Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 4;12(5):2040.
doi: 10.3390/jcm12052040.

Is There a Correlation between the Second-to-Four Digit Ratio (2D:4D) and Endometriosis? Results of a Case-Control Study

Laura Buggio  1 , Marco Reschini  2 , Paola Viganò  2 , Dhouha Dridi  1 , Giulia Galati  3 , Alessandra Chinè  3 , Francesca Giola  4 , Edgardo Somigliana  2   4 , Laura Benaglia  2
Affiliations

Is There a Correlation between the Second-to-Four Digit Ratio (2D:4D) and Endometriosis? Results of a Case-Control Study

Laura Buggio et al. J Clin Med. .

Abstract

The second-to-four digit ratio (2D:4D) has been proposed as a marker of prenatal hormonal exposure. It is suggested that prenatal exposure to androgens results in a shorter 2D:4D ratio, whereas a prenatal oestrogenic environment results in a longer one. In addition, previous research has shown an association between exposure to endocrine-disrupting chemicals and 2D:4D in animals and humans. On the endometriosis side, hypothetically, a longer 2D:4D ratio, reflecting a lower androgenic intrauterine milieu, could represent an indicator of the presence of the disease. In this light, we have designed a case-control study to compare 2D:4D measurements between women with and without endometriosis. Exclusion criteria included the presence of PCOS and previous trauma on the hand that could impact the measurement of the digit ratio. The 2D:4D ratio of the right hand was measured using a digital calliper. A total of 424 participants (endometriosis n = 212; controls n = 212) were recruited. The group of cases included 114 women with endometriomas and 98 patients with deep infiltrating endometriosis. The 2D:4D ratio was significantly higher in women with endometriosis compared to controls (p = 0.002). There is an association between a higher 2D:4D ratio and the presence of endometriosis. Our results support the hypothesis claiming potential influences of intrauterine hormonal and endocrine disruptors exposure on the onset of the disease.

Keywords: 2D:4D; deep endometriosis; digit ratio; endometrioma; endometriosis; intrauterine origin.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
The 2D:4D ratio is calculated by dividing the length of the index finger of a given hand by the length of the ring finger of the same hand.
Figure 2
Figure 2
Distribution of the 2D:4D ratio in the endometriosis and in the control group. The red line represents the median.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Vercellini P., Viganò P. Endometriosis: Pathogenesis and treatment. Nat. Rev. Endocrinol. 2014;29:2171–2175. doi: 10.1038/nrendo.2013.255. - DOI - PubMed
    1. Tomassetti C., Johnson N.P., Petrozza J., Abrao M.S., I Einarsson J., Horne A.W., Lee T.T.M., Missmer S., Vermeulen N., Zondervan K.T., et al. An international terminology for endometriosis, 2021. Hum. Reprod. Open. 2021;2021:hoab029. doi: 10.1093/hropen/hoab029. - DOI - PMC - PubMed
    1. Zondervan K.T., Becker C.M. Endometriosis. N. Engl. J. Med. 2020;382:1244–1256. doi: 10.1056/NEJMra1810764. - DOI - PubMed
    1. Ottolina J., Schimberni M. Early-life factors, in-utero exposures and endometriosis risk: A meta-analysis. Reprod. Biomed. Online. 2020;41:279–289. doi: 10.1016/j.rbmo.2020.04.005. - DOI - PubMed
    1. Buck Louis G.M., Hediger M.L. Intrauterine exposures and risk of endometriosis. Hum. Reprod. 2007;22:3232–3236. doi: 10.1093/humrep/dem338. - DOI - PubMed

LinkOut - more resources