Second-to-fourth Digit Ratio in Systemic Lupus Erythematosus

Doe, Kentaro; Nozawa, Kazuki; Hirai, Takuya; Tsushima, Hirofumi; Hiruma, Kaori; Ando, Seiichiro; Nakano, Soichiro; Kon, Takayuki; Amano, Hirofumi; Yamaji, Katsuhiko; Tamura, Naoto; Takasaki, Yoshinari

doi:10.3899/jrheum.140974

Cited by 5 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, it was noted that the high 2D : 4D ratio is associated with breast cancer and brain tumors being present at young age [2]. Doe et al found that the 2D : 4D ratio was lower in patients with systemic lupus erythematosus than healthy controls and this result supported the exposure to high prenatal testosterone and low estrogen in SLE patients [15].…”

Section: Discussionmentioning

confidence: 96%

Can the Second to Fourth Digit Ratio (2D : 4D) Be a Marker to Determine Ankylosing Spondylitis Disease Activity?

et al. 2019

View full text Add to dashboard Cite

Objective. The length ratio of the index finger (2D) to the ring finger (4D) (2D : 4D ratio) is considered a biomarker of prenatal sex hormone exposure. The 2D : 4D ratio is influenced by prenatal androgen and estrogen levels. Because ankylosing spondylitis (AS) influences men more frequently and severely than women, androgens are proposed to be related to AS pathogenesis. Estrogens have immune-modulating effects and reduce AS disease activity. The aim of this study was to assess the relationship between 2D : 4D ratio and AS disease activity. Material and Methods. In this study, 167 (43 female) patients diagnosed with AS were studied. The lengths of the second and fourth fingers were measured using a digital caliper. The 2D : 4D ratio was found by dividing the length of the second finger by the length of the fourth finger. AS disease activity was assessed with the Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). AS functional status was assessed with Bath Ankylosing Spondylitis Functional Index (BASFI). L-Schober, tragus to wall distance, finger to floor distance, and chest expansion were used to evaluate mobility. Results. In female patients, the right hand 2D : 4D ratios were higher than those in male patients. Biologic drug use was more frequent in males. The BASDAI scores were higher in female patients than in male patients. There were significant negative correlations between right and left hand 2D : 4D ratio and BASFI and BASDAI in female patients. There was no significant correlation between the 2D : 4D ratio and BASFI or BASDAI in male patients. We found a positive correlation between L-Schober and right hand 2D : 4D and a negative correlation between the left hand 2D : 4D ratio and finger to floor distance in female patients with AS. Conclusion. The 2D : 4D ratio of the right and left hand was low in female patients with high BASFI and BASDAI and low spinal mobility (L-Schober) was also linked to low female 2D : 4D. The lack of strong associations between 2D : 4D and AS in male patients may have resulted from their higher use of biologics.

show abstract

Section: Discussionmentioning

confidence: 96%

Can the Second to Fourth Digit Ratio (2D : 4D) Be a Marker to Determine Ankylosing Spondylitis Disease Activity?

et al. 2019

View full text Add to dashboard Cite

show abstract

“…There are no studies concerning prenatal sex steroid influence on Hashimoto thyroiditis and Graves’ disease, and the reports on prenatal estrogen’s influence on autoimmune diseases are also limited. Previous studies showed that patients with systemic lupus erythematosus (SLE) (both women and men) had lower 2D:4D than healthy controls ( 43 ). The authors concluded that high prenatal levels of testosterone and low estrogen can play a role in the etiology of this disease onset and can be its trigger ( 43 ).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that patients with systemic lupus erythematosus (SLE) (both women and men) had lower 2D:4D than healthy controls ( 43 ). The authors concluded that high prenatal levels of testosterone and low estrogen can play a role in the etiology of this disease onset and can be its trigger ( 43 ). Furthermore, they hypothesize that increased aromatase activity can cause an increased level of estrogen, which can lead to the disease’s commencement ( 43 ).…”

Section: Discussionmentioning

confidence: 99%

“…The authors concluded that high prenatal levels of testosterone and low estrogen can play a role in the etiology of this disease onset and can be its trigger ( 43 ). Furthermore, they hypothesize that increased aromatase activity can cause an increased level of estrogen, which can lead to the disease’s commencement ( 43 ). Moreover, because SLE is considered to be a disease in which Th2 cells predominate, the observed correlation can be explained by increased Th2 response promoted by increased androgens’ exposure ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can Digit Ratio (2D:4D) Be Indicative of Predispositions to Autoimmune Thyroid Diseases in Women - Hashimoto Thyroiditis and Graves’ Disease?

et al. 2022

View full text Add to dashboard Cite

Hashimoto thyroiditis and Graves’ disease are autoimmune thyroid diseases which occur much more frequently in women than in men. Estrogen receptors are found in the thyroid gland and can modulate the gland’s function. Digit ratio (2D:4D) is thought to be a negative correlate of prenatal testosterone and a positive correlate of prenatal estrogen. This study aimed to examine a relationship between right and left 2D:4D in women with Hashimoto thyroiditis and Graves’ disease. The cross-sectional study included 106 women with autoimmune thyroid disease: 73 women diagnosed with Hashimoto thyroiditis and 33 women with Graves’ disease, together with 70 healthy women as controls. Second and fourth digit length, weight, height were measured directly, and 2D:4D and BMI were calculated. Compared to controls, right and left 2D:4D were significantly higher in women with Hashimoto thyroiditis and lower in women with Graves’ disease, the effects were higher for right 2D:4D. The mean length of right 4D was significantly lower in the examined women with Hashimoto thyroiditis than in Graves’ disease. Higher right and left 2D:4D in women with Hashimoto thyroiditis suggests that prenatal exposure to high levels of estrogens relative to testosterone may play a role in the development of this disease. Lower right and left 2D:4D in women with Graves’ disease suggest a role of high prenatal androgens relative to estrogens in Graves’ disease pathogenesis.

show abstract

“…Several studies found 2D:4D to be associated with reproductive cancers 25,30,31 . As for general health characteristics, 2D:4D was associated with various cancers 32,33 , idiopathic pulmonary hypertension 34 and other morbidities such as systemic lupus erythematosus 35 , autism spectrum disorders 36 , and congenital adrenal hyperplasia 37,38 .…”

mentioning

confidence: 99%

The association between second to fourth digit ratio, reproductive and general health among women: findings from an Israeli pregnancy cohort

Tabachnik

Wainstock

2020

Sci Rep

View full text Add to dashboard Cite

The ratio between the length of second and fourth digits (2D:4D) is a putative biomarker for prenatal testosterone and estrogen exposure. The aim of the study was to examine the association between 2D:4D and women's general and reproductive health. This analysis was conducted within a prospective pregnancy cohort study. The study population included 187 women. 2D:4D was measured directly in both hands using a digital caliper. Multivariable linear and logistic models were used to study the associations between digit ratio and the studied health characteristics. Mean age of the participants was 30.7 ± 4.9 years. The mean age at menarche was 12.9 ± 1.4 years. Right hand 2D:4D mean ± SD was 0.965 ± 0.03. Left hand 2D:4D mean ± SD was 0.956 ± 0.03. An association was found between right 2D:4D and age at menarche, with older age in women with 2D:4D ≥ mean versus 2D:4D < mean (13.2 ± 1.5 and 12.8 ± 1.3 respectively, b = 0.48, 95%CI:0.06-0.91) while controlling for ethnicity. Higher 2D:4D was also associated with heavier menses bleeding and dysmenorrhea. There is an association between 2D:4D and sub optimal reproductive characteristics, including later age at menarche, heavier menses bleeding and dysmenorrhea. These findings support the association between the intrauterine period and reproductive characteristics. further studies are required to support our findings. The ratio between lengths of the second and the fourth digits (index and ring fingers) (2D:4D) is a putative biomarker of prenatal testosterone and estrogen exposure 1. 2D:4D is sexually dimorphic, and males' 2D:4D is relatively shorter than females' 2,3. 2D:4D is observed at as early as the end of the first trimester 4,5. Relative digit length is considered steady at ages 2 to 25 6 , although other studies suggest that 2D:4D does mildly increase during childhood but remains steady during puberty 7,8. 2D:4D was suggested to be associated with Hox gene family 2,3. Homeobox genes Hox a and Hox d may indirectly influence the prenatal production of androgen by controlling the differentiation of the urogenital system as well as digit development. Considering this, it was suggested that there may be an association between prenatal hormonal function and digit formation, and 2D:4D was proposed as an indicator of first trimester testosterone and estrogen levels, reflecting the Hox genes' action on differentiation 9,10. Environmental exposure to toxicants is critical during early development stages, such as the perinatal period, in which there is a heightened vulnerability to exposures due to potential permanent effect on health and development 11. Previous research showed association between prenatal hormonal environment and exposure to endocrine disrupting chemicals and 2D:4D in animals 12,13 and humans 2,10,14-16. Conversely, some studies found no support for such association 17-19. Assessing the prenatal hormonal environment directly from the fetus in utero is challenging because of the risk for the fetus. Therefor other methods have been used to evaluate prenatal ...

show abstract

Second-to-fourth Digit Ratio in Systemic Lupus Erythematosus

Abstract: Our study suggests that patients with SLE have experienced high prenatal testosterone and low prenatal estrogen. To our knowledge, this is the first study evaluating the association between 2D4D ratio and SLE.

Cited by 5 publications

References 20 publications

Can the Second to Fourth Digit Ratio (2D : 4D) Be a Marker to Determine Ankylosing Spondylitis Disease Activity?

Can the Second to Fourth Digit Ratio (2D : 4D) Be a Marker to Determine Ankylosing Spondylitis Disease Activity?

Can Digit Ratio (2D:4D) Be Indicative of Predispositions to Autoimmune Thyroid Diseases in Women - Hashimoto Thyroiditis and Graves’ Disease?

The association between second to fourth digit ratio, reproductive and general health among women: findings from an Israeli pregnancy cohort

Contact Info

Product

Resources

About