title: Androgens concentrations and second-to fourth-digit ratio (2D:4D) in girls with congenital adrenal hyperplasia (21-hydroxylase deficiency).
abstract: OBJECTIVE
  Excessive hyperandrogenism, though proper hydrocortisone supplementation is a frequent clinical problem in girls with congenital adrenal hyperplasia (CAH). This may result from autonomic regulation of androgen production established in prenatal life. It has been suggested that the length of the second finger relative to the length of the fourth finger (2D;4D ratio) is negatively related to prenatal testosterone concentration.
  
  
  METHODS
  The retrospective study aimed to establish the relationship between the level of androgenization in utero determined using 2D:4D ratio and serum androgen concentrations in treated girls with CAH (21-OH deficiency) has been performed on 19 girls with CAH (21-OH deficiency) at the age of 3.7-19 years (mean 13.8 ± 4.07 years). All subjects were adequately treated with hydrocortisone (10-19 mg/m2; mean 13.81 ± 4.07 mg/m2). Anthropometric measurements of digits length were performed in all girls on X-rays obtained for bone age estimation. Apart from it, serum androgens concentrations (testosterone, androstenedione, s-DHEA) and 17-OH-progesterone (17-OHP) were assayed.
  
  
  RESULTS
  Mean androgens serum concentrations in examined group were: testosterone 150.21 ± 155.44 ng/ml; androstenedione 4.15 ± 5.32 ng/ml, s-DHEA 70.39 ± 85.52 µg/dl. Mean 2D:4D ratio was 0.96 ± 0.04. Analysis of correlation showed positive linear correlations between testosterone, s-DHEA and 2D:4D ratio (r=0.53, p=0.023 and r=0.53; p=0.019, respectively).
  
  
  CONCLUSIONS
  2D:4D ratio parameter may be a simple test in indentification of female CAH patients prone to excessive androgen secretion despite proper treatment. The autonomization of adrenal androgens production in foetal life may cause its elevated levels in female patients with CAH although treated adequately.
authors: Department of Paediatrics, Medical University of Silesia, Katowice, Poland. smina@poczta.onet.pl
authors: Joanna M
authors: JM
authors: Oswiecimska
authors: Agnieszka
authors: A
authors: Ksiazek
authors: Katarzyna
authors: K
authors: Sygulla
authors: Magdalena
authors: M
authors: Pys-Spychala
authors: Grzegorz R
authors: GR
authors: Roczniak
authors: Wojciech
authors: W
authors: Roczniak
authors: Malgorzata
authors: M
authors: Stojewska
authors: Katarzyna
authors: K
authors: Ziora
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology*; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D005385:Fingers / Q000033:anatomy & histology* / Q000254:growth & development / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood; D014770:Virilism / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000728:Androgens; D000893:Anti-Inflammatory Agents; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019326:17-alpha-Hydroxyprogesterone; D006854:Hydrocortisone