perinatal gonadal steroid exposure. In people with IGD, gonadal hormone production is low or absent after the first trimester of gestation. However, because placental gonadotropins drive gonadal hormone secretion during the first trimester when genitalia sexually differentiate, individuals with IGD are unambiguously male or female at birth, consistent with their chromosomal and gonadal sex. Men with IGD report greater CGN, again suggesting that perinatal androgen exposure contributes to male-typical behavioral patterns in humans. Interestingly, women with IGD report less androphilia and more bisexuality than control women, suggesting that perinatal ovarian steroids in females typically augment androphilia in adulthood. Taken together, these findings indicate that the perinatal hormonal milieu influences human sexual orientation and gender conformity.

The relationship between offspring's 2D:4D ratio and postpartum maternal circulating testosterone, estradiol, and their indices in a Ghanaian population

OBJECTIVES

The 2D:4D ratio is influenced by prenatal testosterone (PT) and estrogen (PE) exposure in utero. This study sought to determine whether evidence of Manning's hypothesis can still be observed even in the postpartum period. We hypothesize that the offspring 2D:4D ratios will be inversely correlated with maternal postpartum circulating testosterone but positively correlated with estradiol.

METHODS

This study was conducted between December 2020 and April 2021 and was cross-sectional in nature. There were 272 mother-offspring pairs; the mothers were aged between 18 and 36 years while the median (IQR) age of their offspring was 111 (44-210) days. Offspring right (2D:4DR) and left (2D:4DL) digit ratios were measured using computer-assisted analysis. Sampling was done at 111 (44-210) days postpartum and blood was analyzed for total testosterone (TT), estradiol (E2) and sex hormone-binding globulins using the enzyme-linked immunosorbent assay technique.

RESULTS

The 2D:4DR of sons was significantly lower compared to daughters (p = .031). Mothers with sons had significantly increased levels of serum TT (p = .001) while mothers with daughters had significantly increased levels of E2 (p = .000). As hypothesized, the maternal serum free testosterone (FT%) was inversely correlated with their daughters' (r = -0.320, p = .003), and also with their sons' (r = -0.213, p = .047), 2D:4DL. Unexpectedly, daughters' 2D:4DL was inversely correlated with maternal circulating free E2 (r = -0.255, p = .015).

CONCLUSIONS

In humans, evidence of the relationship between maternal testosterone levels and their offspring's 2D:4D ratio may persist even into the postpartum period.

Central hypogonadism in Klinefelter syndrome: report of two cases and review of the literature

PURPOSE

Klinefelter syndrome (KS) is characterized by late adolescence/young adulthood onset of primary hypogonadism. Hypogonadotropic hypogonadism (HH), when congenital, is usually associated with absent/incomplete puberty and low/normal gonadotropins. We report the clinical and genetic features of two subjects with KS and an unexpected HH hormone profile.

METHODS

Magnetic resonance imaging (MRI) of hypothalamus-pituitary region and next generation sequencing (NGS) of congenital HH-associated genes were obtained. A narrative review of the literature was conducted.

RESULTS

Patients were diagnosed with Klinefelter syndrome following karyotype analysis. Nevertheless, they showed unusual features: both had incomplete puberty, low gonadotropins and testosterone levels, and the first one was anosmic. Sellar lesions were excluded by MRI, and NGS was negative in both subjects. Our data add to those of the only 14 similar cases reported so far. Unexplained HH rarely occurs in KS and is variably associated with anosmia, other pituitary hormones deficiencies and heterogeneous karyotypes. However, most cases show an early, pre-pubertal onset of hypogonadism. If the causes behind this gonadotropins defect are largely unknown, hereby we provide the first review of the literature on this topic and propose some pathogenetic hypotheses, including the coexistence of KS and congenital HH as suggested by overlapping clinical features in some of these patients.

CONCLUSION

HH is an exceptional occurrence in Klinefelter syndrome and is associated with heterogeneous phenotypes and, probably, aetiologies. Moreover, KS could underlie HH nonresponsive to gonadotropins. An exhaustive diagnostic workup and a tailored clinical management are advisable in these rare forms.

Parental income inequality and children's digit ratio (2D:4D): a 'Trivers-Willard' effect on prenatal androgenization?

Income inequality is associated positively with disease prevalence and mortality. Digit ratio (2D:4D) - a negative proxy for prenatal testosterone and a positive correlate of prenatal oestrogen - is related to several diseases. This study examined the association of income inequality (operationalized as relative parental income) and children's 2D:4D. Participants self-measured finger lengths (2D=index finger, and 4D=ring finger) in a large online survey conducted in July 2005 (the BBC Internet Study) and reported their parents' income. Children of parents of above-average income had low 2D:4D (high prenatal testosterone, low prenatal oestrogen) while the children of parents of below-average income had high 2D:4D (low prenatal testosterone, high prenatal oestrogen). The effects were significant in the total sample, present among Whites (the largest group in the sample), in the two largest national samples (UK and USA) and were greater for males than females. The findings suggest a Trivers-Willard effect, such that high-income women may prenatally masculinize their sons at the expense of the fitness of their daughters. Women with low income may prenatally feminize their daughters at the fitness expense of their sons. The effect could, in part, explain associations between low income, high 2D:4D (low prenatal testosterone) and some major causes of mortality such as cardiovascular disease.

Digit ratio, a proposed marker of the prenatal hormone environment, is not associated with prenatal sex steroids, anogenital distance, or gender-typed play behavior in preschool age children

Prenatal hormones have been proposed as key factors impacting child development as well as long-term health and disease. Digit ratio (the ratio of the lengths of the second to fourth digits; 2D:4D) has been proposed as a sexually dimorphic, noninvasive marker of prenatal androgen exposure that can be reliably measured in children and adults. To date, few longitudinal pregnancy cohort studies have examined childhood digit ratio in relation to other relevant measures including prenatal hormones and androgen-sensitive outcomes. To augment the current literature on this topic, we measured right-hand digit ratio in 4-year-old children participating in The Infant Development and the Environment Study, a multicenter longitudinal cohort study that has been following mother-child dyads since the first trimester of pregnancy (n = 321). We assessed sex differences in digit ratio and fit multivariable linear regression models to examine digit ratio in relation to: (1) child sex; (2) maternal sex steroid hormone concentrations in early pregnancy; (3) newborn anogenital distance, another proposed measure of sensitivity to prenatal androgens; and (4) gender-typical play behavior as measured by the Preschool Activities Inventory (PSAI) at age 4. We observed no sex difference in digit ratio; the mean 2D:4D was 0.97 ± 0.05 mm in both sexes. Furthermore, digit ratio was not associated with maternal sex steroid concentrations in early pregnancy, anogenital distance in either sex, or PSAI scores in either sex in covariate-adjusted models. In conclusion, we observed no evidence that early childhood digit ratio was associated with child sex or hormone-sensitive measures in this cohort.

Digit ratio (2D:4D) and congenital adrenal hyperplasia (CAH): Systematic literature review and meta-analysis

The ratio of length between the second and fourth fingers (2D:4D) is commonly used as an indicator of prenatal sex hormone exposure. Several approaches have been used to try to validate the measure, including examining 2D:4D in people with congenital adrenal hyperplasia (CAH), a suite of conditions characterised by elevated adrenal androgen production secondary to defective steroidogenesis. We present a systematic review and meta-analysis that examines the relationship between these two variables. Twelve articles relating to nine CAH cohorts were identified, and 2D:4D comparisons have been made between cases and controls in eight of these cohorts. Altogether, at least one 2D:4D variable has been compared between n = 251 females with CAH and n = 358 unaffected females, and between n = 108 males with CAH and n = 204 unaffected males. A previous meta-analysis (Hönekopp and Watson, 2010) reported lower right hand (R2D:4D) and left hand (L2D:4D) digit ratios in patients with CAH relative to sex-matched controls. Our meta-analysis showed the same pattern, with medium effect sizes for R2D:4D and small effect sizes for L2D:4D. Differences of small magnitude were also observed for M2D:4D, and no significant effects were observed for D_[R-L]. Notably, the only effects that remained statistically significant when stratified by sex were R2D:4D in males and L2D:4D in females, and the average effect size had reduced by 46.70% since the meta-analysis of Hönekopp and Watson (2010). We also found that individual comparisons in this literature were considerably underpowered, and that patterns of sexual dimorphism in 2D:4D were similar in CAH samples as in typically developing populations. Findings are discussed in relation to the prenatal androgen hypothesis as well as alternative explanations.

Effects of prenatal exposure to polybrominated diphenyl ethers (PBDEs) on the second to fourth digit ratio in children aged 4 years

BACKGROUND

The second to fourth digit ratio (2D:4D) is assumed to be a biomarker of prenatal sex steroid exposure, correlating negatively with prenatal testosterone and positively with prenatal estrogen. The ratio has been suggested to be influenced by endocrine disrupting chemicals (EDCs). However, evidence regarding effects of prenatal exposure to polybrominated diphenyl ethers (PBDEs) on 2D:4D of children was sparse.

OBJECTIVES

We investigated the associations between prenatal exposure to PBDEs and 2D:4D of children aged 4 years.

METHODS

Participants were mother-child pairs from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which enrolled pregnant women at 12-16 weeks of gestation from April to December 2012. Nine PBDE congeners in venous umbilical cord plasma of 340 children were measured. Digit lengths were measured using a vernier caliper in children aged 4 years and 2D:4D for left and right hands and average 2D:4D value of both hands were calculated. A total of 281 children (160 boys and 121 girls) who had data on both 2D:4D and PBDE concentrations were included in the final analysis. Associations between prenatal PBDE exposures and 2D:4D were investigated using multiple linear regression models.

RESULTS

Among the nine congeners, BDE-47 had the highest detection rate of 86.12% with the highest median concentration of 0.20 ng/ml lipid. Five PBDE congeners with detection rates greater than or close to 50% (BDE-28, -47, -99, -100 and -153) and Σ₅PBDEs (the sum of them) were included in final analysis. For girls, a consistent pattern for the positive associations between prenatal PBDE exposures and 2D:4D of children was observed mainly for the left hand, where those in the highest exposure groups had higher 2D:4D compared to the lowest exposure groups (a feminizing effect), with statistically significant associations observed for BDE-47 (β = 0.0247, 95% confidence interval (CI): 0.0017, 0.0477), -100 (β = 0.0264, 95% CI: 0.0087, 0.0441) and Σ₅PBDEs (β = 0.0201, 95% CI: 0.0027, 0.0374). For boys, compared with the lowest exposure groups, statistically significantly higher (feminized) 2D:4D for both hands was observed in those with the highest exposure levels of BDE-100 (β = 0.0147, 95% CI: 0.0005, 0.0289 for the left hand; β = 0.0182, 95% CI: 0.0046, 0.0318 for the right hand) and those with the middle and the highest exposure levels of BDE-153 (middle vs. undetected, β = 0.0215, 95% CI: 0.0072, 0.0358 for the left hand; β = 0.0155, 95% CI: 0.0015, 0.0295 for the right hand; highest vs. undetected, β = 0.0162, 95% CI: 0.0017, 0.0307 for the left hand; β = 0.0152, 95% CI: 0.0011, 0.0294 for the right hand).

CONCLUSIONS

Our study provides preliminary evidence that prenatal exposure to PBDEs might be associated with higher 2D:4D in boys and girls.

Understanding COVID-19: Digit ratio (2D:4D) and sex differences in national case fatality rates

BACKGROUND

The reported national case fatality rates (CFRs) for coronavirus disease 2019 (COVID-19) shows a sex bias with males > females. The relative lengths of the index (2D) and ring (4D) fingers (digit ratio; 2D:4D) is a sexually dimorphic (males < females) proxy of fetal sex steroids (low 2D:4D indicates high prenatal testosterone/low prenatal estrogen).

AIM

To examine sex-specific relationships of 2D:4D per nation with national values of COVID-19 CFRs.

STUDY DESIGN

COVID-19 CFRs and the percent of male deaths were related to mean national (self-reported) 2D:4D by sex and hand from a large online survey (the BBC Internet Study).

SUBJECTS

103,482 men and 83,366 women.

OUTCOME MEASURES

Relationships of mean national 2D:4D with CFRs from 41 countries and with national male death rates from 16 countries.

RESULTS

Male right and left hand 2D:4D showed positive relationships with CFR. These relationships remained significant after removing the influence of female 2D:4D. A positive association of male right and left 2D:4D was detected with the percentage of male deaths.

CONCLUSIONS

At the national level, high mean 2D:4D (indicating low prenatal testosterone/high prenatal estrogen) is associated with high CFRs and percent male mortality. At the individual level, high 2D:4D may be a risk factor for severity of COVID-19 in males. We speculate that male 2D:4D is a negative correlate for expression of the SARS-CoV2 receptor (ACE2).

Through a glass, darkly: Human digit ratios reflect prenatal androgens, imperfectly

On average, the length of the index finger (digit 2) divided by the length of the ring finger (digit 4) on the right hand, is greater in women than in men. Converging evidence makes it clear that prenatal androgens affect the development of digit ratios in humans and so are likely responsible for this sex difference. Thus, differences in 2D:4D between groups within a sex may be due to average differences between those groups in prenatal androgen exposure. There have been many reports that lesbians, on average, have a smaller (more masculine) digit ratio than straight women, which has been confirmed by metaanalysis. These findings indicate that lesbians were, on average, exposed to greater prenatal androgen than straight women, which further indicates that greater levels of prenatal androgen predispose humans to be attracted to women in adulthood. Nevertheless, these results only apply to group differences between straight women and lesbians; digit ratios cannot be used to classify individual women as gay or straight.

Exploratory Evidence of Sex-Dimorphic Associations of the Ulna-to-Fibula Ratio, a Potential Marker of Pubertal Sex Steroid Exposure, with the Implicit Need for Power

Objectives

We propose a novel marker of pubertal organizing hormone effects on the brain, long bone length, and assess its relationships to implicit motives, especially the implicit need for power (nPower).

Methods

In a partly exploratory approach, we tested 126 participants (after exclusions; 53 men, 73 women), in a cross-sectional design using the Picture-Story Exercise (nPower, activity inhibition), standard anthropometric measurements (BMI, height), and calipers to assess bone length of the ulna and fibula.

Results

Results indicated that a sex-dimorphic (d = 0.55) Ulna-to-Fibula Ratio (UFR), which is independent of body height, best captures the variance in our data. While we did not find bivariate relationships between long bone length and nPower, a sex-dimorphic interaction of nPower and activity inhibition on UFR-asymmetry (UFRr-l; right versus left UFR) emerged. High UFRr-l scores were related to the inhibited power motive (high nPower, high activity inhibition) in men, while for women the pattern was (non-significantly) reversed. In addition, UFR was predicted by a sex-dimorphic effect of nPower, with low UFR scores being associated with a higher nPower in men and a tendency for high UFR scores being related to lower nPower in women.

Conclusions

We discuss our results regarding UFR’s potential as a sex-dimorphic marker of the organizing effects of pubertal steroid hormones on the motivational brain beyond hand and face parameters routinely used in current research. Finally, we examine how our findings fit recent results obtained for the relationship between 2D:4D digit ratio or facial width-to-height ratio and nPower.

2D:4D Suggests a Role of Prenatal Testosterone in Gender Dysphoria

Gender dysphoria (GD) reflects distress caused by incongruence between one's experienced gender identity and one's natal (assigned) gender. Previous studies suggest that high levels of prenatal testosterone (T) in natal females and low levels in natal males might contribute to GD. Here, we investigated if the 2D:4D digit ratio, a biomarker of prenatal T effects, is related to GD. We first report results from a large Iranian sample, comparing 2D:4D in 104 transwomen and 89 transmen against controls of the same natal sex. We found significantly lower (less masculine) 2D:4D in transwomen compared to control men. We then conducted random-effects meta-analyses of relevant studies including our own (k = 6, N = 925 for transwomen and k = 6, N = 757 for transmen). In line with the hypothesized prenatal T effects, transwomen showed significantly feminized 2D:4D (d ≈ 0.24). Conversely, transmen showed masculinized 2D:4D (d ≈ - 0.28); however, large unaccounted heterogeneity across studies emerged, which makes this effect less meaningful. These findings support the idea that high levels of prenatal T in natal females and low levels in natal males play a part in the etiology of GD. As we discuss, this adds to the evidence demonstrating the convergent validity of 2D:4D as a marker of prenatal T effects.

The association between 2D:4D ratio and aggression in children and adolescents: Cross-cultural and gender differences

BACKGROUND

Two recent meta-analyses have suggested the association between digit ratio (2D:4D) and aggression is weak. This conclusion has been criticised because the meta-analyses conflate forms of aggression that show strong sex differences with those that do not, and most studies have considered post-pubertal participants.

AIMS

We test the influence of 2D:4D and ethnicity in the expression of aggression in children and adolescents in four ethnic groups of European and African origin.

STUDY DESIGN

Buss and Perry aggression questionnaire. Direct measurement of the 2nd and 4th digits.

SUBJECTS

1296 children and adolescents from Tanzania and Russia from 4 ethnic groups - Datoga, Meru, Russians, Tatars.

RESULTS

There were ethnic and gender differences in ratings on aggression with boys consistently reporting more physical aggression. In all four samples right 2D:4D was significantly lower in boys, compared to girls. With regard to our total sample of boys, the right 2D:4D was significantly and negatively associated with self-ratings on physical aggression, but no association was found for left 2D:4D. No associations between 2D:4D and physical aggression were found for girls. Hostility was negatively correlated with 2D:4D for boys, and anger was positively correlated with 2D:4D in girls.

CONCLUSION

Sex differences were strongest for right 2D:4D (boys<girls), and for physical aggression (boys>girls). Right 2D:4D was negatively related to physical aggression in boys only, suggesting possible relationship to prenatal androgenization.

The 2nd to 4th digit length ratio (2D:4D) among children of Seveso women exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin

BACKGROUND

Exposure to endocrine-disrupting chemicals (EDCs) during sensitive developmental windows, such as in utero, may influence disease later in life but direct measurement of fetal hormones is not feasible. The ratio of the length of the second finger digit to the fourth digit (2D:4D), a sexually dimorphic trait, is a biomarker of androgen levels and the androgen/estrogen balance in utero. However, it is unclear whether in utero EDC exposure might alter 2D:4D ratio.

AIMS

We examined 2D:4D ratio in Seveso children in relation to in utero exposure to a potent EDC, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) using linear regression.

STUDY DESIGN

The Seveso Women's Health Study (SWHS) is a historical cohort study, following the health of women exposed to TCDD during a 1976 explosion in Seveso, Italy. Individual-level TCDD was measured for SWHS in serum collected soon after the accident. In 2014, the SWHS children born after the explosion were enrolled in the Seveso Second Generation Study.

SUBJECTS

594 SWHS children born post-explosion to 397 mothers.

OUTCOME MEASURES

Right hand 2D:4D ratio.

RESULTS

On average, 2D:4D ratio for males was significantly lower than for females (p < 0.05). Overall, in utero TCDD exposure, either as maternal initial serum TCDD concentration or as TCDD extrapolated to pregnancy was not significantly associated with 2D:4D ratio in Seveso children. Results from all adjusted sensitivity analyses remained non-significant.

CONCLUSIONS

Our results suggest in utero exposure to TCDD is not associated with alteration in 2D:4D ratio.

Normalized second and fourth finger lengths in male and female partners and IVF cycle outcomes

RESEARCH QUESTION

Hox genes are involved in limb formation during normal embryological development. Their modulation by circulating maternal oestrogens and androgens determines the length of the second and fourth fingers of the adult hand. Do these same intrauterine hormone levels also determine fertility outcomes in the adult?

DESIGN

To study the association between the length of the second and fourth fingers of both partners undergoing IVF (as a surrogate of their previous intrauterine exposure to oestrogens and androgens) with treatment outcome after IVF, data corresponding to 256 IVF cycles were analysed. Finger length was normalized to the individual height.

RESULTS

In the female partner, a longer normalized second finger length of the left (2DLN) hand, reflecting a high intrauterine exposure to oestrogens, was independently and significantly (P = 0.011) associated with obtaining at least one top-quality embryo in a multivariate model. Conversely, in the male partner a longer normalized fourth finger length of the left hand (4DLN), reflecting a high intrauterine exposure to androgens, was independently and significantly (P = 0.032) associated with obtaining at least one top-quality embryo in the same multivariate model. In the female partner, 2DLN was inversely and significantly (P = 0.01) associated with achievement of pregnancy.

CONCLUSIONS

Intrauterine exposure to high levels of oestrogens and androgens in females and males, respectively, predisposes to the production of higher-quality embryos under in-vitro conditions during adulthood. Paradoxically, this also seems to result in a lower pregnancy rate.

Sex differences in psychiatric disorders: what we can learn from sex chromosome aneuploidies

The study of sexual dimorphism in psychiatric and neurodevelopmental disorders is challenging due to the complex interplay of diverse biological, psychological, and social factors. Males are more susceptible to neurodevelopmental disorders including intellectual disability, autism spectrum disorder, and attention-deficit activity disorder. Conversely, after puberty, females are more prone to major depressive disorder and anxiety disorders compared to males. One major biological factor contributing to sex differences is the sex chromosomes. First, the X and Y chromosomes have unique and specific genetic effects as well as downstream gonadal effects. Second, males have one X chromosome and one Y chromosome, while females have two X chromosomes. Thus, sex chromosome constitution also differs between the sexes. Due to this complexity, determining genetic and downstream biological influences on sexual dimorphism in humans is challenging. Sex chromosome aneuploidies, such as Turner syndrome (X0) and Klinefelter syndrome (XXY), are common genetic conditions in humans. The study of individuals with sex chromosome aneuploidies provides a promising framework for studying sexual dimorphism in neurodevelopmental and psychiatric disorders. Here we will review and contrast four syndromes caused by variation in the number of sex chromosomes: Turner syndrome, Klinefelter syndrome, XYY syndrome, and XXX syndrome. Overall we describe an increased rate of attention-deficit hyperactivity disorder and autism spectrum disorder, along with the increased rates of major depressive disorder and anxiety disorders in one or more of these conditions. In addition to contributing unique insights about sexual dimorphism in neuropsychiatric disorders, awareness of the increased risk of neurodevelopmental and psychiatric disorders in sex chromosome aneuploidies can inform appropriate management of these common genetic disorders.

Testosterone measured from amniotic fluid and maternal plasma shows no significant association with directional asymmetry in newborn digit ratio (2D:4D)

Foetal sex hormones can have powerful and far-reaching effects on later phenotype. However, obtaining accurate measurements is difficult for ethical reasons, and researchers often employ proxy variables to examine their effects. The relative length of the second and fourth fingers (digit ratio or 2D:4D) is frequently used for this purpose, as it is hypothesized to index variance in prenatal androgen and oestrogen exposure. Most studies employing this method examine digit ratio for the right hand (R2D:4D) and/or left hand (L2D:4D), though the mean value (M2D:4D) (i.e., the average of R2D:4D and L2D:4D) and directional asymmetry (D[R-L]) (i.e., R2D:4D minus L2D:4D) are also commonly used. As no published studies have examined M2D:4D or D[R-L] in relation to testosterone measured from amniotic fluid, we conducted a secondary analysis of data published by Ventura et al. The sample comprises 106 mothers from Portugal who underwent amniocentesis during the second trimester and their neonates. Newborn M2D:4D was negatively correlated with amniotic testosterone in females (P&lt;0.05) but not in males; no significant association was observed between amniotic testosterone and D[R-L] in either sex. In addition, we examined testosterone measured from maternal circulation during the second trimester, and found that it was not a significant predictor of M2D:4D or D[R-L] in male or female infants. Further research should aim to measure the ratio of testosterone to oestradiol present in amniotic fluid and maternal plasma, to examine whether either is a predictor of digit ratio variables at different stages of postnatal development.

Klinefelter syndrome: more than hypogonadism

Klinefelter syndrome (KS) is the most frequent chromosome disorder in males (1:650 newborn males), defined by 47,XXY karyotype. The classical phenotype is that of a tall male with relatively long legs, small, firm testes and gynecomastia. Azoospermia and infertility are almost inevitably present, but may be overcome by TESE and ICSI. Nevertheless, a broad spectrum of phenotypes has been described and more than 70% of the actually existing KS men may remain undiagnosed throughout their lifespan. Accordingly, hypogonadism is usually not evident until early adulthood and progresses with ageing. KS patients present a series of comorbidities that increase morbidity and mortality by 40%. Such disturbances are the impaired metabolic profile (obesity, dyslipidemia, insulin resistance) and a tendency to thrombosis, which all favor cardiovascular disease. They also present susceptibility for specific neoplasias (breast cancer, extragonadal germ cell tumors), autoimmune diseases as well as osteoporosis and bone fractures. Moreover, KS has been associated with verbal processing and attention deficits as well as social skill impairments, leading KS individuals to academic and professional achievements inferior to those of their peers of comparable socio-economic status. Nevertheless, the majority fall within the average range regarding their intellectual abilities and adaptive functioning. Testosterone replacement therapy (TRT) is the mainstay of treatment in hypogonadal KS patients; however, randomized trials are needed to determine optimal therapeutic regimens and follow-up schedules.

Klinefelter Syndrome: Integrating Genetics, Neuropsychology, and Endocrinology

Although first identified over 70 years ago, Klinefelter syndrome (KS) continues to pose substantial diagnostic challenges, as many patients are still misdiagnosed, or remain undiagnosed. In fact, as few as 25% of patients with KS are accurately diagnosed and most of these diagnoses are not made until adulthood. Classic characteristics of KS include small testes, infertility, hypergonadothropic hypogonadism, and cognitive impairment. However, the pathophysiology behind KS is not well understood, although genetic effects are also thought to play a role. For example, recent developments in genetics and genomics point to a fundamental change in our understanding of KS, with global epigenetic and RNA expression changes playing a central role for the phenotype. KS is also associated with more general health markers, including higher morbidity and mortality rates and lower socioeconomic status (which likely affect both morbidity and mortality). In addition, hypogonadism is associated with greater risk of metabolic syndrome, type 2 diabetes, cardiovascular disease, breast cancer, and extragonadal germ cell tumors. Medical treatment typically focuses on testosterone replacement therapy (TRT), although the effects of this therapy have not been studied rigorously, and future studies need to evaluate the effects of TRT on metabolic risk and neurocognitive outcomes. This review presents a comprehensive interdisciplinary examination of recent developments in genetic, endocrine, and neurocognitive science, including the study of animal models. It provides a number of recommendations for improving the effectiveness of research and clinical practice, including neonatal KS screening programs, and a multidisciplinary approach to KS treatment from childhood until senescence.

Digit ratio (2D:4D) and coronary artery disease in north Chinese women

BACKGROUND

Digit ratio (2D:4D) is fixed in utero and affected by fetal sex steroids. It has been proposed as a putative biomarker of certain hormone- related adult life traits and diseases. Several evidence suggest that 2D:4D ratio may correlate with cardiovascular disease risk (e.g., coronary artery disease).

AIMS

To investigate whether there is a possible relationship between digit ratio (especially 2D:4D ratio) and coronary artery disease (CAD), and age at CAD in north Chinese women.

METHODS

Photographs of the two hands of 303 females (controls: 194; patients: 109) were collected. Left hand, right hand and right minus left hand (Dr-l) digit ratio were analyzed and compared.

RESULTS

The mean values of digit ratio in patients with CAD were lower than controls for each hand. Significant differences of 2D:4D (left and right hand: P<0.01), 2D:5D (left hand: P<0.01; right hand: P<0.05) and 3D:4D (left hand: P<0.01) were found between two groups. There were no associations between 2D:4D ratio and age at CAD on both hands.

CONCLUSION

Decreased digit ratio (especially 2D:4D ratio) may suggest a higher prenatal testosterone (lower prenatal oestrogen) exposure in north Chinese women with coronary artery disease.

Age of pubertal onset and 2nd to 4th digit ratios: Preliminary findings

BACKGROUND

The second to fourth digit ratio (2D:4D) is used as a marker of prenatal sex hormone exposure. The aim of this study was to evaluate the possible relation between digit ratio and age of pubertal onset.

METHODS

Participants were 321 men and 202 women aged between 18 and 28 at the time of assessment who self-reported their onset of puberty (i.e., age at first conscious ejaculation or menarche). Participants' right and left digit lengths were measured from hand scans.

RESULTS

All groups of males, i.e., early, average, and late pubertal onset, had lower mean 2D:4D than the comparable female groups, regardless of the relative timing of their pubertal onset. Among the males, there was a significant difference in digit ratios between individuals who experienced early, average, and late onset of puberty. In the males, we observed a positive relationship between 2D:4D and age of pubertal onset for both right and left hands. There were no significant differences in 2D:4D among the three groups of female maturers. We observed no significant association between digit ratios and age at menarche.

CONCLUSIONS

These data lend further support for using 2D:4D as a measure of prenatal androgen exposure.

Prenatal exposure to testosterone (2D:4D) and social hierarchy together predict voice behavior in bankers

Prohibitive voice behaviors are employees' expressions of concern about practices, incidents, or behaviors that may potentially harm the organization. In this study, we examined a potential biological correlate of prohibitive voice: prenatal exposure to testosterone. In a sample of bankers, we used 2D:4D (i.e., the ratio of the length of the index finger to the length of the ring finger) as a marker for prenatal exposure to testosterone (lower 2D:4D suggests higher prenatal exposure to testosterone). We used a self-report scale to measure prohibitive voice. For low-ranked employees, lower 2D:4D was related to using less voice. No such relation was found for high-ranked employees. Conclusions should be drawn with caution, because the findings only applied to voice regarding the organization as a whole (and not to voice regarding the own team), and because of methodological limitations. However, the findings are consistent with the ideas that (a) people low in 2D:4D tend to strive to attain and maintain social status and that (b) remaining silent about perceived problems in the organization is-at least for low-ranked employees-a means to achieve this goal.

Do sex differences in CEOAEs and 2D:4D ratios reflect androgen exposure? A study in women with complete androgen insensitivity syndrome

Background

Studies investigating the influence of perinatal hormone exposure on sexually differentiated traits would greatly benefit from biomarkers of these early hormone actions. Click-evoked otoacoustic emissions show sex differences that are thought to reflect differences in early androgen exposure. Women with complete androgen insensitivity syndrome (CAIS), who lack androgen action in the presence of XY-chromosomes, enabled us to study the effect of complete androgen inaction. The main goal was to investigate a possible link between click-evoked otoacoustic emissions and effective androgen exposure and, thus, whether this can be used as a biomarker. In addition, we aimed to replicate the only previous 2nd vs 4th digit-ratio study in women with CAIS, because despite the widely expressed criticisms of the validity of this measure as a biomarker for prenatal androgen exposure, it still is used for this purpose.

Methods

Click-evoked otoacoustic emissions and digit ratios from women with CAIS were compared to those from control men and women.

Results

The typical sex differences in click-evoked otoacoustic emissions and digit ratios were replicated in the control groups. Women with CAIS showed a tendency towards feminine, i.e., larger, click-evoked otoacoustic emission amplitudes in the right ear, and a significant female-typical, i.e., larger, digit ratio in the right hand. Although these results are consistent with androgen-dependent development of male-typical click-evoked otoacoustic emission amplitude and 2nd to 4th digit ratios, the within-group variability of these two measures was not reduced in women with CAIS compared with control women.

Conclusions

In line with previous studies, our findings in CAIS women suggest that additional, non-androgenic, factors mediate male-typical sexual differentiation of digit ratios and click-evoked otoacoustic emissions. Consequently, use of these measures in adults as retrospective markers of early androgen exposure is not recommended.

Sexual Dimorphism in Digit Ratios Derived from Dorsal Digit Length among Adults and Children

Sexual dimorphism in ventrally measured digit ratios (2D:4D and other) has been related to prenatal sex-hormone levels. In the present series of three studies, we measured all digit lengths (excluding the thumb) on the dorsal, rather than the ventral, side of left and right hands and investigated the sexual dimorphism in digit ratios in three independent samples, two of them comprising adults (Study I, N = 104; Study II, N = 154), and one further, comprising kindergarten children (Study III, N = 64). Results show that men have lower digit-ratio values compared to women in digit ratios that include digit 5 as one of the constituents of the ratio (i.e., the 4D:5D, 3D:5D, and 2D:5D ratios). Boys have lower values compared to girls for the 4D:5D and 3D:5D ratios, and there is a similar trend of sexual dimorphism in the 2D:5D ratio. Thus, based on the evidence from dorsally measured digit ratios, the present findings from three samples are consistent with the idea that early sex-hormonal effects might be stronger for digit ratios involving digit 5, as compared to the classic, and frequently studied, ventrally measured 2D:4D ratio.

Pubertal Stress and Nutrition and their Association with Sexual Orientation and Height in the Add Health Data

A number of studies have indicated that gay men tend to be shorter, on average, than heterosexual men. Less evidence exists that lesbian women are taller, on average, than heterosexual women. The most popular explanation of the association between sexual orientation and height involves prenatal factors, such that, for example, gay men may have been exposed to lower than typical androgens during fetal development, which impacts their height and sexual orientation as adults. An alternative explanation involves stress, given that stress has been associated with sexual minority identification and with lower height. Another alternative explanation involves nutrition, although its relationship is less clear with sexual minority identification. Using the Add Health data, which is a large, nationally representative and longitudinal sample of American adolescents (n = 14,786), we tested a mediation model, such that sexual orientation → pubertal stress/nutrition → height. Within men, we found that gay men (n = 126) were shorter, on average, than heterosexual men (n = 6412). None of the 24 pubertal stress-related and 15 pubertal nutrition-related variables assessed in the Add Health data mediated the relationship between sexual orientation and height in men. Within women, lesbians (n = 75) did not differ significantly in stature compared to heterosexual women (n = 6267). Thus, prenatal mechanisms (e.g., hormones, maternal immune response) are likely better candidates for explaining the height difference between gay men and heterosexual men.

Why is digit ratio correlated to sports performance?

Second to fourth digit ratio is the ratio of second to fourth digit length. It has been known that digit ratio is sexually dimorphic in humans, such that males tend to have lower digit ratio (longer fourth digits relative to second digits) than females. Digit ratio is thought to be a biomarker of the balance between fetal testosterone (FT) and fetal estrogen (FE) in a relatively narrow developmental window at the end of the first trimester of pregnancy. On the contrary, the relationships between digit ratio and levels of sex steroids in adults are not clear. Most correlational studies between digit ratio and adult sex steroids have revealed that this association is statistically not significant. However, for many years, a lot of researches showed negative relationships between digit ratio and sports performance such as rugby, surfing, rowing, sprinting, endurance, and hand grip strength. Here, we discuss possible mechanisms about the relationships between digit ratio and sports performance.

2D:4D Ratio and its Implications in Medicine

Digit ratios, especially 2D:4D ratio, a potential proxy marker for prenatal androgen exposure shows sexual dimorphism. Existing literature and recent research show accumulating evidence on 2D:4D ratio showing correlations with various phenotypic traits in humans. Ratio of 2D:4D is found to correlate negatively to testosterone and positively to oestrogen in the foetus. Interestingly, it is constant since birth and not influenced by the adult hormone levels. Usually, males have lower ratios when compared to females. Prenatal androgen exposure and therefore, digit ratios have been reported to be associated with numerical competencies, spatial skills, handedness, cognitive abilities, academic performance, sperm counts, personalities and prevalence of obesity, migraine, eating disorders, depression, myopia, autism etc. The authors have attempted to write a brief account on the digit ratios and the dimorphism observed in various physiological, psychological and behavioural traits. Also, the authors have discussed the relevant molecular basics and the methods of measurement of digit ratios.

Exploratory Analysis of the Links among Food Consumption Profiles, Prenatal Androgens, and Selected Measures of Quality of Life

Prenatal sex steroids play a vital role in the development of the whole organism, and therefore also the brain. Exposure of the fetus to testosterone seems to be of special importance both for typical development and pathology. The key factor impacting offspring development (including prenatal androgen levels) appears to be diet, both in terms of shortage and excessive intake of certain food products. Prenatal steroid levels are measured using the ratio of the lengths of the second and fourth fingers (2D:4D). So far, the digit ratio (2D:4D) has been shown to correlate negatively with prenatal testosterone and positively with prenatal estrogen. Numerous correlational studies found relationships between the 2D:4D phenotype and differences in magnitude of many psychological traits. Certain social and demographic variables also correlate with the digit ratio. The present paper offers a preliminary analysis of correlations between diet, prenatal hormones’ levels (established based on the digit ratio), and selected social variables. One of the findings is that countries with high meat consumption present the so-called masculine digit ratio, while countries with plant-based diets – a feminine digit ratio.

Effects of adrenal androgens during the prenatal period on the second to fourth digit ratio in school-aged children

OBJECTIVES

We investigated the relationship between the levels of adrenal steroid hormones in cord blood and the second to fourth digit ratio (2D/4D), which is regarded as an indirect method to investigate the putative effects of prenatal exposure to androgens, in school-aged children.

MATERIALS AND METHODS

Of the 514 mother-child pairs who participated in the prospective cohort study of birth in Sapporo between 2002 and 2005, the following adrenal steroid hormone levels in 294 stored cord blood samples (135 males and 159 females) were measured; cortisol, cortisone, androstenedione and dehydroepiandrosterone (DHEA). A total of 190 out of 350 children who were currently school-aged and contactable for this survey sent back photocopies of their palms for 2D/4D measurements.

RESULTS

2D/4D in all right hands, left hands, and mean values was significantly lower in males than in females (p<0.01). DHEA levels were significantly higher in females. A multivariate regression model showed that 2D/4D negatively correlated with DHEA in males only (p<0.01). No correlations were observed in the other adrenal steroid hormones tested in males or in any adrenal steroid hormones in females.

CONCLUSION

DHEA is mainly secreted in large amounts by the adrenal gland and is transformed into active sex-steroid hormones in peripheral tissues. The present study demonstrated that sex differences in digits were influenced by adrenal androgens during the prenatal period, possibly through intracrinological processes for androgen receptors located in fetal cartilaginous tissues.

2D:4D indicates phimosis risk: A study on digit ratio and early foreskin development

BACKGROUND

Many researchers have adopted 2D:4D (second to fourth finger length ratio) as a noninvasive retrospective biomarker for prenatal androgen exposure in recent years. It is thought to be related to diverse traits including behavioral phenotypes, disease susceptibility, and development of urogenital system.

OBJECTIVE

To examine the relationship between 2D:4D and early foreskin development.

METHODS

We analyzed the digit ratio and foreskin condition in 176 cases (range 0-6years). The boys were divided into four groups according to their ages: group 1, neonates (below 28days, n=13); group 2, infants (1-12months, n=45); group 3, toddlers (1-2years old, n=42); group 4, preschool children (3-6years old, n=76). We measured the lengths of the second and fourth digits of the left and right hands. The foreskin status was classified into 4 types. Type I (phimosis), type II (partial phimosis), type III (adhesion of prepuce), type IV (normal).

RESULTS

The phimosis rate was 92.3%, 82.2%, 45.2%, and 38.7% in group 1 to group 4. In contrast, the proportion of normal foreskin increased from 0% in neonates to 13.2% in preschool children. The percentage of higher level of foreskin development shows a downward trend with the increase of digits ratio, and as the age grows, the percentage of normal foreskin cases also increases.

CONCLUSIONS

These results suggest that a higher R2D:4D (right hand 2D:4D) is a risk factor for phimosis in the early human development. Age is also a significant influence factor of foreskin conditions. Additional research is required to identify pathophysiologic mechanisms and to determine clinical significance.

Second to fourth digit ratio (2D:4D) and coronary heart disease

INTRODUCTION

Sex steroid exposure during human development may influence disease susceptibility. Second to fourth digit ratio (2D:4D) is thought to be a putative biomarker for prenatal hormone level during foetal life. Recently there has been a great deal of interest in 2D:4D and risk of disease in adulthood.

METHODS

We explored the relationship between 2D:4D ratio and coronary heart disease. Photocopies of the two hands of 310 males (controls: 155; patients: 155) were collected at Yin chuan city, in the Ningxia province of China. Left hand, right hand, mean hand and right minus left 2D:4D (Dr-l) were analysed.

RESULTS

The mean values of 2D:4D ratio in patients were higher than those of CSIN controls. The patients showed significantly higher 2D:4D (left hand: P < 0.01; right hand, mean hand: P < 0.05) than controls. In patients, 2D:4D (especially left hand 2D:4D) were inversely associated with age at diagnosis (left hand: P < 0.001; right hand, mean hand: P < 0.05). No association between Dr-l and age or age at presentation of disease was observed in the groups.

CONCLUSION

2D:4D may correlate particularly with risk of coronary heart disease in Chinese men.

Visuo-spatial performance in autism: a meta-analysis

Visuo-spatial skills are believed to be enhanced in autism spectrum disorders (ASDs). This meta-analysis tests the current state of evidence for Figure Disembedding, Block Design, Mental Rotation and Navon tasks in ASD and neurotypicals. Block Design (d = 0.32) and Figure Disembedding (d = 0.26) showed superior performance for ASD with large heterogeneity that is unaccounted for. No clear differences were found for Mental Rotation. ASD samples showed a stronger local processing preference for Navon tasks (d = 0.35); less clear evidence for performance differences of a similar magnitude emerged. We discuss the meta-analysis results together with other findings relating to visuo-spatial processing and three cognitive theories of ASD: Weak Central Coherence, Enhanced Perceptual Functioning and Extreme Male Brain theory.