Prenatal Hormonal Markers and Sleep Characteristics in Young Adults With Joint Hypermobility

Nigde Omer Halisdemir University

Status: Completed

Conditions: Joint Hypermobility; Androgen Effect; Healty Controls; Hormonal; Sleep

Treatments: Behavioral: The Beighton Scoring system; Behavioral: 2D:4D Digit Ratio

Study type: Observational

Funder types: Other

Identifiers

NCT07157930

Joint Hypermobility and 2D:4D

Details and patient eligibility

About

Joint hypermobility is a clinical condition characterized by joints having a range of motion beyond their normal limits. Hormonal factors are thought to play a role in the development of joint hypermobility. One of the most significant indicators of prenatal androgen exposure is considered the ratio of the lengths of the second and fourth fingers (2D:4D). The 2D:4D digit ratio refers to the ratio of the lengths of the second finger (2D; index digit ) and the fourth finger (4D; ring digit). Evidence suggests that the 2D:4D ratio is developmentally stable and stabilizes from the second trimester of pregnancy onward.

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.

Full description

Estrogen affects collagen metabolism and connective tissue structure, which can lead to increased ligament laxity at high levels. Increased estrogen and progesterone during pregnancy cause significant loosening of connective tissue, which can contribute to temporary joint hypermobility. Physiological conditions such as pregnancy and menopause can cause hormonal changes, increasing the risk of joint hypermobility through fluid retention and connective tissue changes.

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.

Enrollment: 180 patients

Sex: All

Ages: 18 to 35 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Individuals aged 18-35
• 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 with any pathology related to the musculoskeletal system
• 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

Trial design

180 participants in 2 patient groups

Young Adults With Joint Hypermobility

Description:

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.

Treatment:

Behavioral: 2D:4D Digit Ratio

Behavioral: The Beighton Scoring system

Healthy Controls (without joint hypermobility)

Description:

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.

Treatment:

Behavioral: 2D:4D Digit Ratio

Behavioral: The Beighton Scoring system