The role of prenatal testosterone-estrogen balance in the development of Os trigonum: A comparative matched-pair analysis

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development Pub Date : 2025-03-25 DOI:10.1016/j.earlhumdev.2025.106250

Mehmet Ali Tokgoz , Asim Ahmadov , Ethem Burak Oklaz , Haluk Yaka , Ramazan Duzgun , Cagatay Delice , Ulunay Kanatli

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引用次数: 0

Abstract

Background

The 2D:4D ratio, a marker of the prenatal testosterone-estrogen balance, is defined as the proportion of the second to fourth finger lengths, with lower values indicating greater testosterone exposure. Studies demonstrated that this exposure affects chondrocyte activity and function during secondary ossification. Considering that the os trigonum is an unfused secondary ossification center, investigating the relationship between hormonal balance and os trigonum could provide valuable insights as etiopathogenesis.

Aim

To investigate the relationship between the presence of os trigonum and the 2D:4D ratio.

Methods

A matched-pair cohort study was conducted to compare patients with and without an os trigonum among those undergoing ankle arthroscopy between 2019 and 2024. 34 patients in each group were matched 1:1 by age, sex, body mass index, and history of ankle overuse before age 14. Finger lengths were measured with a caliper and 2D:4D ratios were determined.

Results

The analysis revealed that patients with os trigonum had significantly lower 2D:4D ratios in the right hand (p < 0.001), left hand (p < 0.001), and average of both (p < 0.001) compared to those without. The average 2D:4D ratio had the highest predictive ability (AUC = 0.867), with a cut-off of 0.997 predicting the presence of os trigonum with 91.2 % sensitivity and 70.6 % specificity.

Conclusion

A low 2D:4D ratio, indicative of high intrauterine testosterone exposure, is associated with the presence of an os trigonum. Therefore, this research contributes to the growing evidence that prenatal testosterone exposure, may influence specific skeletal characteristics, such as the formation of accessory bones.

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来源期刊

Early human development 医学-妇产科学

CiteScore

4.40

自引率

4.00%

发文量

100

审稿时长

46 days

期刊介绍： Established as an authoritative, highly cited voice on early human development, Early Human Development provides a unique opportunity for researchers and clinicians to bridge the communication gap between disciplines. Creating a forum for the productive exchange of ideas concerning early human growth and development, the journal publishes original research and clinical papers with particular emphasis on the continuum between fetal life and the perinatal period; aspects of postnatal growth influenced by early events; and the safeguarding of the quality of human survival. The first comprehensive and interdisciplinary journal in this area of growing importance, Early Human Development offers pertinent contributions to the following subject areas: Fetology; perinatology; pediatrics; growth and development; obstetrics; reproduction and fertility; epidemiology; behavioural sciences; nutrition and metabolism; teratology; neurology; brain biology; developmental psychology and screening.