Association between head circumference and 2D:4D finger ratios in children and adolescents with autism spectrum disorders

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However, the utility of combining these two distinct biological markers as a composite risk factor has not yet been investigated. This descriptive, observational, cross-sectional study included 144 children and adolescents (82% male) with ASD, with measurements of head circumference and finger length for both hands. Correlation, chi-square, and linear regression analyses were conducted to examine associations. Contrary to the traditional Extreme Male Brain hypothesis, we found a significant association between the co-occurrence of macrocephaly and a high (feminized) 2D:4D finger ratio within our cohort. Interestingly, females showed a strong positive correlation between head circumference and the left-hand 2D:4D ratio (rho = 0.629, p = 0.011). Linear regression confirmed that a more feminized left-hand 2D:4D ratio robustly predicts larger head circumference in girls with ASD, explaining 68.08% of the variance. We propose the co-occurrence of macrocephaly and a high 2D:4D ratio as a novel endophenotype for ASD. Our findings support an integrated neurodevelopmental model in which accelerated head growth may be driven by a distinct steroid imbalance, potentially involving maternal estriol (E3) and environmental endocrine disruptors (BPA). This offers a specific, quantifiable, and non-invasive marker for a biologically heterogeneous subgroup within ASD. Introduction Macrocephaly, defined as an unusually large head circumference, is a significant diagnostic concern in pediatric practice and frequently serves as a peripheral biomarker for underlying neurodevelopmental issues [1]. Specifically, its co-occurrence with Autism Spectrum Disorder (ASD) is well-documented [2–4], often reflecting atypical brain growth trajectories in early development. Independent of cranial size, the second-to-fourth finger ratio (2D:4D) has emerged as a widely studied, non-invasive proxy for prenatal androgen exposure. Researchers calculate this ratio by dividing the length of the index finger (2D) by the ring finger (4D). This measure is sexually dimorphic, with lower ratios generally indicating higher prenatal testosterone levels [5]. The Extreme Male Brain theory of ASD posits that elevated prenatal androgens contribute to the autistic phenotype [6]; consequently, a lower 2D:4D ratio has been consistently associated with ASD and related traits [5,7–10]. Despite the established individual links between macrocephaly and ASD and the 2D:4D ratio and ASD, no study has systematically investigated the potential utility of these two distinct biological markers—one reflecting early somatic growth (macrocephaly) and the other reflecting the prenatal hormonal milieu (2D:4D ratio)—as a composite risk factor. We hypothesized that the combination of macrocephaly and an extreme (low) 2D:4D ratio would significantly identify a specific subgroup within the ASD population. This study, therefore, aims to determine the relationship between head circumference, the 2D:4D finger ratio, and the presence of ASD in a pediatric cohort. The study was performed in accordance with the Declaration of Helsinki. This study received approval by the IRB of the institution. Parents received complete information about the procedures and agreed to sign the consent form. Materials and Methods Study design: This is a descriptive, observational, cross-sectional study based on a non-probabilistic sample. Sample: Participants were 144 children and adolescents between 2 and 17 years of age, with a diagnosis of ASD established by the Autism Diagnostic Interview-Revised (ADI-R) of these 85% had head circumference measurement and 71% had photocopies of both hands' ventral surface to measure the second and fourth fingers' length. Procedure: Participants seeking attention for ASD in a child psychiatric hospital were recruited consecutively. They were selected if they met the cutoff criteria of the Autism Diagnostic Interview-Revised (ADI-R) [11]. Children were excluded if they had an associated genetic or metabolic disorder (e.g.: tuberous sclerosis, neurofibromatosis, X fragile syndrome) or sensorial hearing or visual abnormalities. Researchers performed two measurements: 1) The head circumference to determine the cephalic phenotype (normocephaly, microcephaly, or macrocephaly) through the Nellhaus curves. 2) The second and fourth fingers' length through the measurement of the ventral surface of hand photocopies. Measures AUTISM DIAGNOSTIC INTERVIEW-REVIEWED (ADI-R): The Autism Diagnostic Interview-Revised (ADI-R) (Lord et al., 1994) is a semi-structured interview to collect parents' information about their child's development. It is considered the gold standard for diagnosing autism in children and adults of mental age over 18 months. The interview lasts approximately 1.5 to 2.5 hours. It consists of 98 items, divided into a section of open-ended questions and a set of items to assess the domains of reciprocal social interaction and play, communication and language, and stereotypical behaviors and restricted interests. For its interpretation, this interview integrates a diagnostic algorithm for the definition of autism according to ICD 10 and DSM-IV.The cut-off point for the diagnosis of autism is 8 in items of the communication and language domain in verbal subjects and 7 in non-verbal individuals; 10 items in the social interaction domain, and 3 items in the stereotyped behaviors and restricted interests domain. The ADI-R is a reliable and valid instrument for diagnosing autism, with excellent interobserver reliability, with a kappa of 0.62 to 0.89. CEPHALIC PERIMETER ASSESSMENT A researcher measured the cephalic perimeter with a tape placed on the imaginary line that passes just above the edge of the supra-ciliary arch, the highest point of the external auditory canal, and over the external occipital protuberance (the plane of Frankfort). Nellhaus charts for boys and girls were used for classification, plotting the mean head circumference in centimeters or inches, divided by age from 0 months to 18 years [12]. The cephalic phenotype was classified as either macrocephaly, microcephaly, or normocephaly, according to sex- and age-specific normative data. Macrocephaly was defined as a Head Circumference (HC) greater than 2 standard deviations (SD) above the mean. Microcephaly was defined as (HC) less than 2(SD) below the mean. Normocephaly included all cases where (HC) fell within 2 (SD) of the average for their age and sex. FINGER RATIOS 2D:4D We used both hands' ventral surface photocopies to measure the length of the fingers with Vernier calipers, from the proximal fold at its base to the tip. This measurement form has a high degree of repeatability [13] (Maning 1995). The 2D:4D finger ratio is derived by dividing the second and fourth fingers length. It is considered an indirect and non-invasive measure of testosterone levels during pregnancy [5]. Statistical analysis We performed univariate and descriptive analysis of the sample. For quantitative variables, means (M) and standard deviation (SD) were calculated, and a normal distribution was tested with the Shapiro-Wilk test. Dichotomous variables were analyzed by observed sample frequencies by age and gender subgroups. Through a bivariate analysis, the association between continuous variables of the head circumference, age, and finger ratios of both hands were analyzed by calculating the Spearman correlation and testing its validity with a Student t-test. To test the hypothesis of independence between dichotomous variables, we used Pearson's Ji-Square test (χ2), with the 2x2 contingency tables. When the count per cell was less than 5 we used Fisher's exact test. An alpha significance level of 0.05 was considered for all tests, and the R studio statistical package was used for the statistical analyses. We analyzed interrater reliability using intraclass correlation coefficients (ICC) in measurements performed in every 5 cases by 2 different observers. Intraclass correlation coefficients (ICCs) were used to investigate the absolute agreement between and within coders, with values classified as poor (0.00–0.40), fair to good (0.41–0.75), and excellent (>0.75) (Fleiss, 1986). Results The total sample included children and adolescents (N=144), 82% male (n=118), with an age range between 2-17, M=6.89, SD=3.59. CEPHALIC PERIMETER. From the total sample, 84.7% (n=122) had head circumference measure M=52.39 cm, (SD=2.74). By sex the mean head circumference was similar for males M=52.42, (SD= 2.74) and females M=52.23, (SD=2.77) (CI = (-1.174, 1.541), t=0.26, p=0.79). CEPHALIC PERIMETER AND AGE A positive correlation between head circumference and age was demonstrated (rho=0.622, p<0.001) , higher for males (rho=0.627, p<0.001) compared to females (rho=0.556, p<0.001). CEPHALIC PHENOTYPE Most children 77.9% (n=95) with ASD were normocephalic, 19% (n=23) had macrocephaly and fewer microcephaly 3.3% (n=4). Macrocephaly and microcephaly were more common in females 26.3% (n=5) and 5.3% (n=1), compared to males 17.5%, (n=18) and 2.9% (n=3) respectively, without statistical significance (p=0.31). Macrocephaly was highest in the 6-11-year-old range, 28.8% (n=15), followed by the 12-17-year-old range with 15.3% (n=2), and lowest in the 2-5-year-old group with 10.5% (n=6). 2D:4D Finger Ratios. The right hand 2D:4D finger ratio was measured in 70.8% (n=102, 80 male and 22 female), and the left hand 2D:4D finger ratio in 70.1% (n=101, 79 male and 22 female) of the total sample. The inter-observer reliability for the right hand 2D:4D finger ratio was ICC .906 (95% CI= 0.850-0.941), and for the left hand 2D:4D finger ratio was ICC .874 (95% CI= 0.799-0.921). The means for left 2D:4D finger ratio 0.93 (SD=.05), and right 2D:4D finger ratio 0.93 (SD=.04) was similar. By sex, the ratios were very similar: left 2D:4D finger ratio (male: M=0.93, DE=.04; female: M=0.94, DE=.05, p=0.252); right 2D:4D finger ratio (male: M= 0.92, SD=0.04; female: M=0.93, SD=0.04, p=0.345). FINGER RATIOS VS. CEPHALIC PHENOTYPE . Left and right 2D:4D finger ratio were significantly higher in the macrocephalic vs. normocephalic groups. By sex, only females show significantly higher left 2D:4D finger ratio in the macrocephalic vs. normocephalic group (0.95 vs. 0.91) respectively. FINGER RATIOS CORRELATION AND AGE A low positive non-significant correlation between the finger ratio and age was demonstrated for the left 2D:4D finger ratio (rho=0.105) and right hand 2D:4D finger ratio (rho=0.109). By sex, the correlation was higher in females left 2D:4D finger ratio (rho=0.355) right 2D:4D ratio (rho=0.112) compared to males left 2D:4D finger ratio (rho=0.051) and right 2D:4D finger ratio (rho=0.081). CEPHALIC PERIMETER CORRELATION - FINGER RATIOS From the total sample, 80 participants had both measurements (head circumference and finger ratios). Strikingly, females alone showed a moderate-to-strong positive correlation between head circumference and the left-hand 2D:4D finger ratio (rho = 0.629, p = 0.011). Linear regression confirmed that a more feminized left 2D:4D finger ratio robustly predicts larger head circumference in girls with ASD. We found a low positive correlation between head circumference and finger ratios of both hands: left 2D:4D finger ratio, rho=0.10, p>.05, and right 2D:4D finger ratio: rho=0.22, p=0.04. In males the correlation was positive but very low in the left 2D:4D finger ratio: rho=0.006, p>.05, and right 2D:4D finger ratio: rho=0.19, p>.05. In contrast, females showed a moderate positive correlation in both left 2D:4D finger ratio: rho=0.629, p=0.011, and right 2D:4D finger ratio: rho=0.44, p>.05. A linear regression analysis was performed separately for each sex, the dependent variables were head circumference, and the independent variables were age and the finger ratio. Head circumference and age were significantly correlated in both sexes (male sex with p < 0.001, and female sex with p = 0.01), and between the head circumference and the left finger ratios in the female sex. In the model shown in Table 3, the intercept and age contribute significantly to explain the head circumference in males. The model fits statistically significant with a test F=16.93 and p<0.001. Reporting and R2=43.14% total variability of the problem explained by the model. The model shown in Table 4, age and left 2D:4D finger ratio contributes significantly to explaining the head circumference in females. The model fits statistically significant with a test F=10.95 and p<0.001. Reporting and R² =68.08% total variability of the problem explained by the model. Discussion In this study, we investigated the association between the head circumference size and the 2D:4D finger ratio in children with autism spectrum disorder. The prevalence of macrocephaly in children with ASD was 19%, within the range reported by previous studies, 15-35%. [14–16] The prevalence of microcephaly in our study was 3.3%, similar to other reports (Davidovitch et al., 1996a). This low prevalence might reflect a selection bias against microcephaly given its common association with other medical conditions [3,17], and intellectual disability [18], comorbidities commonly excluded in many studies of autism. Macrocephaly and microcephaly were more frequent in girls than in boys, although the difference did not reach statistical significance a pattern consistent with several previous reports [3,17]. However, [4] in an enriched ASD sample with females, found significant differences in the frequency of macrocephaly by sex, suggesting the need to include more females in future studies. Contrary to our hypothesis, we demonstrated that the combined presence of macrocephaly and a high 2D:4D finger ratio is significantly associated with a specific subgroup of children within the ASD population. This finding supports the notion that this subset of ASD cases possesses a distinct biological signature originating during prenatal development. Specifically, females showed a moderately positive significant correlation between the left 2D:4D finger ratio and the head circumference, with a large size effect (d=5.97). These results demonstrate that a feminized (high) left 2D:4D finger ratio strongly predicts macrocephaly in female children with autism. To our knowledge, the present study is the first to directly examine the association between head circumference and 2D:4D finger ratio in ASD. The Macrocephaly-2D:4D Dyad as a Novel Endophenotype We propose the co-occurrence of macrocephaly and a high 2D:4D finger ratio as a novel endophenotype for ASD. Endophenotypes represent measurable biological or behavioral traits that exist on the causal pathway between genetic risk and overt illness. [19]. Individually, macrocephaly reflects early, accelerated brain overgrowth, typically occurring during the second trimester and the first year of life [20,21]. Conversely, the 2D:4D finger ratio provides a stable, lifelong measure of the fetal hormonal environment, primarily reflecting the influence of testosterone during the critical developmental window of 9 to 14 weeks of gestation. [13] Our data demonstrate that combining these two markers—one reflecting accelerated growth and the other reflecting a hormonal signal suggests a shared, underlying pathogenic mechanism. Some studies support our female-specific findings. For example, Whitehouse et al [22] studied 82 female infants with typical development from a large representative birth cohort. They analyzed umbilical-cord blood androgen concentrations (total testosterone, androstenedione, dehydroepiandrosterone, and the sulfated metabolite of dehydroepiandrosterone [DHEAS]) and head circumference from birth to one year of age. At birth, they observed no correlation between head circumference and androgen levels. However, at 12 months of age, they found a significant inverse correlation between total testosterone, free testosterone, delta 4 androstenedione levels, the sulphated metabolite of dehydroepiandrosterone [DHEAS] and head circumference, an association not evident with total body growth. Moreover, several studies suggest a specific influence by estrogen type on cephalic growth, finger ratio, and ASD. For example, Troisi et al. [23] studied estrogen and androgen concentrations in maternal and umbilical cord sera from 86 neurotypical, singletons, uncomplicated pregnancies. Interestingly, they found that measures of birth size, such as weight, length, and head circumference, were positively correlated with DHEAS concentrations in the umbilical cord (r. 0.24-0.41) and with maternal Estriol (E3) (r. 0.25-0.36) but not with other forms of estrogen, such as Estrone (E1) and Estradiol (E2), nor with umbilical cord Estriol (E3) levels. Instead, they found mean differences in the serum of the umbilical cord Estradiol (E2) and Estrone (E1) between head circumference tertiles and significant differences in maternal serum for the levels of Estriol (E3) and head circumference tertiles. Also, maternal Estriol (E3) level was higher when the product of pregnancy was female. Moreover, Mucci et al. also reported a positive relationship between Estriol (E3) maternal serum levels measured during the 16th and 27th gestational week, and the cephalic perimeter of the product at birth, but without statistical significance [24]. In the same direction, Zhang et al [25] reported a positive association between maternal serum Estriol (E3) levels and head circumference in healthy black newborns but not in white newborns. [25] In contrast, Wang et al. demonstrated a negative association between Estradiol (E2) level in cord blood and birth size head circumference. [26] Hormonal Environment: Estriol (E3) and the Cephalic Growth Hypothesis The placenta predominantly produces Estriol (E3) from dehydroepiandrosterone sulfate (DHEAS) elaborated by the fetal adrenal glands (24), while Estriol (E3) is quantitatively the major estrogen in fetal plasma. The established link between the finding of a feminized (high 2D:4D) finger ratio in macrocephalic girls drives a deeper investigation into the broader hormonal milieu. This result suggests that the accelerated cephalic growth in this subgroup might be mediated by estrogen-sensitive mechanisms or by a steroid imbalance distinct from the hyper-androgenic one. Several studies suggest a specific influence of estrogens on head circumference and, potentially, on the 2D:4D finger ratio and the ASD phenotype. This evidence provides strong background support for our finding, as it establishes a specific link between maternal Estriol (E3) and early cephalic growth of the fetus. Similarly, Mucci et al. (2003) [24] reported a positive, albeit statistically insignificant, relationship between maternal serum Estriol (E3) levels (measured during the 16th and 27th gestational week) and the newborn’s cephalic perimeter. In the same direction, Zhang et al. (2007) [25] documented a positive association between maternal serum Estriol (E3) levels and head circumference in healthy black newborns, but not in white newborns. Conversely, Wang et al. (2019) [27]demonstrated a negative association between Estradiol (E2) levels in cord blood and birth size head circumference. The convergence of these findings strongly suggests that the macrocephaly component of our proposed endophenotype originates from a complex, non-linear interaction involving maternal Estriol (E3) and fetal androgen signaling (indexed by 2D:4D). This hormonal interplay drives the accelerated head growth characteristic of a subgroup of children with ASD. Linking Hormonal Dysregulation to Endocrine Disruptors This identified hormonal dysregulation requires further consideration of environmental factors, particularly the endocrine-disrupting chemicals (EDCs) like Bisphenol A (BPA). The established link between Estriol (E3) and cephalic growth implies that any substance interfering with E3 homeostasis could precipitate the macrocephalic phenotype. BPA, ubiquitous in plastics and consumer goods, mimics or antagonizes endogenous hormones. Prenatal exposure to BPA exhibits a strong potential to interfere with both Estriol (E3) synthesis and testosterone metabolism. BPA directly binds to estrogen receptors and alters the expression of key steroidogenic enzymes. Therefore, we speculate that high maternal exposure to EDCs, such as BPA, initiates a cascade of hormonal shifts that simultaneously result in the high 2D:4D finger ratio and the accelerated brain growth underlying macrocephaly, thus characterizing the newly defined ASD endophenotype. Future mechanistic studies must directly measure prenatal testosterone, Estriol (E3), and BPA concentrations in amniotic fluid or cord blood to test this integrated hypothesis. Limitations A primary limitation of this study is the reliance on the 2D:4D finger ratio as an indirect proxy for prenatal androgen/estrogen exposure. This measure is static and cannot definitively confirm the underlying hormonal mechanisms we propose. Future research efforts must therefore prioritize integrating direct hormonal assays (e.g., analysis of amniotic fluid or cord blood) to fully validate the differential estrogenic influence hypothesized for the female macrocephalic ASD phenotype." Despite the small sample size for female participants (n=19) we conducted a post hoc power analysis for the most significant correlation: the association between head circumference and the 2D:4D left finger ratio (r=0.62). The calculated statistical power for this finding was 81.75%. This result exceeds the conventional 80% threshold, reinforcing the robustness and reliability of our key finding regarding the novel female endophenotype. Conclusions We found a significant association between the co-occurrence of macrocephaly and a high 2D:4D finger ratio within our pediatric ASD cohort. 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Total Male Female HC-LFR 0.10 0.006 0.62** HC-RFR 0.22* 0.19 0.44 Age-LFR 0.10 0.05 0.35 Age-RFR 0.10 0.08 0.11 Note: *= <.05, **= |t|) Intercepto 47.387 6.015 7.877 7.877 7.94e-11 *** Age 0.436 0.064 6.791 5.68e-09 *** LFR -6.098 5.133 -1.188 0.24 RFR 8.678 6.252 1.388 0.17 Note: *= 0.05, **= 0.01, ***= 0.001, ‘.’ = 0.1 Formula: Cephalic perimeter = Edad + LFR + RFR Table 4 . Lineal Regression in Females Variables in the model Beta Standard Error t statistic Pr(>|t|) Intercepto 22.956 11.460 2.00 0.070 Age 0.322 0.095 3.36 0.006** LFR 34.792 11.676 2.9 0.012 * RFR -5.445 8.727 -0.6 0.545 Note: *= 0.05, **= 0.01, ***= 0.001, ‘.’ 0.1 Formula: Cephalic Perimeter = Age+ LFR + RFR Additional Declarations No competing interests reported. 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Specifically, its co-occurrence with Autism Spectrum Disorder (ASD) is well-documented [2–4], often reflecting atypical brain growth trajectories in early development.\u003c/p\u003e\n\u003cp\u003eIndependent of cranial size, the second-to-fourth finger ratio (2D:4D) has emerged as a widely studied, non-invasive proxy for prenatal androgen exposure. Researchers calculate this ratio by dividing the length of the index finger (2D) by the ring finger (4D). This measure is sexually dimorphic, with lower ratios generally indicating higher prenatal testosterone levels [5].\u003c/p\u003e\n\u003cp\u003eThe Extreme Male Brain theory of ASD posits that elevated prenatal androgens contribute to the autistic phenotype \u0026nbsp;[6]; consequently, a lower 2D:4D ratio has been consistently associated with ASD and related traits [5,7–10]. Despite the established individual links between macrocephaly and ASD and the 2D:4D ratio and ASD, no study has systematically investigated the potential utility of these two distinct biological markers—one reflecting early somatic growth (macrocephaly) and the other reflecting the prenatal hormonal milieu (2D:4D ratio)—as a composite risk factor.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe hypothesized that the combination of macrocephaly and an extreme (low) 2D:4D ratio would significantly identify a specific subgroup within the ASD population. This study, therefore, aims to determine the relationship between head circumference, the 2D:4D finger ratio, and the presence of ASD in a pediatric cohort.\u003c/p\u003e\n\u003cp\u003eThe study was performed in accordance with the Declaration of Helsinki. This study received approval by the IRB of the institution. Parents received complete information about the procedures and agreed to sign the consent form.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design:\u003c/strong\u003e This is a descriptive, observational, cross-sectional study based on a non-probabilistic sample.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample:\u003c/strong\u003e Participants were 144 children and adolescents between 2 and 17 years of age, with a diagnosis of ASD established by the Autism Diagnostic Interview-Revised (ADI-R) of these 85% had head circumference measurement and 71% had photocopies of both hands' ventral surface to measure the second and fourth fingers' length.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedure:\u003c/strong\u003e Participants seeking attention for ASD in a child psychiatric hospital were recruited consecutively. They were selected if they met the cutoff criteria of the Autism Diagnostic Interview-Revised (ADI-R) [11]. Children were excluded if they had an associated genetic or metabolic disorder (e.g.: tuberous sclerosis, neurofibromatosis, X fragile syndrome) or sensorial hearing or visual abnormalities. Researchers performed two measurements: 1) The head circumference to determine the cephalic phenotype (normocephaly, microcephaly, or macrocephaly) through the Nellhaus curves. 2) The second and fourth fingers' length through the measurement of the ventral surface of hand photocopies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTISM DIAGNOSTIC INTERVIEW-REVIEWED (ADI-R):\u003c/strong\u003e The Autism Diagnostic Interview-Revised (ADI-R) (Lord et al., 1994) is a semi-structured interview to collect parents' information about their child's development. It is considered the gold standard for diagnosing autism in children and adults of mental age over 18 months. The interview lasts approximately 1.5 to 2.5 hours. It consists of 98 items, divided into a section of open-ended questions and a set of items to assess the domains of reciprocal social interaction and play, communication and language, and stereotypical behaviors and restricted interests. For its interpretation, this interview integrates a diagnostic algorithm for the definition of autism according to ICD 10 and DSM-IV.The cut-off point for the diagnosis of autism is 8 in items of the communication and language domain in verbal subjects and 7 in non-verbal individuals; 10 items in the social interaction domain, and 3 items in the stereotyped behaviors and restricted interests domain. The ADI-R is a reliable and valid instrument for diagnosing autism, with excellent interobserver reliability, with a kappa of 0.62 to 0.89.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCEPHALIC PERIMETER ASSESSMENT\u003c/strong\u003e A researcher measured the cephalic perimeter with a tape placed on the imaginary line that passes just above the edge of the supra-ciliary arch, the highest point of the external auditory canal, and over the external occipital protuberance (the plane of Frankfort). Nellhaus charts for boys and girls were used for classification, plotting the mean head circumference in centimeters or inches, divided by age from 0 months to 18 years [12]. The cephalic phenotype was classified as either macrocephaly, microcephaly, or normocephaly, according to sex- and age-specific normative data. \u003cstrong\u003eMacrocephaly\u003c/strong\u003e was defined as a Head Circumference (HC) greater than 2 standard deviations (SD) above the mean. \u003cstrong\u003eMicrocephaly\u003c/strong\u003e was defined as (HC) less than 2(SD) below the mean. \u003cstrong\u003eNormocephaly\u003c/strong\u003e included all cases where (HC) fell within 2 (SD) of the average for their age and sex.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFINGER RATIOS 2D:4D\u003c/strong\u003e We used both hands' ventral surface photocopies to measure the length of the fingers with Vernier calipers, from the proximal fold at its base to the tip. This measurement form has a high degree of repeatability [13] (Maning 1995). The 2D:4D finger ratio is derived by dividing the second and fourth fingers length. It is considered an indirect and non-invasive measure of testosterone levels during pregnancy [5].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e We performed univariate and descriptive analysis of the sample. For quantitative variables, means (M) and standard deviation (SD) were calculated, and a normal distribution was tested with the Shapiro-Wilk test. Dichotomous variables were analyzed by observed sample frequencies by age and gender subgroups. Through a bivariate analysis, the association between continuous variables of the head circumference, age, and finger ratios of both hands were analyzed by calculating the Spearman correlation and testing its validity with a Student t-test. To test the hypothesis of independence between dichotomous variables, we used Pearson's Ji-Square test (χ2), with the 2x2 contingency tables. When the count per cell was less than 5 we used Fisher's exact test. An alpha significance level of 0.05 was considered for all tests, and the R studio statistical package was used for the statistical analyses. We analyzed interrater reliability using intraclass correlation coefficients (ICC) in measurements performed in every 5 cases by 2 different observers. Intraclass correlation coefficients (ICCs) were used to investigate the absolute agreement between and within coders, with values classified as poor (0.00–0.40), fair to good (0.41–0.75), and excellent (\u0026gt;0.75) (Fleiss, 1986).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe total sample included children and adolescents (N=144), 82% male (n=118), with an age range between 2-17, M=6.89, SD=3.59.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCEPHALIC PERIMETER.\u003c/strong\u003e From the total sample, 84.7% (n=122) had head circumference measure M=52.39 cm, (SD=2.74). By sex the mean head circumference was similar for males M=52.42, (SD= 2.74) and females M=52.23, (SD=2.77) (CI = (-1.174, 1.541), t=0.26, p=0.79).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCEPHALIC PERIMETER AND AGE\u003c/strong\u003e A positive correlation between head circumference and age was demonstrated (rho=0.622, p\u0026lt;0.001) , higher for males (rho=0.627, p\u0026lt;0.001) compared to females (rho=0.556, p\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCEPHALIC PHENOTYPE\u003c/strong\u003e Most children 77.9% (n=95) with ASD were normocephalic, 19% (n=23) had macrocephaly and fewer microcephaly 3.3% (n=4). Macrocephaly and microcephaly were more common in females 26.3% (n=5) and 5.3% (n=1), compared to males 17.5%, (n=18) and 2.9% (n=3) respectively, without statistical significance (p=0.31). Macrocephaly was highest in the 6-11-year-old range, 28.8% (n=15), followed by the 12-17-year-old range with 15.3% (n=2), and lowest in the 2-5-year-old group with 10.5% (n=6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2D:4D Finger Ratios.\u003c/strong\u003e The right hand 2D:4D finger ratio was measured in 70.8% (n=102, 80 male and 22 female), and the left hand 2D:4D finger ratio in 70.1% (n=101, 79 male and 22 female) of the total sample. The inter-observer reliability for the right hand 2D:4D finger ratio was ICC .906 (95% CI= 0.850-0.941), and for the left hand 2D:4D finger ratio was ICC .874 (95% CI= 0.799-0.921). The means for left 2D:4D finger ratio 0.93 (SD=.05), and right 2D:4D finger ratio 0.93 (SD=.04) was similar. By sex, the ratios were very similar: left 2D:4D finger ratio (male: M=0.93, DE=.04; female: M=0.94, DE=.05, p=0.252); right 2D:4D finger ratio (male: M= 0.92, SD=0.04; female: M=0.93, SD=0.04, p=0.345).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFINGER RATIOS VS. CEPHALIC PHENOTYPE\u003c/strong\u003e. \u0026nbsp;Left and right 2D:4D finger ratio were significantly higher in the macrocephalic vs. normocephalic groups. By sex, only females show significantly higher left 2D:4D finger ratio in the macrocephalic vs. normocephalic group (0.95 vs. 0.91) respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFINGER RATIOS CORRELATION AND AGE\u003c/strong\u003e A low positive non-significant correlation between the finger ratio and age was demonstrated for the left 2D:4D finger ratio (rho=0.105) and right hand 2D:4D finger ratio (rho=0.109). By sex, the correlation was higher in females left 2D:4D finger ratio (rho=0.355) right 2D:4D ratio (rho=0.112) compared to males left 2D:4D finger ratio (rho=0.051) and right 2D:4D finger ratio (rho=0.081).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCEPHALIC PERIMETER CORRELATION - FINGER RATIOS\u003c/strong\u003e From the total sample, 80 participants had both measurements (head circumference and finger ratios). Strikingly, females alone showed a moderate-to-strong positive correlation between head circumference and the left-hand 2D:4D finger ratio (rho = 0.629, p = 0.011). Linear regression confirmed that a more feminized left 2D:4D finger ratio robustly predicts larger head circumference in girls with ASD. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe found a low positive correlation between head circumference and finger ratios of both hands: left 2D:4D finger ratio, rho=0.10, p\u0026gt;.05, and right 2D:4D finger ratio: rho=0.22, p=0.04.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn males the correlation was positive but very low in the left 2D:4D finger ratio: rho=0.006, p\u0026gt;.05, and right 2D:4D finger ratio: rho=0.19, p\u0026gt;.05. In contrast, females showed a moderate positive correlation in both left 2D:4D finger ratio: rho=0.629, p=0.011, and right 2D:4D finger ratio: rho=0.44, p\u0026gt;.05. A linear regression analysis was performed separately for each sex, the dependent variables were head circumference, and the independent variables were age and the finger ratio. Head circumference and age were significantly correlated in both sexes (male sex with p \u0026lt; 0.001, and female sex with p = 0.01), and between the head circumference and the left finger ratios in the female sex.\u003c/p\u003e\n\u003cp\u003eIn the model shown in Table 3, the intercept and age contribute significantly to explain the head circumference in males. The model fits statistically significant with a test F=16.93 and p\u0026lt;0.001. Reporting and R2=43.14% total variability of the problem explained by the model. The model shown in Table 4, age and left 2D:4D finger ratio contributes significantly to explaining the head circumference in females. The model fits statistically significant with a test F=10.95 and p\u0026lt;0.001. Reporting and R\u0026sup2; =68.08% total variability of the problem explained by the model.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we investigated the association between the head circumference size and the 2D:4D finger ratio in children with autism spectrum disorder. The prevalence of macrocephaly in children with ASD was 19%, within the range reported by previous studies, 15-35%. [14\u0026ndash;16] The prevalence of microcephaly in our study was 3.3%, similar to other reports (Davidovitch et al., 1996a). This low prevalence might reflect a selection bias against microcephaly given its common association with other medical conditions [3,17], and intellectual disability \u0026nbsp;[18], comorbidities commonly excluded in many studies of autism.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMacrocephaly and microcephaly were more frequent in girls than in boys, although the difference did not reach statistical significance a pattern consistent with several previous reports \u0026nbsp;[3,17]. However, [4] in an enriched ASD sample with females, found significant differences in the frequency of macrocephaly by sex, suggesting the need to include more females in future studies.\u003c/p\u003e\n\u003cp\u003eContrary to our hypothesis, we demonstrated that the combined presence of macrocephaly and a high 2D:4D finger ratio is significantly associated with a specific subgroup of children within the ASD population. This finding supports the notion that this subset of ASD cases possesses a distinct biological signature originating during prenatal development.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSpecifically, females showed a moderately positive significant correlation between the left 2D:4D finger ratio and the head circumference, with a large size effect (d=5.97). These results demonstrate that a feminized (high) left 2D:4D finger ratio strongly predicts macrocephaly in female children with autism.\u003c/p\u003e\n\u003cp\u003eTo our knowledge, the present study is the first to directly examine the association between head circumference and 2D:4D\u0026nbsp;finger ratio in ASD.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Macrocephaly-2D:4D Dyad as a Novel Endophenotype\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe propose the co-occurrence of macrocephaly and a high 2D:4D\u0026nbsp;finger ratio as a novel endophenotype for ASD. Endophenotypes represent measurable biological or behavioral traits that exist on the causal pathway between genetic risk and overt illness. [19]. Individually, macrocephaly reflects early, accelerated brain overgrowth, typically occurring during the second trimester and the first year of life\u0026nbsp;[20,21]. Conversely, the 2D:4D\u0026nbsp;finger ratio provides a stable, lifelong measure of the fetal hormonal environment, primarily reflecting the influence of testosterone during the critical developmental window of 9 to 14 weeks of gestation. [13]\u0026nbsp;Our data demonstrate that combining these two markers\u0026mdash;one reflecting accelerated growth and the other reflecting a hormonal signal suggests a shared, underlying pathogenic mechanism.\u003c/p\u003e\n\u003cp\u003eSome studies support our female-specific findings. For example, Whitehouse et al\u0026nbsp;[22]\u0026nbsp;studied 82 female infants with typical development from a large representative birth cohort. They analyzed umbilical-cord blood androgen concentrations (total testosterone, androstenedione, dehydroepiandrosterone, and the sulfated metabolite of dehydroepiandrosterone [DHEAS]) and head circumference from birth to one year of age. At birth, they observed no correlation between head circumference and androgen levels. However, at 12 months of age, they found a significant inverse correlation between total testosterone, free testosterone, delta 4 androstenedione levels, the sulphated metabolite of dehydroepiandrosterone [DHEAS] and head circumference, an association not evident with total body growth.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMoreover, several studies suggest a specific influence by estrogen type on cephalic growth, finger ratio, and ASD. For example, Troisi et al. [23] \u0026nbsp;studied estrogen and androgen concentrations in maternal and umbilical cord sera from 86 neurotypical, singletons, uncomplicated pregnancies. Interestingly, they found that measures of birth size, such as weight, length, and head circumference, were positively correlated with DHEAS concentrations in the umbilical cord (r. 0.24-0.41) and with maternal Estriol (E3) (r. 0.25-0.36) but not with other forms of estrogen, such as Estrone (E1) and Estradiol (E2), nor with umbilical cord Estriol (E3) levels. Instead, they found mean differences in the serum of the umbilical cord Estradiol (E2) and Estrone (E1) between head circumference tertiles and significant differences in maternal serum for the levels of Estriol (E3) and head circumference tertiles. Also, maternal Estriol (E3) level was higher when the product of pregnancy was female.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMoreover, Mucci et al. also reported a positive relationship between Estriol (E3) maternal serum levels measured during the 16th and 27th gestational week, and the cephalic perimeter of the product at birth, but without statistical significance [24].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the same direction, Zhang et al \u0026nbsp;[25] reported a positive association between maternal serum Estriol (E3) levels and head circumference in healthy black newborns but not in white newborns. [25] In contrast, Wang et al. demonstrated a negative association between Estradiol (E2) level in cord blood and birth size head circumference. [26]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHormonal Environment: Estriol (E3) and the Cephalic Growth Hypothesis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe placenta predominantly produces Estriol (E3) from dehydroepiandrosterone sulfate (DHEAS) elaborated by the fetal adrenal glands (24), while Estriol (E3) is quantitatively the major estrogen in fetal plasma.\u003c/p\u003e\n\u003cp\u003eThe established link between the finding of a feminized (high 2D:4D) finger ratio in macrocephalic girls drives a deeper investigation into the broader hormonal milieu. This result suggests that the accelerated cephalic growth in this subgroup might be mediated by estrogen-sensitive mechanisms or by a steroid imbalance distinct from the hyper-androgenic one. Several studies suggest a specific influence of estrogens on head circumference and, potentially, on the 2D:4D finger ratio and the ASD phenotype.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis evidence provides strong background support for our finding, as it establishes a specific link between maternal Estriol (E3) and early cephalic growth of the fetus. Similarly, Mucci et al. (2003)\u0026nbsp;[24]\u0026nbsp;reported a positive, albeit statistically insignificant, relationship between maternal serum Estriol (E3) levels (measured during the 16th and 27th gestational week) and the newborn\u0026rsquo;s cephalic perimeter. In the same direction, Zhang et al. (2007)\u0026nbsp;[25]\u0026nbsp;documented a positive association between maternal serum Estriol (E3) levels and head circumference in healthy black newborns, but not in white newborns. Conversely, Wang et al. (2019)\u0026nbsp;[27]demonstrated a negative association between Estradiol (E2) levels in cord blood and birth size head circumference.\u003c/p\u003e\n\u003cp\u003eThe convergence of these findings strongly suggests that the macrocephaly component of our proposed endophenotype originates from a complex, non-linear interaction involving maternal Estriol (E3) and fetal androgen signaling (indexed by 2D:4D). This hormonal interplay drives the accelerated head growth characteristic of a subgroup of children with ASD.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLinking Hormonal Dysregulation to Endocrine Disruptors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis identified hormonal dysregulation requires further consideration of environmental factors, particularly the endocrine-disrupting chemicals (EDCs) like Bisphenol A (BPA). The established link between Estriol (E3) and cephalic growth implies that any substance interfering with E3 homeostasis could precipitate the macrocephalic phenotype. BPA, ubiquitous in plastics and consumer goods, mimics or antagonizes endogenous hormones. Prenatal exposure to BPA exhibits a strong potential to interfere with both Estriol (E3) synthesis and testosterone metabolism. BPA directly binds to estrogen receptors and alters the expression of key steroidogenic enzymes. Therefore, we speculate that high maternal exposure to EDCs, such as BPA, initiates a cascade of hormonal shifts that simultaneously result in the high 2D:4D finger ratio and the accelerated brain growth underlying macrocephaly, thus characterizing the newly defined ASD endophenotype. Future mechanistic studies must directly measure prenatal testosterone, Estriol (E3), and BPA concentrations in amniotic fluid or cord blood to test this integrated hypothesis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA primary limitation of this study is the reliance on the 2D:4D finger ratio as an indirect proxy for prenatal androgen/estrogen exposure. This measure is static and cannot definitively confirm the underlying hormonal mechanisms we propose. Future research efforts must therefore prioritize integrating direct hormonal assays (e.g., analysis of amniotic fluid or cord blood) to fully validate the differential estrogenic influence hypothesized for the female macrocephalic ASD phenotype.\u0026quot;\u003c/p\u003e\n\u003cp\u003eDespite the small sample size for female participants (n=19) we conducted a post hoc power analysis for the most significant correlation: the association between head circumference and the 2D:4D left finger ratio (r=0.62). The calculated statistical power for this finding was 81.75%. This result exceeds the conventional 80% threshold, reinforcing the robustness and reliability of our key finding regarding the novel female endophenotype.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eWe found a significant association between the co-occurrence of macrocephaly and a high 2D:4D finger ratio within our pediatric ASD cohort. This co-occurrence establishes a specific, quantifiable, and non-invasive endophenotype that reflects atypical prenatal development involving both somatic growth acceleration and extreme fetal hormonal milieu. Our findings support an integrated neurodevelopmental model where hormonal factors, possibly including the influence of maternal Estriol (E3) and environmental endocrine disruptors (BPA), contribute to the accelerated head growth characteristic of a subgroup of children with ASD.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eL. Albores Gallo, F. Volkmar, Macrocephaly Phenotype and Psychiatric Comorbidity in Autism Spectrum Disorder, in: F.R. Volkmar (Ed.), Encycl. Autism Spectr. Disord., Springer New York, New York, NY, 2020: pp. 1\u0026ndash;4. https://doi.org/10.1007/978-1-4614-6435-8_102370-1.\u003c/li\u003e\n\u003cli\u003eM. Davidovitch, B. Patterson, P. Gartside, Head Circumference Measurements in Children With Autism, J. 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He, PFOS, PFOA, estrogen homeostasis, and birth size in Chinese infants, Chemosphere 221 (2019) 349\u0026ndash;355. https://doi.org/10.1016/j.chemosphere.2019.01.061.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cimg 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\" width=\"526\" height=\"768\"\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Correlation of finger ratio with head circumference and age.\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHC-LFR\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.10\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e0.006\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.62**\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHC-RFR\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.22*\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e0.19\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.44\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge-LFR\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.10\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e0.05\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.35\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge-RFR\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.10\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e0.08\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.11\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eNote:\u003c/em\u003e\u003c/strong\u003e *= \u0026lt;.05, **= \u0026lt;.01, HC= head circumference, LFR = left finger ratio \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRFR: right finger ratio,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eLinear Regression in Males\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eVariables in the model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eBeta\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eStandard error\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;t statistic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003ePr(\u0026gt;|t|)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eIntercepto\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e47.387\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e6.015\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e7.877\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e7.877 7.94e-11 ***\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.436\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.064\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e6.791\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e5.68e-09 ***\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eLFR\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-6.098\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e5.133\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-1.188\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e0.24\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eRFR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e8.678\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e6.252\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e1.388\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e0.17\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 623px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eNote:\u003c/em\u003e\u003c/strong\u003e *= 0.05, \u0026nbsp;**= 0.01, \u0026nbsp; ***= 0.001, \u0026nbsp; \u0026lsquo;.\u0026rsquo; = 0.1\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFormula: Cephalic perimeter = Edad + LFR + RFR\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 . Lineal Regression in Females\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eVariables in the model\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eBeta\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eStandard Error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;t statistic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003ePr(\u0026gt;|t|)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eIntercepto\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e22.956\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e11.460\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.070\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.095\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e3.36\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;0.006**\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; LFR\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e34.792\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e11.676\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e2.9\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0.012 *\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eRFR\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-5.445\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e8.727\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-0.6\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.545\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 588px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eNote:\u003c/em\u003e\u003c/strong\u003e *= 0.05, \u0026nbsp;**= 0.01, \u0026nbsp; ***= 0.001, \u0026nbsp; \u0026lsquo;.\u0026rsquo; 0.1\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFormula: Cephalic Perimeter = Age+ LFR + RFR \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8338452/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8338452/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Macrocephaly and the second-to-fourth digit ratio (2D:4D), a non-invasive proxy for prenatal androgen exposure, are independent biomarkers associated with Autism Spectrum Disorder (ASD). However, the utility of combining these two distinct biological markers as a composite risk factor has not yet been investigated.\nThis descriptive, observational, cross-sectional study included 144 children and adolescents (82% male) with ASD, with measurements of head circumference and finger length for both hands. Correlation, chi-square, and linear regression analyses were conducted to examine associations.\nContrary to the traditional Extreme Male Brain hypothesis, we found a significant association between the co-occurrence of macrocephaly and a high (feminized) 2D:4D finger ratio within our cohort. Interestingly, females showed a strong positive correlation between head circumference and the left-hand 2D:4D ratio (rho = 0.629, p = 0.011). Linear regression confirmed that a more feminized left-hand 2D:4D ratio robustly predicts larger head circumference in girls with ASD, explaining 68.08% of the variance.\nWe propose the co-occurrence of macrocephaly and a high 2D:4D ratio as a novel endophenotype for ASD. Our findings support an integrated neurodevelopmental model in which accelerated head growth may be driven by a distinct steroid imbalance, potentially involving maternal estriol (E3) and environmental endocrine disruptors (BPA). This offers a specific, quantifiable, and non-invasive marker for a biologically heterogeneous subgroup within ASD.\n ","manuscriptTitle":"Association between head circumference and 2D:4D finger ratios in children and adolescents with autism spectrum disorders","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-12 06:34:34","doi":"10.21203/rs.3.rs-8338452/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"65aa5154-f939-4b72-9363-59c853a955dc","owner":[],"postedDate":"December 12th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-02T01:38:51+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-12 06:34:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8338452","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8338452","identity":"rs-8338452","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}