Second to fourth digit ratio, handedness and testicular germ cell tumors

Are the digit ratio (2D:4D) and hand grip strength related to Parkinson disease in elderly males?

BACKGROUND

Sex hormones affect the pathogenesis of Parkinson patients and it has been suggested that gender is the most important factor in the development and progression of Parkinson's disease. Studies have shown that the second to fourth digit ratio (2D:4D) is affected by the prenatal testosterone and estrogen levels and can predict predisposition to disease. In addition, decreased muscle strength in people with Parkinson's has been repeatedly reported. Hand grip strength (HGS) is a suitable measure to evaluate the musculoskeletal system among the elderly and it is considered as an indicator of the overall strength of the body. This study aimed at investigating the relationship between Parkinson's disease and HGS and 2D:4D ratio.

METHODS

In this study 117 elderly men with Parkinson disease (mean age of 61.66 ± 11.28 years) and 156 healthy control subjects (mean age of 61.86 ± 6.29 years) participated. After determining the level of disability of Parkinson patients by a neurologist (level of disability in the range of 1-4), anthropometric indices (height, weight, length of the second and fourth fingers) and maximum HGS were measured.

RESULTS

Although 2D:4D ratios (right and left hand) of male patients with Parkinson's disease were higher than those of healthy males, this difference was not statistically significant (P = 0.12, P = 0.40; respectively). Conversely, HGS for the right and left hands of Parkinson patients were significantly lower than those of healthy males (P = 0.02, P = 0.03; respectively). The results showed a significant negative relationship between Parkinson disease and the right and left HGS (R = -0.16, P = 0.005; R = -0.17, P = 0.003; respectively). Parkinson disease had no significant relationship with 2D:4D of the right hand, left hand, mean finger ratio and D_R-L 2D:4D (P > 0.05). The regression results showed that the right and left HGS were not able to predict Parkinson disease (P = 0.25, P = 0.16; respectively).

CONCLUSION

We concluded that HGS was negatively associated with the Parkinson disease, but conversely, 2D:4D may not be a valuable biomarker of elevated risk of Parkinson in elderly males.

Digital biomarker 2D:4D as a predictor of cancer: A systematic review

BACKGROUND

The digital ratio between the second and fourth digits of the hands, known as 2D:4D, is sexually dimorphic. It has been suggested that a low 2D:4D indicates high exposure to prenatal testosterone and low estrogen exposure while a high 2D:4D indicates the inverse. The 2D:4D may be predictive of cancer susceptibility, and this may be particularly true in cancers that show differences between sexes in their occurrence.

AIM

To conduct a systematic review of published epidemiological literature examining the association between 2D:4D and cancer.

METHOD

This review was carried out according to criteria recommended for the systematic review of Statement PRISMA. We enrolled 25 papers involving eleven cancer topographies with 4,569 cases and 19,416 controls from Europe, America, Asia and Australia.

RESULTS

We noticed variations and discrepancies in the results of the association between 2D:4D and cancer among the studies, either in those that had evaluated the same or different types of cancer, or in the same or distinct lateralities. However, a high 2D:4D was considered a likely predictor of cancer risk in 11 of 25 studies, a low 2D:4D was suggested as a predictor of risk in eight papers, and five of the twenty-five studies did not demonstrate any association.

CONCLUSIONS

Although this biomarker has the advantage of being easy to measure, it is noted that its relationship with sex hormone levels at specific stages of life has not yet been well quantified, and it has still been questioned. Hence, it is suggested that those findings from studies involving 2D:4D as a proxy for foetal hormone exposure should be interpreted with caution, as well as those studies which claim its association with cancer. Thus, this review shows the need for a greater number of epidemiological studies using more homogeneous methodology and techniques to better investigate the strength of the findings.

Digit ratio (2D:4D) and handedness: A meta-analysis of the available literature

The Geschwind-Behan-Galaburda and sexual differentiation models predict an association between elevated foetal androgen exposure and left-handedness whereas the callosal hypothesis predicts the opposite. We present a meta-analysis of correlations between handedness and digit ratio (2D:4D), a putative marker of prenatal testosterone. Left-handedness predicted low (male-typical) right-hand digit ratio (R2D:4D), high (female-typical) left-hand digit ratio (L2D:4D), and low R2D:4D-L2D:4D directional asymmetry (D_[R-L]). Effect sizes were extremely small and not moderated by sex or method of measuring handedness or 2D:4D. The same general pattern was observed after excluding the very large study (110,329 males, 90,412 females) of Manning and Peters ([2009]. Digit ratio (2D:4D) and hand preference for writing in the BBC Internet Study. Laterality: Asymmetries of Body, Brain and Cognition, 14(5), 528-540. doi:10.1080/13576500802637872); however, no significant effects for R2D:4D were observed once these samples were removed. The results do not confirm any theory linking prenatal androgens with handedness, so we speculate they instead reflect the mechanical action of writing causing subtle changes in the musculature and/or fat pads of the fingers. Gripping a pen/pencil might cause an increase in 2D relative to 4D (and/or decrease in 4D relative to 2D) resulting in higher ratios on the writing-hand; furthermore, this could differ between left- and right-handers due to writing in the left-to-right direction (as in English) having asymmetrical effects depending on which hand is used.

Can sex ratios at birth be used in the assessment of public health, and in the identification of causes of selected pathologies?

This paper will consist of two parts. In the first, further support is given to the proposal that offspring sex ratios (proportions male) may usefully be regarded as indicators of public health. In the second, it is shown that sex ratios may help in the identification of the causes and effects of several pathologies that seriously impinge on public health viz. autism, testicular cancer, hepatitis B and toxoplasmosis.

The Association of Digit Ratio (2D : 4D) with Cancer: A Systematic Review and Meta-Analysis

Objective

Intrauterine sex hormone environment as indicated by the second to the fourth digit ratio (2D : 4D) can be associated with cancer risk. This systematic review and meta-analysis aimed to evaluate the association of 2D : 4D with cancer diagnosis, malignancy, and age at presentation.

Methods

Studies that evaluated the association of 2D : 4D with cancer risk were collected from Pubmed/MEDLINE and Clarivate Analytics databases. Nineteen studies were included in the qualitative analysis.

Results

The 2D : 4D ratio was studied in prostate cancer, breast cancer, testicular cancer, gastric cancer, oral cancer, brain tumors, and cervical intraepithelial neoplasia. Low 2D : 4D was associated with prostate cancer, gastric cancer, and brain tumors, while high 2D : 4D, with breast cancer risk and cervical dysplasia. The 2D : 4D ratio was not associated with prostate, breast, and gastric cancer stage. Greater 2D : 4D ratio was associated with younger presentation of breast cancer and brain tumors. The meta-analyses demonstrated that testicular cancer was not associated with right-hand 2D : 4D ratio (p = 0.74) and gastric cancer was not associated with right-hand (p = 0.15) and left-hand (p = 0.95) 2D : 4D ratio.

Conclusions

Sex hormone environment during early development is associated with cancer risk later in life. Further studies exploring the link between intrauterine hormone environment and cancer risk are encouraged.

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.

Potential Intervention Targets in Utero and Early Life for Prevention of Hormone Related Cancers

Hormone-related cancers have long been thought to be sensitive to exposures during key periods of sexual development, as shown by the vulnerability to such cancers of women exposed to diethylstilbestrol in utero. In addition to evidence from human studies, animal studies using new techniques, such as gene knockout models, suggest that an increasing number of cancers may be hormonally related, including liver, lung, and bladder cancer. Greater understanding of sexual development has also revealed the "mini-puberty" of early infancy as a key period when some sex hormones reach levels similar to those at puberty. Factors driving sex hormones in utero and early infancy have not been systematically identified as potential targets of intervention for cancer prevention. On the basis of sex hormone pathways, we identify common potentially modifiable drivers of sex hormones, including but not limited to factors such as obesity, alcohol, and possibly nitric oxide. We review the evidence for effects of modifiable drivers of sex hormones during the prenatal period and early infancy, including measured hormones as well as proxies, such as the second-to-fourth digit length ratio. We summarize the gaps in the evidence needed to identify new potential targets of early life intervention for lifelong cancer prevention.

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.