EARLY HUMAN DEVELOPMENT, cilt.187, 2023 (SCI-Expanded)
Background: The 2D:4D ratio (an indicator of prenatal testosterone-estrogen balance) is the ratio of the second finger length to the fourth finger length. We hypothesized that low 2D:4D values indicating high prenatal testosterone exposure may be associated with increased critical shoulder angle (CSA).Aims: The aim of this study was to evaluate the relationship between CSA and 2D:4D ratio.Methods: Meeting the study criteria, 252 patients were included in the study. We measured CSA on true anterior-posterior radiographs, glenoid version(GV) and glenoid inclination(GI) on MRI images and the lengths of the second and fourth fingers on both hands of the patients. Additionally, we compared 2D:4D ratios and CSA, GV, GI measurements.Results: We found a significant negative correlation between CSA and the 2D:4D ratio in both hands (p < 0.001). Patients with CSA > 35 degrees had a significantly lower 2D:4D ratio than patients with CSA < 35 degrees (p < 0.001). When the patients were grouped according to CSA35 degrees, the cut-off value for the left-hand 2D:4D ratio was 0.96, which showed 84.8 % sensitivity and 83.3 % specificity(AUC:0.911). Patients were compared in terms of CSA by categorizing as 2D:4D > 1 and 2D:4D < 1. Accordingly, the CSA value was significantly lower in patients with 2D:4D > 1. In the classification made according to this length classification of the left hand, the cut-off value was 30.25 degrees. This value showed 92.2 % sensitivity and 85 % specificity(AUC:0.956).Conclusion: The 2D:4D ratio is related to CSA. A low 2D:4D ratio(<0.96), indicating high intrauterine testosterone exposure, is associated with CSA > 35 degrees, while a high 2D:4D ratio (>1), indicating low intrauterine testosterone exposure, is associated with a low CSA(<30.25 degrees).