The relationship between digit ratio (2D:4D) and muscular fitness: A systematic review and meta-analysis

Digit ratio (2D:4D), a marker of prenatal testosterone exposure, is a weak negative correlate of sports/athletic/fitness performance. While numerous studies have examined the relationship between 2D:4D and physical fitness, there has never been a comprehensive study that has synthesized studies examining relationships between 2D:4D and muscular fitness.

To systematically review and meta-analyze the relationship between 2D:4D and muscular fitness measured as handgrip strength (HGS).

We systematically searched five electronic databases, reference lists, topical systematic reviews/meta-analyses, and personal libraries in November 2020. Peer-reviewed, cross-sectional studies that reported Pearson's correlation coefficients between objectively measured 2D:4D and HGS were included. We used random-effects meta-analysis to estimate the pooled correlation and the 95% confidence interval (95%CI), and moderator analyses to estimate the influence of sex and age.

Data from 22 studies, representing 5271 individuals from 11 countries ranging in (mean) age from 10.4 to 58.0 years, were included. Overall, there was a weak negative correlation between 2D:4D and HGS (r = -0.15, 95%CI = -0.20 to -0.09), indicating that individuals with low 2D:4Ds had high HGS. We found substantial heterogeneity between studies (Q = 123.4, p < .0001; I²  = 74%), but neither sex (Q = 0.003, p = .96) nor age (Q = 0.46, p = .50) significantly moderated the pooled correlation.

We found a weak negative relationship between 2D:4D and HGS, which showed substantial heterogeneity between studies, but was neither moderated by sex nor age. Our finding probably reflects both the long-term (organizational) and short-term (activational) benefits of testosterone.