Gizem Melissa KOCAMAN, RECEP ÖZMERDİVENLİ, ÇİĞDEM YEKTAŞ, Semih BOLU, Yunus Emre HASKILIÇ, AYTEN ERDOĞAN

Konjenital adrenal hiperplazisi olan çocuk ve ergenlerde otistik özellikler ve 2D:4D parmak oranlarının ilişkisi

Amaç: Hem konjenital adrenal hiperplazi (KAH), hem de otizm spektrum bozukluğu (OSB) çok nadir olarak görüldüğünden, KAH olan çocuk ve ergenlerde OSB görülme oranının artmış olup olmadığını saptamak güçtür. KAH ile OSB'nin düşük 2D:4D parmak oranları arasında ilişki olabileceği bildirilmiştir. Bu çalışmada KAH olan çocuk ve ergenlerde ve normal kontrol grubu çocuklarda OSB ve 2D:4D parmak oranları arasındaki ilişkinin belirlenmesi amaçlandı. Yöntem: Çalışmaya, 3-18 yaşları arasında, Düzce Üniversitesi ve Erciyes Üniversitesi Tıp Fakültesi Hastanesi Çocuk Endokrinolojisi bölümünde izlenen klasik KAH tanısı konmuş otuz çocuk ve ergen alındı. Kontrol grubuna yaş ve cinsiyet açısından hasta grubuyla bire bir eşleştirilmiş 30 sağlıklı çocuk ve ergen alınmıştır. Araştırma kapsamındaki çocuk ve ergenlerin anne-babalarının Otizm Davranış Kontrol Listesi (Autism Behavior Checklist-ABC) ve sosyodemografik veri formunu doldurmaları sağlandı. Sosyodemografik veri formunda olgunun yaş, cinsiyet, annenin gebeliği sırasında yaşadığı psikiyatrik ve fiziksel sorunlar, sigara, alkol kullanım öyküleri, aldığı ilaç ve tedaviler, gebelik komplikasyonları, erken ve zor doğum öyküsü sorgulandı. Çalışmaya alınan tüm olgularla psikiyatrik eş tanıları dışlamak amacıyla klinik görüşme yapıldı. Bulgular: KAH ve kontrol grubunun sağ ve sol el 2D:4D oranları karşılaştırıldığında, KAH'lı grupta sağ el 2D:4D oranı istatistiksel olarak anlamlı düzeyde düşük saptandı. KAH grubu, kontrol grubu ile karşılaştırıldığında, KAH grubu ABC ölçeği puanları istatistiksel olarak anlamlı düzeyde yüksek bulundu. KAH'li grupta ABC ölçeği puanları ile sağ el 2D:4D oranları arasında pozitif korelasyon saptandı. Sonuç: Çalışmamızda elde edilen sonuçlara göre, düşük sağ el 2D:4D oranı ile OSB'nin etiyolojisinde testosteron hormonunun rolünün olabileceği şeklinde yorumlanabilir. Gelecekte sadece her iki cinsiyetteki çocuk ve ergenlerin alt tip dağılımındaki sayıları artırılarak yapılacak çalışmaların bu ilişkilerin daha iyi tanımlanabilmesi açısından önemli olabileceğini düşünmekteyiz.

Autistic feature and 2D:4D finger ratio relations children and adolescents with congenital adrenal hyperplasia

Objective: Because congenital adrenal hiperplazi (CAH) and autism spectrum sisorders (ASD) is rarely seen, it is difficult to assess whether the increased incidence of ASD in girls with CAH. ASD behaviors and 2D:4D finger ratio changes in patients with androgen overproduction have been reported. The aim of this study is determining the 2D:4D finger ratios and ASD features in girls with CAH and normal control group. Methods: The study group will consist of thirty female children and adolescents between the ages of 3 and 15 who are diagnosed with classic CAH who were followed at the Pediatric Endocrinology Department of Düzce University Medical Faculty Hospital. For the control group, 30 healthy children and adolescents equalized with CAH patients in terms of age and gender will be taken. Al patients and controls examined for psychiatric disorders. by clinicians Patients and control groups filled Autism Behavior Checlist and semistructured sociodemogrphic form that evaluated the gender, age, pregnancy and birth complications, history of mothers' cigarette and alcohol use. 2D:4D ratios were measured in both of control and CAH groups. Results: KAH group right and left hand 2D:4D ratios were statistically lower compared to controls and also lower 2D:4D ratios had association with high ABC scores. When compared with control group, CAH group ABC scores were significantly higher. In KAH group there was a pozitive correlation between 2D:4D ratios and ABC scores. Conclusion: In light of present study findings, suggest that high androjen may have effect on low 2D:4D ratios and high ASD symptoms. Further researchs with a large sample are needed in this field.

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