{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:13:36Z","timestamp":1788531216144,"version":"build-2803163510"},"reference-count":30,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Early Human Development"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.earlhumdev.2026.106608","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:03:15Z","timestamp":1781136195000},"page":"106608","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Higher 2d:4d digit ratios are associated with adolescent idiopathic scoliosis and correlate linearly with cobb angle severity: A sex-stratified case-control study"],"prefix":"10.1016","volume":"222","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3685-1865","authenticated-orcid":false,"given":"Mustafa","family":"Is\u0131k","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1036-6710","authenticated-orcid":false,"given":"Beytullah","family":"Unat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0691-1289","authenticated-orcid":false,"given":"Nevzat","family":"G\u00f6nder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7164-3156","authenticated-orcid":false,"given":"Onur","family":"Kaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4243-5218","authenticated-orcid":false,"given":"Cansu","family":"Ozturk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8716-3472","authenticated-orcid":false,"given":"Rabia","family":"Tasdemir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.earlhumdev.2026.106608_bb0005","doi-asserted-by":"crossref","first-page":"784","DOI":"10.21037\/atm-20-3171","article-title":"Lower androgen levels promote abnormal cartilage development in female patients with adolescent idiopathic scoliosis","volume":"9","author":"Wu","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0010","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.67781","article-title":"An adhesion G protein-coupled receptor is required in cartilaginous and dense connective tissues to maintain spine alignment","volume":"10","author":"Liu","year":"2021","journal-title":"eLife"},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0015","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/S0306-9877(02)00400-0","article-title":"Finger and toe ratios in humans and mice: implications for the aetiology of diseases influenced by HOX genes","volume":"60","author":"Manning","year":"2003","journal-title":"Med. Hypotheses"},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0020","doi-asserted-by":"crossref","first-page":"3000","DOI":"10.1093\/humrep\/13.11.3000","article-title":"The ratio of 2nd to 4th digit length: a predictor of sperm numbers and concentrations of testosterone, luteinizing hormone and oestrogen","volume":"13","author":"Manning","year":"1998","journal-title":"Hum. Reprod."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0025","doi-asserted-by":"crossref","DOI":"10.1016\/j.earlhumdev.2024.105972","article-title":"Association between the digit ratio (2D:4D), handgrip strength, wrist ratio, and body fat distribution in women with different carpal tunnel syndrome severity","volume":"190","author":"Aky\u0131ld\u0131z","year":"2024","journal-title":"Early Hum. Dev."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0030","doi-asserted-by":"crossref","DOI":"10.1016\/j.earlhumdev.2023.105901","article-title":"Digit ratio and the femoral circumflex artery perforator: a sex-dependent association between the vascular system of the thigh and prenatal sex hormones?","volume":"188","author":"Kasielska-Trojan","year":"2024","journal-title":"Early Hum. Dev."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0035","doi-asserted-by":"crossref","DOI":"10.1016\/j.earlhumdev.2025.106250","article-title":"The role of prenatal testosterone-estrogen balance in the development of Os trigonum: a comparative matched-pair analysis","volume":"204","author":"Tokgoz","year":"2025","journal-title":"Early Hum. Dev."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0040","doi-asserted-by":"crossref","DOI":"10.1016\/j.earlhumdev.2023.105890","article-title":"Is prenatal testosterone-estrogen balance related to critical shoulder angle?","volume":"187","author":"Yaka","year":"2023","journal-title":"Early Hum. Dev."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0045","doi-asserted-by":"crossref","DOI":"10.1016\/j.earlhumdev.2025.106319","article-title":"Is prenatal testosterone-estrogen balance related to enchondroma?","volume":"208","author":"Ya\u015f","year":"2025","journal-title":"Early Hum. Dev."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0050","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1477-7827-4-10","article-title":"The use of digit ratios as markers for perinatal androgen action","volume":"4","author":"McIntyre","year":"2006","journal-title":"Reprod. Biol. Endocrinol."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0055","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3389\/fendo.2014.00009","article-title":"Digit ratio (2D:4D): a biomarker for prenatal sex steroids and adult sex steroids in challenge situations","volume":"5","author":"Manning","year":"2014","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0060","doi-asserted-by":"crossref","first-page":"72","DOI":"10.3390\/sym9050072","article-title":"Androgen levels and body size are associated with directional as well as fluctuating asymmetry patterns in adult! Kung san and Kavango males from northern Namibia","volume":"9","author":"Kirchengast","year":"2017","journal-title":"Symmetry"},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0065","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1007\/s00586-023-07566-y","article-title":"Vitamin D and adolescent idiopathic scoliosis, should we stop the hype? A cross-sectional observational prospective study based on a geometric morphometrics approach","volume":"32","author":"Gonz\u00e1lez-Ruiz","year":"2023","journal-title":"Eur. Spine J."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0070","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.2174\/1874325001711011466","article-title":"Etiological theories of adolescent idiopathic scoliosis: past and present","volume":"11","author":"Fadzan","year":"2017","journal-title":"Open Orthop. J."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0075","doi-asserted-by":"crossref","DOI":"10.1186\/s12872-026-05786-w","article-title":"Association between right-hand 2D:4D ratio and left main coronary artery stenosis in women","volume":"26","author":"Y\u0131ld\u0131r\u0131m","year":"2026","journal-title":"BMC Cardiovasc. Disord."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0080","doi-asserted-by":"crossref","first-page":"4039","DOI":"10.1007\/s10508-025-03254-8","article-title":"Radiologically assessed sex-specific left-hand digit ratio (2D:4D) in Caucasian children and adolescents from South Germany","volume":"54","author":"Schiergens","year":"2025","journal-title":"Arch. Sex. Behav."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0085","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/s13018-025-05620-7","article-title":"A deep learning model for radiological measurement of adolescent idiopathic scoliosis using biplanar radiographs","volume":"20","author":"Xie","year":"2025","journal-title":"J. Orthop. Surg. Res."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0090","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/6357171","article-title":"Cobb angle measurement of spine from X-ray images using convolutional neural network","volume":"2019","author":"Horng","year":"2019","journal-title":"Comput. Math. Methods Med."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0095","doi-asserted-by":"crossref","first-page":"519","DOI":"10.31616\/asj.2018.0096","article-title":"Etiology of adolescent idiopathic scoliosis: a literature review","volume":"13","author":"Kikanloo","year":"2019","journal-title":"Asian Spine J."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0100","first-page":"98","article-title":"Omurga Geli\u015fimi ve Genetik Kontrol","volume":"12","author":"Ba\u011fr\u0131yan\u0131k","year":"2021","journal-title":"J. Turk. Spin. Surg."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0105","doi-asserted-by":"crossref","DOI":"10.12659\/MSM.940864","article-title":"Pubertal stage-dependent anthropometric variations in Turkish children with adolescent idiopathic scoliosis: an in-depth analysis","volume":"29","author":"Bala","year":"2023","journal-title":"Med. Sci. Monit."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0110","doi-asserted-by":"crossref","DOI":"10.12659\/MSM.940355","article-title":"Association among complete blood count parameters, bone mineral density, and cobb angle in cases of adolescent idiopathic scoliosis","volume":"29","author":"Bala","year":"2023","journal-title":"Med. Sci. Monit."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0115","article-title":"2D: 4D digit ratio, bilateral asymmetry, and insulin resistance in women with obesity","volume":"217","author":"Yurtsever","year":"2026","journal-title":"Early Hum. Dev."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0120","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.995025","article-title":"Right-left digit ratios, a novel form of asymmetry: patterns of instability in children and relationships to platelet counts and hospitalization in adults with COVID-19","volume":"10","author":"Kasielska-Trojan","year":"2022","journal-title":"Front. Public Health"},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0125","doi-asserted-by":"crossref","first-page":"4573","DOI":"10.1038\/s41598-022-08646-7","article-title":"Digit ratios and their asymmetries as risk factors of developmental instability and hospitalization for COVID-19","volume":"12","author":"Kasielska-Trojan","year":"2022","journal-title":"Sci. Rep."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0130","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.psyneuen.2004.10.006","article-title":"Fluctuating asymmetry, second to fourth finger length ratios and human sexual orientation","volume":"30","author":"Rahman","year":"2005","journal-title":"Psychoneuroendocrinology"},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0135","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s10508-007-9282-0","article-title":"Sexual orientation and fluctuating asymmetry in men and women","volume":"37","author":"Hall","year":"2008","journal-title":"Arch. Sex. Behav."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0140","doi-asserted-by":"crossref","DOI":"10.1016\/j.earlhumdev.2020.105293","article-title":"The effects of hand preference and sex on right-left asymmetry in dorsal digit lengths among adults and children","volume":"153","author":"Kumar","year":"2021","journal-title":"Early Hum. Dev."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0145","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/j.1469-7580.2008.00940.x","article-title":"Human 2D (index) and 4D (ring) finger lengths and ratios: cross-sectional data on linear growth patterns, sexual dimorphism and lateral asymmetry from 4 to 60 years of age","volume":"213","author":"Gillam","year":"2008","journal-title":"J. Anat."},{"key":"10.1016\/j.earlhumdev.2026.106608_bb0150","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13018-024-05383-7","article-title":"Intelligent measurement of adolescent idiopathic scoliosis x-ray coronal imaging parameters based on VB-net neural network: a retrospective analysis of 2092 cases","volume":"20","author":"Liu","year":"2025","journal-title":"J. Orthop. Surg. Res."}],"container-title":["Early Human Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0378378226001337?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0378378226001337?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:19:16Z","timestamp":1788527956000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0378378226001337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":30,"alternative-id":["S0378378226001337"],"URL":"https:\/\/doi.org\/10.1016\/j.earlhumdev.2026.106608","relation":{},"ISSN":["0378-3782"],"issn-type":[{"value":"0378-3782","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Higher 2d:4d digit ratios are associated with adolescent idiopathic scoliosis and correlate linearly with cobb angle severity: A sex-stratified case-control study","name":"articletitle","label":"Article Title"},{"value":"Early Human Development","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.earlhumdev.2026.106608","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"106608"}}