{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T13:39:38Z","timestamp":1788010778695,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hum Biol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The pronounced female preponderance in Sj\u00f6gren's syndrome (SS) points to a potential role for sex hormones in disease development. The ratio of the second to fourth digit (2D:4D), which serves as an indirect marker of fetal androgen exposure, has shown associations with several immune\u2010mediated conditions. The present study assessed whether 2D:4D ratios are lower in women diagnosed with SS relative to healthy individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this case\u2013control investigation, 57 female SS patients (classified per the 2016 ACR\/EULAR criteria) and 44 age\u2010matched healthy women were recruited. The lengths of the index and ring fingers were measured on both hands with digital calipers, and digit ratios were derived. Group comparisons were conducted with Welch's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test and supplemented by Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      \u2010tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Women with SS had lower 2D:4D ratios on both sides (right: 0.938\u2009\u00b1\u20090.030 vs. 1.011\u2009\u00b1\u20090.024,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; left: 0.925\u2009\u00b1\u20090.034 vs. 1.009\u2009\u00b1\u20090.026,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The observed effect sizes were large (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009&gt;\u20092.6). Lower ratios were driven predominantly by elongated ring fingers rather than shortened index fingers, a pattern compatible with heightened fetal androgen exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women with primary SS exhibit lower 2D:4D digit ratios compared with healthy controls, suggesting that a shifted prenatal estrogen\u2010to\u2010androgen balance may prime the immune system toward the glandular autoimmunity and exocrine dysfunction that define this disease. These findings implicate the prenatal hormonal milieu as a potential contributor to the immunological processes underlying SS pathogenesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajhb.70257","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:27:12Z","timestamp":1775802432000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The\n                    <scp>2D<\/scp>\n                    :\n                    <scp>4D<\/scp>\n                    Digit Ratio and Primary Sj\u00f6gren's Syndrome: A Window Into Prenatal Hormonal Influences on Exocrine Autoimmunity"],"prefix":"10.1002","volume":"38","author":[{"given":"Mustafa","family":"G\u00fcr","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Faculty of Medicine Firat University  Elazig Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramazan Fazil","family":"Akkoc","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine Firat University  Elazig Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burak","family":"Oz","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Faculty of Medicine Firat University  Elazig Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6725-4182","authenticated-orcid":false,"given":"Ahmet","family":"Karatas","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Faculty of Medicine Firat University  Elazig Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00fcleyman Serdar","family":"Koca","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Faculty of Medicine Firat University  Elazig 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