High digit ratio (2D:4D) is associated with attack frequency and severity in hereditary angioedema patients

• Published in: Early human development Vol. 177-178; p. 105724
• Main Authors: Evcen, Recep, Çölkesen, Fatih, Saygın, Duygu Akın, Aykan, Filiz Sadi, Kılınç, Mehmet, Ergün, Ümmügülsüm Yılmaz, Akkuş, Fatma Arzu, Önalan, Tuğba, Yıldız, Eray, Arslan, Şevket
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.03.2023
• Subjects: 2D:4D ratio; Angioedemas, Hereditary; Attack severity; C1 inhibitor; Digit Ratios; Female; Fingers - anatomy & histology; Hereditary angioedema; Humans; Laryngeal attacks; Male; C1 inhibitor; 2D:4D ratio; Laryngeal attacks; Hereditary angioedema; Attack severity
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2023.105724

Hereditary angioedema (HAE) caused by a deficiency or dysfunction of the plasma protease C1-inhibitor is a rare autosomal-dominant disorder. We explored a possible correlation between the ratio of the second and fourth finger lengths (2D:4D) and the frequency of HEA attacks, and whether the ratio might predict laryngeal attack. We evaluated 35 HEA patients aged 19 to 66 years; 3 were subsequently excluded. The 2D:4D ratio was calculated by dividing the length of the second finger by that of the fourth finger of both hands. A structured clinical questionnaire exploring HAE course and treatment over the prior year was administered. Of the 32 participants, 56.25 % (n = 18) were female. Of them, those with high 2D:4D ratios suffered significantly more laryngeal attacks than others; 93.3% of patients with high 2D:4D ratios experienced ≥5 attacks annually, significantly more than those with low ratios. Among type 2 HEA patients, 75 % of those experiencing ≥5 attacks annually had high 2D:4D ratios; all patients with low 2D:4D ratios reported <5 attacks annually. These significant effects were found for right-hand 2D:4D ratios and not left-hand 2D:4D ratios. The data suggest that intrauterine sex hormone exposure, which affects the 2D:4D ratio, is significantly associated with HEA attack frequency and severity, and laryngeal edema. •Although Hereditary angioedema is seen equally in both sexes, it is more severe and life-threatening in women.•Among female Hereditary angioedema patients, those with high 2D:4D ratios had more laryngeal attacks than others.•Most of those with high 2D:4D ratios had ≥5 attacks per year.•The 2D:4D ratio is significantly associated with HEA attack frequency, severity, and laryngeal edema.