Prenatal Hormonal Markers and Sleep Characteristics in Young Adults With Joint Hypermobility
NCT ID: NCT07157930
Last Updated: 2025-12-24
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
180 participants
OBSERVATIONAL
2025-08-20
2025-12-17
Brief Summary
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To our knowledge, intrauterine androgen exposure (2D:4D) has not been examined in populations with joint hypermobility.
Therefore, the planned study aimed to examine the 2D:4D digit ratio in young adults with joint hypermobility and compare it with that of individuals without joint hypermobility.
Detailed Description
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Testosterone, on the other hand, is a hormone that strengthens muscle mass and tendon structure, while at low levels it can cause connective tissue to remain looser. Therefore, the combination of high estrogen and relatively low testosterone, particularly in women of reproductive age, may contribute to the higher prevalence of hypermobility.
Therefore, the aim of the planned study was to examine the 2D:4D digit ratio in young adults with joint hypermobility and compare this ratio with individuals without joint hypermobility.
Conditions
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Keywords
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Study Design
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CASE_CONTROL
PROSPECTIVE
Study Groups
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Young Adults With Joint Hypermobility
Joint hypermobility makes individuals more vulnerable to trauma through increased joint range of motion, changes in neuromuscular reflexes, and decreased joint position sense. The Beighton Scoring system is widely used to distinguish individuals with generalized joint hypermobility from those without.In adults up to 50 years of age, a score of ≥5 out of 9 indicates hypermobility, while in adults over 50, a score of ≥4 out of 9 is considered positive for hypermobility.
The study will include young adults aged 18-35 with joint hypermobility. It has been reported in the literature that estrogen may be associated with connective tissue laxity and joint hypermobility. The 2D:4D digit ratio will be assessed and compared with young adults without joint hypermobility.
The Beighton Scoring system
The Beighton Scoring System is widely used to distinguish individuals with generalized joint hypermobility from those without. The Beighton Scoring System consists of: • Passive dorsiflexion of the fifth metacarpophalangeal joint • Passive hyperextension of the elbow • Passive hyperextension of the knee joint • Passive placement of the thumb on the flexor side of the forearm • Forward flexion of the trunk In adults up to 50 years of age, a score of ≥5 out of 9 indicates joint hypermobility, while in adults over 50, a score of ≥4 out of 9 is considered positive for joint hypermobility.
2D:4D Digit Ratio
The lengths of the second (2D) and fourth (4D) digits will be measured separately on both hands. Measurements will be taken with the participants' hands placed on a flat surface with the palms facing upward. Digit length will be defined as the distance from the midpoint of the proximal crease at the base of the finger to the distal tip of the finger. A digital caliper with a precision of 0.01 mm will be used, and two separate measurements will be obtained for each finger, with the mean value recorded. Based on these measurements, the 2D:4D digit ratio will be calculated for each hand by dividing the length of the second digit by that of the fourth digit. To enhance reliability, assessments will be performed independently by two different researchers, and inter-rater agreement will be evaluated.
Healthy Controls (without joint hypermobility)
This group consisted of individuals without generalized joint hypermobility, confirmed by a Beighton score below the diagnostic cut-off. This study will include young adults aged 18-35 who do not have joint hypermobility.The Beighton Scoring system is widely used to distinguish individuals with generalized joint hypermobility from those without.In adults up to 50 years of age, a score of ≥5 out of 9 indicates hypermobility, while in adults over 50, a score of ≥4 out of 9 is considered positive for hypermobility. Individuals with musculoskeletal, neurological, or systemic conditions that may affect joint mobility will be excluded from the study.
The Beighton Scoring system
The Beighton Scoring System is widely used to distinguish individuals with generalized joint hypermobility from those without. The Beighton Scoring System consists of: • Passive dorsiflexion of the fifth metacarpophalangeal joint • Passive hyperextension of the elbow • Passive hyperextension of the knee joint • Passive placement of the thumb on the flexor side of the forearm • Forward flexion of the trunk In adults up to 50 years of age, a score of ≥5 out of 9 indicates joint hypermobility, while in adults over 50, a score of ≥4 out of 9 is considered positive for joint hypermobility.
2D:4D Digit Ratio
The lengths of the second (2D) and fourth (4D) digits will be measured separately on both hands. Measurements will be taken with the participants' hands placed on a flat surface with the palms facing upward. Digit length will be defined as the distance from the midpoint of the proximal crease at the base of the finger to the distal tip of the finger. A digital caliper with a precision of 0.01 mm will be used, and two separate measurements will be obtained for each finger, with the mean value recorded. Based on these measurements, the 2D:4D digit ratio will be calculated for each hand by dividing the length of the second digit by that of the fourth digit. To enhance reliability, assessments will be performed independently by two different researchers, and inter-rater agreement will be evaluated.
Interventions
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The Beighton Scoring system
The Beighton Scoring System is widely used to distinguish individuals with generalized joint hypermobility from those without. The Beighton Scoring System consists of: • Passive dorsiflexion of the fifth metacarpophalangeal joint • Passive hyperextension of the elbow • Passive hyperextension of the knee joint • Passive placement of the thumb on the flexor side of the forearm • Forward flexion of the trunk In adults up to 50 years of age, a score of ≥5 out of 9 indicates joint hypermobility, while in adults over 50, a score of ≥4 out of 9 is considered positive for joint hypermobility.
2D:4D Digit Ratio
The lengths of the second (2D) and fourth (4D) digits will be measured separately on both hands. Measurements will be taken with the participants' hands placed on a flat surface with the palms facing upward. Digit length will be defined as the distance from the midpoint of the proximal crease at the base of the finger to the distal tip of the finger. A digital caliper with a precision of 0.01 mm will be used, and two separate measurements will be obtained for each finger, with the mean value recorded. Based on these measurements, the 2D:4D digit ratio will be calculated for each hand by dividing the length of the second digit by that of the fourth digit. To enhance reliability, assessments will be performed independently by two different researchers, and inter-rater agreement will be evaluated.
Eligibility Criteria
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Inclusion Criteria
* Individuals who scored 5 out of 9 or higher on the Beighton score
* Control group: Those with a Beighton score of ≤ 4
Exclusion Criteria
* Individuals diagnosed with metabolic, neurological, or genetic diseases (tissue diseases such as Ehlers-Danlos syndrome and Marfan syndrome)
* Those with a history of surgery within the last 6 months
* Those who are pregnant or breastfeeding
18 Years
35 Years
ALL
Yes
Sponsors
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Nigde Omer Halisdemir University
OTHER
Responsible Party
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Rabia ZORLULAR
principal investigator
Locations
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Nigde Omer Halisdemir University
Niğde, , Turkey (Türkiye)
Countries
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References
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Fink B, Manning JT, Neave N. The 2nd-4th digit ratio (2D:4D) and neck circumference: implications for risk factors in coronary heart disease. Int J Obes (Lond). 2006 Apr;30(4):711-4. doi: 10.1038/sj.ijo.0803154.
Engelbert RH, Bank RA, Sakkers RJ, Helders PJ, Beemer FA, Uiterwaal CS. Pediatric generalized joint hypermobility with and without musculoskeletal complaints: a localized or systemic disorder? Pediatrics. 2003 Mar;111(3):e248-54. doi: 10.1542/peds.111.3.e248.
Smits-Engelsman B, Klerks M, Kirby A. Beighton score: a valid measure for generalized hypermobility in children. J Pediatr. 2011 Jan;158(1):119-23, 123.e1-4. doi: 10.1016/j.jpeds.2010.07.021. Epub 2010 Sep 17.
Gruber PC, Fuller LC. Lipoatrophy semicircularis induced by trauma. Clin Exp Dermatol. 2001 May;26(3):269-71. doi: 10.1046/j.1365-2230.2001.00812.x.
Other Identifiers
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Joint Hypermobility and 2D:4D
Identifier Type: -
Identifier Source: org_study_id