Dutasteride, who is it more effective for? Second to fourth digit ratio and the relationship with prostate volume reduction by dutasteride treatment

Abstract

E 8 5 7What ' s known on the subject? and What does the study add? The second to fourth digit ratio (hereafter the digit ratio) of the right hand is related to the activity of the androgen receptor. Five α -reductase inhibitor (5ARI) reduces the prostate volume of patients with BPH. In terms of prostate volume reduction, large-scale placebo-controlled studies show that patients with BPH do not always respond well to 5ARI treatment.Patients with a higher digit ratio respond well to dutasteride treatment compared to those with a lower digit ratio. These results suggest that the digit ratio might be a predictor of the response to dutasteride treatment. OBJECTIVE• To investigate the relationship between second to fourth digit ratio (hereafter the digit ratio) and prostate volume reduction by dutasteride treatment. PATIENTS AND METHODS• A total of 142 men aged ≥ 40 years with a clinical diagnosis of benign prostatic hyperplasia and an enlarged prostate (prostate volume ≥ 30 mL) were prospectively enrolled.• Before prostate-specifi c antigen (PSA) level determination and transrectal ultrasonography (TRUS), the lengths of the second and fourth digits of the right hand were measured by an investigator using a digital vernier calliper.• Using TRUS, pre-and post-treatment prostate volume (PV1 and PV2) were measured by an uroradiologist who was unaware of fi nger lengths. We investigated the change in prostate volume and PSA level at least 6 months after the initiation of dutasteride therapy. RESULTS• When the patients were divided into two groups according to digit ratio (A: digit ratio < 0.95, n = 71; B: digit ratio ≥ 0.95, n = 71), there was a greater reduction in prostate volume in group B compared to group A (PV2 -PV1: − 9.4 mL vs − 13.2 mL, P = 0.042; [ PV2 -PV1 ] /PV1: − 17.5% vs − 24.5%, P = 0.027; [ PV2 -PV1 ] /duration: − 1.1 mL/month vs − 1.6 mL/month, P = 0.041; [ PV2 -PV1 ] /PV1/duration: − 2.0%/ month vs − 3.0%/month, P = 0.016).• Signifi cant negative correlations were found between the digit ratio and reduction rate ( [ PV2 -PV1 ] /duration: r = − 0.165, P = 0.049; [ PV2 -PV1 ] /PV1/duration: r = − 0.191, P = 0.023). CONCLUSIONS• Patients with higher digit ratios respond well to dutasteride treatment.• The results obtained in the present study suggest that the digit ratio is a predictor of the response to dutasteride treatment. Dutasteride, who is it more effective for? Second to fourth digit ratio and the relationship with prostate volume reduction by dutasteride treatment KEYWORDS

Second to fourth digit ratio: a predictor of adult lung function

“…In addition, the mean value of the females’ digit ratio was lower than that of males in our previous studies (0.952,19 0.97,20 0.951,58 and 0.94859. However, in one study conducted among 664 (332 males, 332 females) university students (mean age: male: 22.4 years, female: 21 years), the digit ratio in Korean men was significantly lower than that of Korean women (0.96 vs 0.97, P < 0.001) 60.…”

Second to fourth digit ratio and lung function (forced vital capacity): predictors of maximum urinary flow rate after holmium laser enucleation of the prostate

“…() showed a greater reduction in prostate volume after dutasteride treatment in higher digit ratio (≥0.95) group compared with lower digit ratio (<0.95) group (−24.5% vs. −17.5%, p = 0.027). This means that patients with higher digit ratios respond well to dutasteride treatment (Kim et al ., ).…”

“…A previous study reported that digit ratio is negatively correlated with fetal testosterone to fetal estradiol ratio (Lutchmaya et al ., ), that is, a high fetal testosterone to fetal estradiol ratio results in a low digit ratio. Zheng & Cohn () reported that digit ratio is controlled by the balance between androgen and estrogen signaling during digit development (Manning, ; Zheng & Cohn, ), and recently, it was reported digit ratio is related to BPH and BPH treatment (Kim et al ., ; Sudhakar et al ., ). Sudhakar et al .…”

“…() also showed that individuals with lower digit ratios are at a higher risk of developing BPH than members of the general population (Sudhakar et al ., ). Furthermore, BPH patients with higher digit ratios respond well to dutasteride treatment for BPH (Kim et al ., ). These findings suggest individuals with higher digit ratios might experience better results after HoLEP.…”

“…Second to fourth digit ratios (digit ratio) are lower for men than women (Manning et al ., ; McFadden & Shubel, ; Hönekopp & Watson, ), and have been reported to be related to sex hormone, that is, a high fetal testosterone to fetal estradiol ratio results in a low digit ratio (Lutchmaya et al ., ; Manning et al ., ; Manning, ; Zheng & Cohn, ). Furthermore, it has been recently reported that digit ratio is related to BPH and BPH treatment (Kim et al ., ; Sudhakar et al ., ).…”