Guyatt Anna Louise, Heron Jon, Knight Bernice Le Cornu, Golding Jean, Rai Dheeraj
Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit, School of Social & Community Medicine, University of Bristol, Bristol, UK.
Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
BMJ Open. 2015 Aug 25;5(8):e007433. doi: 10.1136/bmjopen-2014-007433.
To investigate whether second-to-fourth digit ratio (2D:4D), a measure commonly used as a proxy for fetal testosterone exposure, is associated with autism spectrum disorders (ASDs), as predicted by the extreme male brain theory of autism.
A birth cohort study.
The Avon Longitudinal Study of Parents and Children (ALSPAC).
6015 ALSPAC children with data on digit ratio, at least 1 outcome measure and information on potential confounding variables (parental occupational class, maternal education and age at digit ratio measurement). Digit ratio was measured by the photocopy and calliper method.
ASD diagnosis (cases were identified previously by record linkage or maternal report) and 4 measures that combine optimally within ALSPAC to predict ASD: the Children's Communication Checklist (coherence subscale), the Social and Communication Disorders Checklist, a repetitive behaviour measure, and the Emotionality, Activity and Sociability scale (sociability subscale). These measures were dichotomised, with approximately 10% defined as the 'risk' group.
Using logistic regression, we examined the association of 2D:4D with ASDs and 4 dichotomised ASD traits. Covariates were occupational class, maternal education and age at 2D:4D measurement. 2D:4D was not associated with ASDs in males (adjusted OR per 1 SD increase in mean 2D:4D, 0.88 (95% CI 0.65 to 1.21), p=0.435) or females (adjusted OR=1.36 (95% CI 0.81 to 2.28), p=0.245). Similar results were observed after adjustment for IQ. There was 1 weak association between reduced coherence and increased left 2D:4D in males, in the opposite direction to that predicted by the extreme male brain theory (adjusted OR=1.15 (95% CI 1.02 to 1.29), p=0.023). Given multiple comparisons, this is consistent with chance.
In this population-based study, there was no strong evidence of an association between 2D:4D and ASD diagnosis or traits, although the CIs were wide. These results are not consistent with the extreme male brain theory.
根据自闭症的极端男性大脑理论预测，研究常用作胎儿睾酮暴露指标的食指与无名指比例（2D:4D）是否与自闭症谱系障碍（ASD）有关。
一项出生队列研究。
阿冯父母与儿童纵向研究（ALSPAC）。
6015名ALSPAC儿童，有关于指比的数据、至少一项结局指标以及潜在混杂变量（父母职业阶层、母亲教育程度和测量指比时的年龄）的信息。指比通过影印和卡尺法测量。
ASD诊断（病例先前通过记录链接或母亲报告确定）以及在ALSPAC中能最佳组合以预测ASD的4项指标：儿童沟通检查表（连贯性子量表）、社交与沟通障碍检查表、重复行为测量指标以及情绪、活动与社交能力量表（社交能力子量表）。这些指标进行了二分法划分，约10%被定义为“风险”组。
使用逻辑回归，我们研究了2D:4D与ASD以及4个二分法划分的ASD特征之间的关联。协变量为职业阶层、母亲教育程度和测量2D:4D时的年龄。2D:4D与男性ASD无关（平均2D:4D每增加1个标准差的调整后比值比为0.88（95%置信区间0.65至1.21），p = 0.435），与女性ASD也无关（调整后比值比 = 1.36（95%置信区间0.81至2.28），p = 0.245）。调整智商后观察到类似结果。在男性中，连贯性降低与左2D:4D增加之间存在1个微弱关联，与极端男性大脑理论预测的方向相反（调整后比值比 = 1.15（95%置信区间1.02至1.29），p = 0.023）。考虑到多次比较，这与偶然情况相符。
在这项基于人群的研究中，虽然置信区间较宽，但没有强有力的证据表明2D:4D与ASD诊断或特征之间存在关联。这些结果与极端男性大脑理论不一致。
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