Dutasteride, who is it more effective for? Second to fourth digit ratio and the relationship with prostate volume reduction by dutasteride treatment - Abstract

The second to fourth digit ratio (hereafter the digit ratio) of the right hand is related to the activity of the androgen receptor.

Five α-reductase inhibitor (5ARI) reduces the prostate volume of patients with BPH. In terms of prostate volume reduction, large-scale placebo-controlled studies show that patients with BPH do not always respond well to 5ARI treatment. Patients with a higher digit ratio respond well to dutasteride treatment compared to those with a lower digit ratio. These results suggest that the digit ratio might be a predictor of the response to dutasteride treatment.

OBJECTIVE: To investigate the relationship between second to fourth digit ratio (hereafter the digit ratio) and prostate volume reduction by dutasteride treatment.

PATIENTS AND METHODS: A total of 142 men aged ≥40 years with a clinical diagnosis of benign prostatic hyperplasia and an enlarged prostate (prostate volume ≥30 mL) were prospectively enrolled.  Before prostate-specific antigen (PSA) level determination and transrectal ultrasonography (TRUS), the lengths of the second and fourth digits of the right hand were measured by an investigator using a digital vernier calliper.  Using TRUS, pre- and post-treatment prostate volume (PV1 and PV2) were measured by an uroradiologist who was unaware of finger lengths. We investigated the change in prostate volume and PSA level at least 6 months after the initiation of dutasteride therapy.

RESULTS: When the patients were divided into two groups according to digit ratio (A: digit ratio < 0.95, n= 71; B: digit ratio ≥0.95, n= 71), there was a greater reduction in prostate volume in group B compared to group A (PV2-PV1: -9.4 mL vs -13.2 mL, P= 0.042; [PV2-PV1]/PV1: -17.5% vs -24.5%, P= 0.027; [PV2-PV1]/duration: -1.1 mL/month vs -1.6 mL/month, P= 0.041; [PV2-PV1]/PV1/duration: -2.0%/month vs -3.0%/month, P= 0.016). Significant negative correlations were found between the digit ratio and reduction rate ([PV2-PV1]/duration: r=-0.165, P= 0.049; [PV2-PV1]/PV1/duration: r=-0.191, P= 0.023).

CONCLUSIONS: Patients with higher digit ratios respond well to dutasteride treatment. The results obtained in the present study suggest that the digit ratio is a predictor of the response to dutasteride treatment.

Written by:
Kim TB, Oh JK, Kim KH, Jung H, Yoon SJ, Lee MS, Kim SW.   Are you the author?
Department of Urology, Gachon University Gil Hospital, Incheon Health Insurance Review & Assessment Service, Seoul Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea.

Reference: BJU Int. 2012 Jul 3. Epub ahead of print.
doi: 10.1111/j.1464-410X.2012.11343.x

PubMed Abstract
PMID: 22755506

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