King's College London

Research portal

2D:4D ratio in children at familial high-risk for eating disorders: The role of prenatal testosterone exposure

Research output: Contribution to journalArticlepeer-review

Radha Kothari, Joseph Gafton, Janet Treasure, Nadia Micali

Original languageEnglish
Pages (from-to)176-182
Number of pages7
Issue number2
PublishedMar 2014

King's Authors


Markers of prenatal hormone exposure have been associated with the development of eating disorder (ED) behaviors. Our aim was to determine whether 2D:4D ratio, a marker for in utero testosterone exposure, is associated with risk for ED in a large population-based cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods: This is the first study to investigate prenatal testosterone exposure in children at high-risk for ED, using 2D:4D as a marker. We compared children whose mothers reported a lifetime ED (anorexia, bulimia, or both; N = 446) to children whose mothers did not (n = 5,367). Results: Daughters of women with lifetime bulimia nervosa (BN) had lower 2D:4D ratio (B: −0.01, 95% CI: −0.02 to −0.002, P = 0.02), indicating higher prenatal testosterone exposure, than daughters of mothers unaffected by ED. No differences were observed in the male children of women with an ED. Conclusions: Findings suggest that children at high-risk for BN may be exposed to higher levels of testosterone in utero. Fetal exposure to androgen excess is thought to be causal in the development of polycystic ovary syndrome (PCOS), a disorder which is highly comorbid with binge eating and BN. Future research should investigate the potential role of testosterone exposure in utero as a risk factor for BN and binge eating.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454