The Second-to-Fourth Digit Ratio in Cryptorchidism: A Case-Control Study

Abstract

PurposeThe homeobox (Hox) genes a and d controlling limb and genital development influence the digit ratio and the fetal production of testicular androgen, which may result in testicular descent in boys. To assess whether the digit ratio reflects disease status, we investigated the second and fourth finger lengths in children with cryptorchidism, in children with hydrocele as a disease control, and in healthy controls (boys and girls).Materials and MethodsOne hundred ninety-six children (46 with cryptorchidism, 50 with hydrocele, 50 healthy boys, and 50 healthy girls) who were 6 to 23 months of age were prospectively enrolled. Digit lengths were measured by 2 investigators, and the mean value was recorded.ResultsThe second-to-fourth digit ratios (2D:4Ds) of the left hand in the cryptorchidism group, hydrocele group, healthy boys, and healthy girls were 0.958, 0.956, 0.950, and 0.956, respectively. The 2D:4D values of the right hand were 0.946, 0.945, 0.952, and 0.969, respectively. The right and left 2D:4D ratios were not significantly different among groups. The 2D:4D of both hands was not related to age, weight, or height.ConclusionsAccording to these results, the 2D:4D was not significantly different in boys with cryptorchidism than in boys with hydrocele or in healthy controls (boys and girls) and failed to reflect disease conditions in the infant period.

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

“…In addition to CAH, 2D:4D has been examined in a range of conditions associated with atypical androgen activity, such as CAIS (Berenbaum et al, 2009;van Hemmen et al, 2017), cryptorchidism and/or hypospadias (Abbo et al, 2015;Hwang et al, 2014;O'Kelly, DeCotiis, Zu'bi, Farhat, & Koyle, 2020), polycystic ovarian syndrome (PCOS) (Cattrall, Vollenhoven, & Weston, 2005;Lujan, Bloski, Chizen, Lehotay, & Pierson, 2010;Pandit, Setiya, Yadav, & Jehan, 2016;Roy, Kundu, Sengupta, & Hazra, 2016), autism (Hönekopp, 2012;Manning et al, 2001;Schieve et al, 2018;Teatero & Netley, 2013), ADHD (Martel, Gobrogge, Breedlove, & Nigg, 2008), and gender dysphoria/gender identity disorder and gender variance (Richards, Wei, & Hendriks, 2020;Voracek, Kaden, Kossmeier, Pietschnig, & Tran, 2018). Interest has also been expressed in examining digit ratio in populations with sex chromosome aberrations .…”

Male infants with hypospadias and/or cryptorchidism show a lower 2D/4D digit ratio than normal boys

“…They do however confirm the influence of sex hormones on digit growth and genital development in primates. In a recent report by Hwang et al from Korea, the authors found no difference in digit ratio in boys with cryptorchidism as compared with boys with hydrocele 32. They also found no difference between healthy control boys and healthy control girls which could imply lack of statistical power.…”