Early human development · 2025
The role of prenatal testosterone-estrogen balance in the development of Os trigonum: A comparative matched-pair analysis.
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Tokgoz Mehmet Ali, Ahmadov Asim, Oklaz Ethem Burak, Yaka Haluk, Duzgun Ramazan, Delice Cagatay, Kanatli Ulunay
Аннотация
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.
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.