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Article

Basic Human Body Dimensions Relate to Alcohol Dependence and Predict Hospital Readmission

1
Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, D-91054 Erlangen, Germany
2
Human Motivation and Affective Neuroscience Lab, Department of Psychology, Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Nägelsbachstraße 49 b, D-91052 Erlangen, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2076; https://doi.org/10.3390/jcm8122076
Received: 2 October 2019 / Revised: 5 November 2019 / Accepted: 12 November 2019 / Published: 27 November 2019
(This article belongs to the Section Clinical Neurology)

Abstract

:
Alcohol dependence is a severe mental illness and there is a need for more effective preventive and therapeutic strategies. Translational research suggests that intrauterine sex hormone exposure modulates the risk and course of alcohol dependence during adulthood. During development, sex hormones permanently shape sexually dimorphic body dimensions. Thus, these dimensions may provide insight into sex hormone organization. Here, we compared body measurements (absolute, relative to, and residualized on height) between 200 alcohol-dependent in-patients and 240 age-matched healthy control subjects and investigated how these measurements associate with the patients’ prospective 12- and 24-month outcome. The results show that alcohol dependence is related to lower absolute, relative, and residualized body measurements for height and weight, head circumference, bitragion head arc, lip-chin distance, hip, thigh, and calf circumference, and foot length and breadth. In male alcohol-dependent in-patients, higher risk, shorter latency, and more alcohol-related readmissions were predicted by higher absolute, relative, and residualized thigh and calf circumferences. The second-to-fourth finger length ratio, a putative proxy for prenatal sex hormone organization, was not convincingly correlated with the body dimensions, suggesting that the results represent pubertal (or later) effects. The study’s findings have implications for further research. The body measurements’ high accessibility may facilitate the future transition into clinical settings.

1. Introduction

The World Health Organization (WHO) estimated that the harmful use of alcohol accounted for 5.1% of all deaths and 5.3% of all disability-adjusted life years during 2016. Worldwide, the highest levels of alcohol consumption per capita were found within the European region [1]. To develop preventive and individualized treatment strategies, we need to improve the knowledge of the mechanisms that underlie alcohol dependence. Easily accessible and clinically relevant biomarkers for both alcohol dependence per se and its prospective course are required.
In 2016, males in all WHO regions were more likely to be current alcohol drinkers and had heavy drinking sessions more often than females. In the European Region, 14.8% of males and 3.5% of females suffered from alcohol use disorder. Globally, 2.3 million male deaths compared to 0.7 million female deaths have been attributed to alcohol [1]. Alcohol dependence often runs a chronic course, with higher 12-month alcohol-related readmission rates following withdrawal in males (57.5%) compared to females (41.4%) [2]. Men are also known to have higher striatal dopamine release after oral alcohol intake than women [3]. These sex differences suggest that sex hormone activities are involved in alcohol dependence. This assumption is supported by studies that associate alcohol dependence and its related phenotypes with genes that are involved in sex hormone signaling, biosynthesis, and degradation (estrogen receptor 1 [4,5], androgen receptor [6,7], aromatase [8], 5α-reductases [9,10]). However, to our knowledge, the cited genetic links still lack replication and only one association originates from a genome-wide association study [4].
Animal and human studies indicate that during key periods such as the prenatal window and puberty, sex hormones organize the development of the brain with lasting behavioral effects and, in parallel, shape the body with lifelong consequences [11,12,13]. Hence, permanent sex dimorphisms in many human body dimensions are established during certain developmental episodes and thereafter remain stable or at least do not severely change throughout life. Thus, differences in body dimensions between males and females may be used to investigate the associations of organizing prenatal, pubertal, and later sex hormone exposures with psychiatric disorders, which include alcohol dependence.
The second-to-fourth finger length ratio (2D:4D) has been proposed as a proxy for the intrauterine sex hormone exposure, with lower values indicating prenatal hyperandrogenization [14,15] (for a critical review see [16,17]). Lower 2D:4D has been associated with a whole range of impairments such as behavioral problems in childhood [18], video game addiction [19], problematic and pathological internet use during adolescence [20], suicide in adulthood [21,22], and reduced life expectancy [23,24,25].
Lower 2D:4D has been reported in males and females that have high alcohol consumption defined as “daily” or “daily+” in a large BBC internet study [26] and as “at least two problems in the CAGE test and alcohol consumption of at least a few times each week” in a young university student sample [27]. Our first investigation on the 2D:4D-alcohol dependence relationship revealed lower 2D:4D in both males and females that were diagnosed with alcohol dependence [28]. Three additional studies on this topic have since been published [25,29,30]. In support of the initial investigation, our recent meta-analysis confirmed lower 2D:4D in alcohol-dependent males with a medium effect size (Hedge’s g = −0.552) [31]. Lower 2D:4D has also been shown to predict more alcohol-related 12-month hospital readmissions in alcohol-dependent in-patients [29]. These results suggest that higher androgen load during early intrauterine development increases the risk of alcohol dependence in adulthood and also predicts a worse outcome in affected in-patients. This early sex hormone activity model for alcohol dependence [32] is in agreement with a rodent study that demonstrated that prenatal androgen receptor inhibition reduces alcohol consumption in adult male mice, and that prenatal androgen receptor stimulation increases alcohol consumption in adult female mice [12]. Further support is provided by the fact that the opioid receptor mu 1 may interact with prenatal androgen exposure [12] and 2D:4D [33] to influence alcohol consumption during adulthood.
Another method to investigate prenatal influences of androgens on adult behaviors is the twin testosterone transfer model (TTT). The TTT is based on the assumption that compared to a female twin, a male twin increases the prenatal androgen load of his co-twin in the shared intrauterine environment [34,35]. A study using a discovery sample and an independent replication sample has shown that in males, a male co-twin reduces the risk for alcohol dependence during adulthood; in this study, there was no significant effect of the co-twin’s sex on risk of alcohol dependence in females [36]. Another study exclusively on females showed more lifetime alcohol use disorder symptoms in women with a male co-twin than in women with a female co-twin [37]. The inconsistent results in females may indicate false positive findings. By contrast, the consistent observations in males suggest that higher androgen load during early intrauterine development might decrease the risk of alcohol dependence in adulthood, which is in line with the early sex hormone activity model of alcohol dependence. However, it also implies a protective effect of higher prenatal androgen exposure in males, which may seem contradictory to the 2D:4D results described above. 2D:4D and the TTT may provide insight regarding the different prenatal developmental windows. 2D:4D sex dimorphisms are thought to originate during early pregnancy (i.e., before gestational week 9 [38] and 14 [39]). Thus, 2D:4D is believed to represent a marker of the first trimester. Because androgen levels in male fetuses peak between gestational weeks 12 and 18, the TTT may be used to investigate phenotypes that are established during the second trimester [35]. However, other explanations might also account for the inconsistent findings of studies using 2D:4D and those based on the TTT. Opposite- and same-sex human twins may differ in postnatal social factors (e.g., peer group characteristics) which also influence the risk to develop alcohol dependence later in life. Such bias may entail misinterpretation of results based on the TTT. Additionally, it cannot be ruled out that some of the above cited investigations have produced false positive findings.
In summary, a direct preclinical study and human investigations using the indirect biomarker 2D:4D and the TTT suggest that sex hormone exposure during development modulates the risk of alcohol dependence during adulthood. The organizational effects of sex hormones may depend on the developmental window during which they occur. Although an initial clinical study is being conducted to transfer this knowledge into prevention techniques [40], the field is subject to several limitations that include weaknesses related to 2D:4D and the TTT. Today, we are far from using such knowledge to improve the treatment of alcohol-dependent patients.
Moreover, little is known about the organizational effects of sex hormone exposures during puberty (and later) on alcohol dependence during adulthood. Only recently, the novel research area on sex hormone organization during the pubertal window has evolved [13]. Pubertal sex hormones shape sexual dimorphisms in physical traits and these might, therefore, be used to enlighten the associations between behavioral traits and pubertal sex hormone exposures; e.g., meta-analyses have demonstrated that the facial width-to-height ratio, which is subject to a sexual dimorphism appearing during puberty [41], is related to aggression and threat behavior among males and to dominance behavior in both sexes [42,43].
As far as we know, the association of easily measurable and thus highly accessible sexually dimorphic body dimensions with alcohol dependence and the prospective course of affected in-patients has not been systematically investigated.

Aims of the Study

Sex dimorphisms in body dimensions can provide initial insights into the organizational effects of sex hormones on the brain with clinically relevant behavioral outcomes. Thus, we analyzed here the differences in 15 absolute body measurements, 13 body measurements divided by height (= relative), and 13 body measurements residualized on height between alcohol-dependent in-patients and healthy control subjects of both sexes. We also investigated their relationships to the patients’ prospective 12- and 24-month outcome, following alcohol withdrawal treatment, in an effort to identify parameters that will be helpful to determine the individual prognosis. Finally, we explored the associations between absolute, relative, and residualized body measurements with 2D:4D, the age of onset of regular alcohol drinking, the age of the first in-patient treatment due to alcohol problems, total lifetime drinking, and daily ethanol intake.

2. Materials and Methods

2.1. Study Sample

This project was part of the bicentric, cross-sectional, and prospective Neurobiology of Alcoholism (NOAH) study, which included 200 alcohol-dependent in-patients and 240 age-matched healthy controls subjects [29]. All in-patients were diagnosed with alcohol dependence according to the tenth revision of the International Classification of Diseases (ICD-10) criteria [44] and alcohol use disorder according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria [45]. During the screening procedure, alcohol-dependent in-patients were excluded due to denial of written informed consent (n = 379), a mental comorbidity, such as primary depression (i.e., depression was present before the alcohol dependence), anxiety disorder, schizophrenia, substance use disorder other than alcohol or nicotine, posttraumatic stress disorder, or eating disorder (n = 194), a severe somatic disorder (n = 90), abstinence longer than 72 hours prior to inclusion (n = 88), or other reasons (n = 37). Healthy control subjects were hired with online advertisement and distribution of flyers. After a multistep screening procedure of 1215 interested individuals, 240 healthy control subjects were enrolled. The exclusion criteria of the control group included severe somatic disorders, prior medical treatment due to alcohol dependence, ≥2 affirmed CAGE questions [46], prior psychiatric in-patient treatment, psychiatric or psychotherapeutic outpatient treatment during the past 10 years, and an Alcohol Use Disorders Identification Test (German version [47]) score > 12.
The NOAH study design included two study-visits for alcohol-dependent in-patients and one study-visit for healthy control subjects. For in-patients, the first study-visit took place during early abstinence (i.e., 24–72 h of abstinence according to the in-patients’ self-reports of their last alcohol intake prior to study inclusion); 81.5% of the in-patients attended the second direct study-visit, which took place during the median 5th day post-inclusion (interquartile range (IQR) 3–6). The subjects were recruited at the Psychiatrische und Psychotherapeutische Klinik of the Universitätsklinikum Erlangen and at the Klinik für Psychiatrie, Sucht, Psychotherapie und Psychosomatik of the Klinikum am Europakanal, Germany. Post-inclusion, we followed the patients’ records for 12 and 24 months to analyze the outcome parameters: alcohol-related readmissions per se, latency (in days) to the first alcohol-related readmission, and total number of alcohol-related readmissions during the 12- and 24-month follow-up periods. For statistical analyses, days to first readmission were set to 365 (12-month follow-up) and 730 days (24-month follow-up) in patients without any recorded alcohol-related readmission during the observation period. Clinically experienced psychiatrists and well-trained and regularly supervised doctoral students (from our study team) conducted the semi-structured interviews. The interviews at study enrolment included the age of onset of regular alcohol drinking (i.e., daily over at least 7 days), the age of first in-patient treatment due to alcohol problems, the alcohol lifetime drinking history [48], and the number of previous in-patient withdrawal treatments in the group of alcohol-dependent in-patients, the Alcohol Use Disorders Identification Test (German version [47]) for the group of healthy control subjects, and smoking status for both groups. We also quantified the breath alcohol concentration in alcohol-dependent in-patients. Moreover, carbohydrate-deficient transferrin (CDT) was measured in serum samples of both groups (Central Laboratory of the University Hospital Erlangen, Germany, DIN EN ISO 15189 accredited). For previously published articles of the NOAH study, see [2,5,29,33,49,50,51,52].

2.2. Ethical Approval

This study was approved by the Ethics Committee of the Medical Faculty from the Friedrich-Alexander University Erlangen-Nürnberg (ID 81_12 B; April 19, 2012). All participants provided written informed consent. The study is in accordance with the ethical principles of the World Medical Association (sixth revision of the Declaration of Helsinki, Seoul 2008).

2.3. Basic Human Body Dimensions

We selected body height, body weight, and mandibular arc as established, sexually dimorphic features [53,54,55]. The lip-chin distance was included as an indicator for jaw height, which is a constituent part of facial masculinity [56]. We used lip-chin distance instead of full jaw height to exclude lower lip height, which is larger in females than males [57]. The waist and hip circumferences were investigated as sexually dimorphic traits that are largely determined during puberty [58]. Additional parameters with likely relationships to skeletal and/or soft-tissue growth in general were included, such as head, thigh, calf, and ankle circumference, bitragion and sagittal head arcs, foot length and breadth.
For the measurements, the participants wore only underwear and took off their shoes. Body height, body weight, head circumference, bitragion and sagittal head arcs, wrist, waist, hip, thigh, and calf circumferences, as well as foot length and breadth were quantified according to the Basic human measurements for technological design—Part 1: Body measurement definitions and landmarks (ISO 7250-1:2008); German version EN ISO 7250-1:2010. For body dimensions not included in the above list, we used the following definitions: Mandibular arc, distance between the two anguli mandibulae spanning over the point of the chin; lip-chin distance, lower lip mucocutaneous boundary to platysma mandible insertion; hip circumference, length over the widest part of the gluteal region; ankle circumference, maximum length parallel to the floor over the malleoli mediales and laterales. Body weight was measured in kg using a weighing scale and length dimensions in cm with a tape measure. All measurements were conducted once, by a non-blinded rater, in the standing position with the exception of foot length and breadth. Soles of the right and left feet were scanned in the sitting position using an HP Scanjet G4050 (HP Deutschland GmbH, Böblingen, Germany). Foot length and breadth were quantified by three independent and blinded raters with Microsoft PowerPoint (two-way random intra-class correlation coefficients (absolute agreement): mean of right and left foot length 0.996, mean of right and left foot breadth 0.990). We did not exclude hallux valgus deformations. Most of the missing values in the alcohol-dependent in-patients were due to a lower participation rate in the second study-visit, during which body measurements were conducted (if not already done during the first study visit).

2.4. 2D:4D

Right and left hands were scanned using an HP Scanjet G4050. The absolute index and ring finger lengths were quantified by three independent blinded raters and we analyzed the means of the right-hand and left-hand 2D:4D values, which are published (GNU Image Manipulation Program, www.gimp.org, two-way random intra-class correlation coefficient (absolute agreement) of mean of the right-hand and left-hand 2D:4D 0.986) [29].

2.5. Statistical Analyses

Data were analyzed using SPSS for Windows 24.0 (SPSS Inc., Chicago, IL, USA). The descriptive statistics report medians, IQR, and frequencies, which were calculated with the custom tables function of SPSS. We used the Mann–Whitney U test and Spearman’s correlation because some of the body measurements deviated significantly from a normal distribution, according to the Kolmogorov–Smirnov test. The χ2 test was employed to analyze differences in the frequency of nominal variables. Values of P < 0.05 for two-tailed tests were considered significant. To respect the well-known sex differences in alcohol dependence [32], we analyzed males and females separately.
Mean values of right and left-side body measurements were analyzed for wrist, thigh, calf, and ankle circumferences as well as foot length and breadth. We tested for associations of absolute body measurements, body measurements divided by height, and body measurements residualized on height with alcohol dependence and outcome. Body measurements were divided by height to obtain a relative measure in analogy to those frequently used in other fields of marker research (e.g., 2D:4D, facial width-to-height ratio). Moreover, the absolute values of body measurements were residualized for height to determine possible sex differences in and the predictive value of each parameter above and beyond general differences in body height. Linear regression, using the whole study population, was applied to residualize each single body measurement (dependent variable) on body height (predictor). The obtained residuals were interpreted as body measurement values that are independent of general body height. Residuals were z-standardized.
The field of organizational sex hormone effects in alcohol dependence is early in development. Hence, we tested a high number of predictors. In total, we predefined the following 656 statistical tests:
  • 82 group comparisons “alcohol-dependent in-patients versus healthy control subjects”: (15 absolute body measurements + 13 body measurements divided by height + 13 body measurements residualized on height) × 2 sexes
  • 164 group comparisons “readmission yes versus no”: (15 absolute body measurements + 13 body measurements divided by height + 13 body measurements residualized on height) × 2 sexes × 2 follow-up periods (12-month, 24-month)
  • 328 correlations with “outcome parameters”: (15 absolute body measurements + 13 body measurements divided by height + 13 body measurements residualized on height) × 2 sexes × 2 follow-up periods (12-month, 24-month) × 2 outcome parameters (latency, number)
  • 82 group comparisons “male versus female”: (15 absolute body measurements + 13 body measurements divided by height + 13 body measurements residualized on height) × 2 groups (alcohol-dependent in-patients versus healthy control subjects)
All reported P values are uncorrected. To consider type 1 error risk in multiple hypothesis testing, we employed the false discovery rate (FDR) procedure using a macro for Microsoft Excel (see Appendix S1 of Pike [59], classical one-stage method including all 656 tests; critical P value (FDR-derived significance threshold): 0.007470; [60]). In parallel, we also employed the more conservative Bonferroni adjustment (critical P value: 0.05/656 = 0.000076). We chose both correction methods to differentiate between robust (FDR) and very robust (Bonferroni) results. However, we acknowledge the problem of statistical power in view of the high number of tests. The sample size has been initially chosen to demonstrate group differences in 2D:4D already published in [29]. The body measurements analyzed in this article represent secondary endpoints and were not included into the a priori sample size estimation.
Finally, we performed the following explorative analyses that were not corrected for multiple hypothesis testing:
  • Correlations of absolute, relative, and residualized body measurements with 2D:4D in alcohol-dependent in-patients and healthy control subjects of both sexes.
  • Correlations of absolute, relative, and residualized body measurements with the age of onset of regular alcohol drinking and the age of first in-patient treatment due to alcohol problems in alcohol-dependent in-patients of both sexes.
  • Correlations of absolute, relative, and residualized body measurements with total lifetime drinking and daily ethanol intake in alcohol-dependent in-patients of both sexes.
  • Inter-correlations among the body measurements within the three groups of absolute, relative, and residualized body dimensions in alcohol-dependent in-patients and healthy control subjects of both sexes.

3. Results

3.1. Sociodemographic Characteristics

Both male and female alcohol-dependent in-patients did not significantly differ from healthy control subjects with regard to age, but were more often active and ever-smokers and had higher CDT blood levels. In the group of alcohol-dependent in-patients, male sex was significantly related to a younger age of onset of regular alcohol drinking (i.e., daily over at least 7 days), higher total lifetime drinking and daily ethanol intake since onset, a higher alcohol concentration at admission, higher CDT blood levels, and worse 12- and 24-month outcomes. Moreover, we found significantly higher Alcohol Use Disorders Identification Test scores and higher CDT blood levels in male (than in female) healthy control subjects (Table 1).

3.2. Basic Human Body Dimensions: Alcohol-Dependent In-Patients versus Healthy Control Subjects

After FDR correction, several absolute, relative, and residualized body measurements were significantly and consistently lower in alcohol-dependent in-patients than in healthy control subjects, except for sagittal head arc divided by height, which was significantly longer in alcohol-dependent in-patients (Table 2).
Absolute Body Measurements: Alcohol dependence was related to shorter head, hip, and thigh circumference in both sexes and to lower body height and weight, bitragion head arc length, lip-chin distance, calf circumference, and foot length and breadth in males. Body Measurements Divided by Height: Alcohol dependence was associated with shorter thigh circumference in both sexes, with longer sagittal head arc length and shorter hip and calf circumference in males, and with shorter head circumference in females. Body Measurements Residualized on Height: Alcohol dependence was related to shorter hip and thigh circumferences in both sexes, to a shorter bitragion head arc, calf circumference, and foot breadth in males, and to shorter head circumference in females.
The smaller absolute, relative, and residualized hip, thigh, and calf circumferences and the smaller absolute body weight and foot breadth in male alcohol-dependent in-patients, in comparison to male healthy control subjects, remained significant after the Bonferroni correction.

3.3. Basic Human Body Dimensions: Prospective Alcohol-Related Readmission

After FDR correction, worse patients’ outcomes were consistently related to significantly higher absolute, relative, and residualized thigh and calf circumferences in male alcohol-dependent in-patients. We did not find any significant association of absolute, relative, or residualized body measurement with outcomes in female alcohol-dependent in-patients (Table 3, Table 4 and Table 5).
Absolute Body Measurements: Thigh circumference was linked to risk, latency, and the number of alcohol-related readmissions throughout the 12-month follow-up. Calf circumference correlated with the 12-month latency to alcohol-related readmission. Body Measurements Divided by Height: Thigh circumference was associated with risk, latency, and the number of alcohol-related readmissions for the 12-month and 24-month follow-ups. Calf circumference was linked to 12-month risk and 12-month and 24-month latency to alcohol-related readmission. Moreover, there was an association between head circumference values and number of alcohol-related readmissions during the 24-month follow-up. Body Measurements Residualized on Height: Thigh circumference was linked to risk, latency, and the number of alcohol-related readmission for the 12-month follow-up and the number of alcohol-related readmissions for the 24-month follow-up. Calf circumference related to 12-month und 24-month latency to alcohol-related readmission.
None of these effects remained significant after the Bonferroni adjustment.

3.4. Basic Human Body Dimensions: Sex Differences

After FDR correction, we found significantly longer absolute and residualized body measurements in males than in females, except for the shorter residualized thigh circumference in male than in female alcohol-dependent in-patients. Many relative body measurements were significantly lower in males than in females (Table 2).
Absolute Body Measurements: Male sex was related to higher body weight and height, head circumference, lengths of bitragion and sagittal head arc and mandibular arc, lip-chin distance, wrist, waist, and ankle circumference, and foot length and breadth in both groups and to a longer calf circumference in the healthy control subjects. Body Measurements Divided by Height: Male sex was linked to lower head circumference values, lengths of bitragion and sagittal head arc, a higher wrist circumference, and lower hip and thigh circumferences in both groups, to a smaller calf circumference and a longer foot length in alcohol-dependent in-patients, and to a higher waist circumference in healthy control subjects. Body Measurements Residualized on Height: Male sex was associated with longer head and wrist circumference in both groups, with a longer mandibular arc, shorter thigh circumference, and higher foot length in alcohol-dependent in-patients, and with longer lip-chin distance, waist and ankle circumference, and foot breadth in healthy control subjects.
Many of these sex differences remained significant after the Bonferroni correction.

3.5. Basic Human Body Dimensions: Exploratory Analysis of Correlations with 2D:4D, the Age of Onset of Regular Alcohol Drinking and First In-Patient Treatment Due to Alcohol Problems, Total Lifetime Drinking and Daily Ethanol Intake, and Inter-Correlations

The analyses revealed no convincing pattern of significant relationships between 2D:4D and absolute body measurements, body measurements divided by height, or body measurements residualized on height (no significant correlation except for seven tests with P > 0.039, Table A1 in Appendix A).
The age of onset of regular drinking (i.e., daily over at least 7 days) and the age of the subjects’ first in-patient treatment due to alcohol problems correlated positively and significantly with many absolute, relative, and residualized body measurements in both male and female alcohol-dependent in-patients; however, there were also significant negative correlations with the lengths of sagittal head arc and thigh circumference in male patients (Table A2 in Appendix A).
Absolute Body Measurements: In male alcohol-dependent in-patients, the age of onset of regular drinking and/or the age of first in-patient treatment due to alcohol problems correlated positively with lengths of mandibular arc, waist, hip, and ankle circumferences and negatively with sagittal head arc and thigh circumference. Body Measurements Divided by Height: The age of onset of regular drinking and/or the age of first in-patient treatment due to alcohol problems correlated positively with lengths of mandibular arc and waist and ankle circumference and negatively with sagittal head arc and thigh circumference in male alcohol-dependent in-patients and positively with wrist and ankle circumference and foot length and breadth in female alcohol-dependent in-patients. Body Measurements Residualized on Height: The age of onset of regular drinking and/or the age of first in-patient treatment due to alcohol problems correlated positively with lengths of mandibular arc and waist, hip, and ankle circumferences and negatively with sagittal head arc and thigh circumference in male alcohol-dependent in-patients and positively with bitragion head arc, wrist and ankle circumference, and foot length and breadth in female alcohol-dependent in-patients.
Total lifetime drinking and daily ethanol intake did not significantly correlate with absolute, relative, or residualized body measurements in male and female alcohol-dependent in-patients, except for a significant negative correlation between total lifetime drinking and absolute lip-chin distance in male patients and between daily ethanol intake and absolute, relative, and residualized mandibular arc length in male and female patients (P > 0.025) (Table A3 in Appendix A).
We found multiple significant inter-correlations among the absolute body measurements (Table A4 and Table A5 in Appendix A), the body measurements divided by height (Table A6 and Table A7 in Appendix A), and the body measurements residualized on height (Table A8 and Table A9 in Appendix A).

4. Discussion

As far as we know, this is the first systematic and comprehensive anthropomorphic study that determined the associations between basic human body dimensions and alcohol dependence. Separately for both sexes, we have found many shorter body measurements in alcohol-dependent in-patients than in healthy control subjects. These results are supported by two earlier studies that indicated that participants recruited from alcoholism in-patient treatment programs have lower body height, body weight, and thigh volume than controls [61,62], although it should be noted that these projects focused primarily on body composition and sex differences in alcohol consumption. Moreover, we showed here for the first time that in male alcohol-dependent in-patients, a higher thigh circumference may predict a worse 12-month outcome with a higher risk, shorter latency to the first alcohol-related readmission, and a higher number of alcohol-related readmissions.
We were able to verify many of the a priori expected sexual dimorphisms with shorter absolute and residualized on height physical dimensions in females than males. These results confirm the assumption that the body dimensions may provide insight into the organizational effects of sex hormones. Hence, the associations between sexually dimorphic body measurements and alcohol dependence observed here may support that the organizational effects of sex hormones are involved in alcohol dependence. Interestingly, the absolute, relative, and residualized body measurements did not convincingly correlate with 2D:4D in any subgroup. The independence of these factors may suggest that, rather than prenatal sex hormones, the pubertal (or later) sex hormones organize the physical dimensions analyzed in this study. Support of this idea comes from a rodent study that failed to show consistent effects of prenatal androgen receptor modulation on head size and body length [11]. It is therefore more likely that pubertal (or even later), rather than prenatal sex hormone effects, account for the differences between alcohol-dependent in-patients and healthy control subjects observed here. Moreover, the smaller body height of alcohol-dependent males in comparison to healthy control males detected here is contradictory to the expectations based on findings from the TTT. In males, a male co-twin in comparison to a female co-twin reduces both the risk for later alcohol dependence [36] and body height [63], although the effect sizes were small in both investigations. However, this entails the prediction of larger body height in alcohol-dependent males. The opposite finding in this study further corroborates that, rather than prenatal sex hormones, the pubertal (or later) sex hormones organize the physical dimensions analyzed here. It may also indicate that other factors as discussed in the following section are involved.

4.1. Possible Reasons for Smaller Body Dimensions in Alcohol Dependence

We detected many shorter absolute, relative, and residualized body measurements in alcohol-dependent in-patients than in healthy control subjects. Shorter measurements for most of the absolute and residualized parameters were also present in females than in males. At first glance, the shorter body measurements in the alcohol dependence group (compared to the control group), in light of the shorter values in females than in males, might appear contradictory to the higher prevalence of alcohol dependence in males than in females [1]. However, different reasons might account for these results.
Prepubertal boys show lower estradiol levels than prepubertal girls [64], which entails the later onset of puberty in males. Sex differences in bone mass, size, and strength strongly increase during puberty, with higher values in males compared to females [65,66]. Males are taller and develop longer bones than females because their growth spurts last longer before the epiphyses fuse, which results from the later rise and lower peak levels of estradiol (see [67], regarding sex differences in estrogen and epiphyseal fusing). Thus, lifelong smaller body measurements, which were observed here in alcohol dependence, may result from both a later pubertal onset and factors that reinforce estrogen signaling during puberty that may prematurely terminate the growth of the body. With regard to pubertal onset, we have already shown that male alcohol-dependent in-patients and male binge drinkers report a later age at puberty onset than control males [24,29], which may result in shorter body measurements. In addition, we hypothesize a premature termination of pubertal growth in the group of alcohol-dependent in-patients. Here, we found an overlap between the age of onset of regular alcohol drinking and puberty (the age of onset of regular alcohol drinking in years: minimum to 25% percentile, males 14–19, females 14–23) and 17.4% of males (16 out of 92) and 4.5% of females (3 out of 67) stated that they had started drinking alcohol regularly before turning 18 years old. Phytoestrogens are found in many alcoholic beverages. They are produced from plants that contain estrogen-like substances [68]. In addition, low dose alcohol consumption has been shown to increase testosterone levels in both sexes [69,70] and testosterone is converted to estradiol by aromatase. We speculate that the early onset of regular alcohol drinking in the groups studied here, in male, and to a lesser extent, female alcohol-dependent in-patients, may have led to a premature epiphyseal fusing via phytoestrogens and testosterone to estradiol conversion (see [67], regarding sex differences in estrogen and epiphyseal fusing, [71]). We provide some support for this model in that the age of onset of regular drinking (i.e., daily over at least 7 days) and the age of first in-patient treatment due to alcohol problems were found to correlate positively with many absolute, relative, and residualized body measurements in both male and female alcohol-dependent in-patients. However, we acknowledge that the age of onset of regular drinking was assessed retrospectively and that the correlations do not allow for causal conclusions. In a nutshell, the smaller body dimensions in alcohol dependence observed here might be explained by a shorter pubertal growth period with later ages of pubertal onset and a premature end of bone growth. Additionally, the data reported here indicate that earlier ages at the onset of regular alcohol drinking (i.e., daily over at least 7 days) in males (more than in females) may account for the stronger group differences in body measurements between males and females that were observed in this study.
Moreover, additive genetic effects explain 40% of pubertal timing in boys and 46% in girls [72], and genes involved in sex hormone signaling have previously been associated with alcohol dependence and craving for alcohol [4,5,6,8,9,10]. Hence, shared genetic variance of pubertal timing and addictive behaviors might explain why absolute, relative, and residualized body dimensions are smaller in alcohol-dependent in-patients in the analyzed cohort.
Fetal alcohol spectrum disorder (FASD) provides another explanation for the many lower values of absolute, relative, and residualized body measurements in alcohol-dependent in-patients compared to the healthy control subjects in this study. A meta-analysis reported a high prevalence of pooled alcohol or drug dependence in 54.5% of the subjects diagnosed with FASD [73]. Growth restriction including height and head circumference is a typical phenomenon in subjects with FASD, which is also present in adulthood [74]. Thus, a higher percentage of prenatal alcohol exposure in the in-patients’ cohort might also account for the smaller absolute, relative, and residualized body dimensions. We have not investigated FASD in this project and future research is necessary to further test this hypothesis. However, a recent register-based study estimated a rate of FASD of 177 children per 10,000 live births [75]. Although this study might underestimate the prevalence of FASD, it is unlikely that FASD explains the observed group differences completely.
Unhealthy nutrition and poor physical activity are frequent consequences of alcohol dependence and influence body composition, particularly the muscle and fat tissues. The smaller body dimensions, including body weight and hip, thigh, and calf circumferences in the in-patients’ groups, may represent direct sequelae of alcohol dependence. Surprisingly, total lifetime drinking and daily ethanol intake in the cohort of male and female in-patients did not convincingly correlate with absolute, relative, or residualized body measurements (except for some correlations with lip-chin distance and mandibular arc). This suggests that the individual alcohol intake over time does not largely account for the group differences in body measurements and their associations with prospective outcomes. However, the lack of a clear correlation between lifetime drinking history and body measurements might be specific to the investigated cohort, because the patients were exclusively recruited in psychiatric hospitals and we did not include in-patients with severe somatic disorders. Furthermore, alcohol-dependent in-patients in this study are more likely than healthy control subjects to identify as active (males: 78% versus 22%, females: 77% versus 19%) or ever-smoker (males: 92% versus 59%, females: 85% versus 48%). Both lifetime and current smoking might influence body dimensions and contribute to the effects observed here.
In summary, the smaller body dimensions in alcohol dependence may be due to a later age of pubertal onset, a premature end of bone growth due to the effects of alcohol, such as phytoestrogens and impaired sex hormone signaling, an increased rate of FASD, and unhealthy life-style factors that include nutrition, physical activity, and smoking behavior, which are related to alcohol dependence.

4.2. Thigh Circumference: Alcohol Dependence and Prospective Outcome

In this study, we found shorter thigh circumference in alcohol-dependent in-patients than in healthy control subjects. Moreover, longer thigh circumference predicted a worse prospective outcome in male alcohol-dependent patients. The latter associations with outcome did not remain significant after Bonferroni correction; although they did remain significant after FDR correction, and are thus considered robust, these results should be interpreted with caution.
In the same cohort that was analyzed here, we previously showed a lower body mass index in alcohol-dependent in-patients than in healthy control subjects [29] and an association between higher body mass index and a worse outcome in the patients’ group [52]. This parallels the pattern demonstrated here for thigh circumference. Thigh circumference mirrors a combination of both bone and soft tissue, which is a similarity to the body mass index. The smaller thigh circumference (in line with the lower body mass index) in alcohol-dependent in-patients compared to the healthy control subjects might be a consequence of malnutrition and/or inactivation. Because of a strong positive correlation between body mass index and thigh circumference (males: alcohol-dependent in-patients, n = 105, ρ = 0.833, P < 0.001, healthy control subjects, n = 133, ρ = 0.666, P < 0.001; females: alcohol-dependent in-patients, n = 75, ρ = 0.730, P < 0.001, healthy control subjects, n = 105, ρ = 0.807, P < 0.001), the relationship between higher thigh circumference and alcohol-related readmissions in male alcohol-dependent in-patients observed here might be explained by potential mediators of the association between higher body mass index and alcohol relapse, which we elaborated on in [52], such as N-acetylaspartate, appetite-regulating peptides, neuroticism, impulsivity, and temporal discounting. Both increased relapse risk and higher body mass index have been associated with low thalamic N-acetylaspartate [76,77] and neuroticism [78,79,80]. Moreover, ghrelin, which regulates energy homeostasis, influences cerebral reward pathways. Pharmacological strategies targeting ghrelin pathways are being tested in the treatment of alcohol-dependent patients [81]. Higher body mass index and obesity are associated with higher impulsivity and higher temporal discounting [82,83]. Thus, higher thigh circumference (indicating higher body mass index) may be related to higher impulsivity and temporal discounting with more difficulties to resist the urge to drink alcohol in risky situations. Future longitudinal studies are needed to investigate these hypotheses.

4.3. Limitations and Strengths

The present research project is subject to several limitations. We did not differentiate between bone and soft tissue [for a discussion of this topic in a pubertally organized marker, see [84]. This is especially critical for thigh circumference, which is clinically the most promising body dimension identified here. Future research, which might involve medical imaging techniques in addition to direct surface measurement, is needed to disentangle the different roles of bone and soft tissue. We wish to note that this limitation is true for a large part of marker research in general. Even the correlation between surface and x-ray-measurements of 2D:4D as an often used biomarker is comparatively low (r = 0.45 [85]). The related imprecision might result in an underestimation of the relationship between markers and external criteria. Moreover, we cannot conclusively determine to what extent prenatal, pubertal, and even later factors account for the observations. Here, we provided evidence in the form of associations that does not allow for drawing causal conclusions. Further studies using longitudinal designs and investigating neurobiological aspects are needed to relate the potential mechanisms underlying the development of the here quantified absolute, relative, and residualized body measurements to alcohol dependence. The field’s early stage of development resulted in many statistical tests involving absolute values, ratios, and residuals. Aiming to identify promising markers, we decided to use the less conservative FDR method to consider the type 1 error risk. Unsurprisingly, some of the significant effects disappeared after the more conservative Bonferroni adjustment. However, the results from this research project build a solid basis and reveal which body measurements merit future research to confirm that the results can be replicated and generalized. We acknowledge that the patients’ outcome data were gathered using electronic patient records; no direct resurveys have been conducted. The parameter quantified here, i.e., alcohol-related readmission, differs from alcohol relapse.
The strengths of our study include the sex- and age-balanced cohorts and the long-term follow-up of alcohol-dependent patients. We specifically addressed alcohol-related readmissions, which are substantial problems in the long-term course of alcohol dependence. We also found consistent differences between alcohol-dependent in-patients and healthy control subjects across several body dimensions and considered the absolute values, ratios, and residuals. Finally, the physical measurements are easily accessible, which facilitates the transition of the results into daily clinical routine.

5. Conclusions

Here, we reported consistently lower values of a line of absolute, relative, and residualized body dimensions in alcohol-dependent in-patients than in healthy control subjects across both sexes. Differences in pubertal age, the effects of alcohol drinking during puberty, such as phytoestrogens and impaired sex hormone signaling, FASD, and life-style alterations related to alcohol dependence might account for these effects. Moreover, our results may have important clinical implications, as thigh circumference has turned out to be a potential and easily measureable predictor for alcohol-related readmissions. If the results observed here can be replicated, thigh circumference might serve as a measure to assess an in-patient’s risk of prospective hospital readmissions. These findings can be utilized to establish individualized treatment strategies.

Author Contributions

Conceptualization, B.L. and J.K.; methodology, B.L. and M.G.K.; validation, C.M., C.W. and J.K.; formal analysis, B.L.; resources, J.K.; data curation, B.L.; writing—original draft preparation, B.L.; writing—review and editing, M.G.K., C.M., C.W. and J.K.; project administration, B.L.

Funding

This work was supported by intramural grants from the University Hospital of the Friedrich-Alexander University Erlangen-Nürnberg (FAU). C.M. is an associated fellow of the research training group 2162 funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)-270949263/GRK2162. The funders had no role in the study design, data collection, analyses, decision to publish, or preparation of the manuscript.

Acknowledgments

We thank Andreas Ahnert, Ute Hamers, and Kristina Bayerlein for the opportunity and the support to recruit in-patients at the Klinik für Psychiatrie, Sucht, Psychotherapie und Psychosomatik of the Klinikum am Europakanal. We are grateful and appreciate the support of Birgit Braun, Juliane Behrens, Sarah Kubis, Katrin Mikolaiczik, Sarah Saigali, Marina Sibach, and Petya Tanovska for recruiting patients and control subjects. We thank Sina Therese Kirsten and Terezie Sedlinská for measuring foot length and breadth and Katrin Mikolaiczik, Marcel-René Muschler, and Petya Tanovska for measuring index and ring finger lengths. Moreover, we thank the reviewers for constructive suggestions.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Abbreviations

2D:4DSecond-to-fourth finger length ratio
CDTCarbohydrate-deficient transferrin
DSM-5Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders
FASDFetal alcohol spectrum disorder
FDRFalse discovery rate
ICD-10Tenth revision of the International Classification of Diseases
IQRInterquartile range
TTTTwin testosterone transfer model
WHOWorld Health Organization

Appendix A

Table A1. Spearman correlations of body measurements with 2D:4D in male and female alcohol-dependent in-patients (ADP) and healthy control subjects (HCS).
Table A1. Spearman correlations of body measurements with 2D:4D in male and female alcohol-dependent in-patients (ADP) and healthy control subjects (HCS).
MalesFemales
ADPHCSADPHCS
NρPNρPNρPNρP
Absolute measure
Body height1030.0490.625133−0.0680.43976−0.0160.8941050.0900.360
Body weight102−0.1120.261133−0.0590.50176−0.1040.3691040.0060.955
Head circumference1030.0110.914133−0.1090.210780.0600.603105−0.0380.703
Bitragion head arc1030.0030.9791330.0620.480780.0080.944105−0.0150.878
Sagittal head arc1030.0070.943133−0.0480.587780.0290.802105−0.0570.564
Mandibular arc102−0.0660.512133−0.0560.52676−0.1300.2641040.1120.259
Lip-chin distance102−0.0210.832132−0.0340.70278−0.0690.549105−0.0920.351
Wrist circumference98−0.1560.126128−0.0910.308740.0610.609101−0.1240.218
Waist circumference102−0.1430.153133−0.1310.13476−0.0170.8861050.0260.789
Hip circumference102−0.1870.060133−0.0860.32576−0.0740.523105−0.0240.810
Thigh circumference102−0.0520.601133−0.0860.32378−0.1190.297104−0.0590.549
Calf circumference102−0.0820.412132−0.0460.59978−0.0550.6351050.0650.508
Ankle circumference102−0.0410.682131−0.1760.044780.0550.6301050.0510.603
Foot length960.0610.5561050.0740.451760.0470.689980.0390.702
Foot breadth97−0.0210.842107−0.0880.368770.0300.79899−0.0250.806
Measure divided by body height
Head circumference103−0.0370.711133−0.0020.985760.0220.853105−0.1690.085
Bitragion head arc103−0.0320.7481330.1050.227760.0100.929105−0.0900.361
Sagittal head arc1030.0000.999133−0.0020.981760.0490.671105−0.1510.124
Mandibular arc102−0.0920.358133−0.0400.64974−0.1050.3721040.0160.875
Lip-chin distance102−0.0570.570132−0.0270.76276−0.0560.634105−0.1300.188
Wrist circumference98−0.2040.044128−0.0180.836720.0590.622101−0.1980.048
Waist circumference102−0.1530.125133−0.0840.33574−0.0110.926105−0.0190.850
Hip circumference102−0.1970.047133−0.0390.65574−0.0230.845105−0.0730.459
Thigh circumference102−0.0600.549133−0.0430.62676−0.0930.425104−0.1220.217
Calf circumference102−0.0790.431132−0.0310.72676−0.0040.975105−0.0030.979
Ankle circumference102−0.0900.367131−0.1530.082760.0790.496105−0.0600.546
Foot length96−0.0430.6761050.0600.546730.0670.57398−0.0920.368
Foot breadth97−0.1030.313107−0.0870.374740.0200.86499−0.0970.341
Measure residualized on body height
Head circumference103−0.0030.979133−0.0770.378760.0430.715105−0.1070.276
Bitragion head arc103−0.0060.9521330.0820.34976−0.0190.872105−0.0420.674
Sagittal head arc1030.0170.868133−0.0180.840760.0020.988105−0.0950.335
Mandibular arc102−0.0900.367133−0.0460.59674−0.1380.2411040.0500.617
Lip-chin distance102−0.0590.556132−0.0320.71776−0.0540.641105−0.1200.221
Wrist circumference98−0.2040.044128−0.0210.810720.0590.624101−0.2010.044
Waist circumference102−0.1560.118133−0.1010.24574−0.0180.882105−0.0140.887
Hip circumference102−0.1900.055133−0.0860.32674−0.0620.602105−0.0260.789
Thigh circumference102−0.0550.585133−0.0810.35576−0.1210.296104−0.0660.503
Calf circumference102−0.0830.407132−0.0560.52476−0.0440.7031050.0400.688
Ankle circumference102−0.0920.357131−0.1800.040760.0690.556105−0.0270.787
Foot length96−0.0480.6411050.0510.606730.0770.51998−0.0950.354
Foot breadth97−0.0910.377107−0.0910.351740.0000.99999−0.0980.333
P < 0.05 in bold. Significant negative correlation.
Table A2. Spearman correlations of body measurements with the age of onset of regular alcohol drinking (i.e., daily over at least 7 days) and the age of first in-patient treatment due to alcohol problems in male and female alcohol-dependent in-patients.
Table A2. Spearman correlations of body measurements with the age of onset of regular alcohol drinking (i.e., daily over at least 7 days) and the age of first in-patient treatment due to alcohol problems in male and female alcohol-dependent in-patients.
Males: The Age ofFemales: The Age of
Onset of Regular Alcohol Drinking (i.e., Daily over at Least 7 Days)First In-Patient Treatment Due to Alcohol ProblemsOnset of Regular Alcohol Drinking (i.e., Daily over at Least 7 Days)First In-Patient Treatment Due to Alcohol Problems
NρPNρPNρPNρP
Absolute measure
Body height91−0.0870.41295−0.0430.67761−0.1450.26571−0.0890.462
Body weight91−0.0700.510950.1330.201610.0310.812710.0550.650
Head circumference910.0390.715950.1290.21263−0.0150.906730.0300.800
Bitragion head arc910.1270.231950.1100.288630.0610.637730.1590.180
Sagittal head arc91−0.2250.03295−0.3110.002630.0560.662730.1160.330
Mandibular arc900.2130.044940.2020.051610.0840.519710.0510.674
Lip-chin distance900.0110.921940.1150.271630.0230.861730.0440.714
Wrist circumference87−0.0770.478910.1500.157610.1320.311700.2020.094
Waist circumference910.0160.880950.2150.036630.1240.331710.1100.359
Hip circumference910.0610.569950.2210.031630.0240.851710.1110.356
Thigh circumference91−0.2220.035950.0480.64663−0.0280.825730.0180.882
Calf circumference91−0.1610.126950.0720.485630.0460.722730.0540.653
Ankle circumference91−0.1030.333950.2340.02263−0.0930.470730.1080.361
Foot length84−0.0970.382870.0900.40562−0.1230.339710.0250.838
Foot breadth85−0.0490.659880.1550.149630.1890.137720.1800.130
Measure divided by body height
Head circumference910.0970.361950.0780.451610.1700.190710.1200.319
Bitragion head arc910.1640.121950.1360.190610.2190.090710.2190.067
Sagittal head arc91−0.1470.16495−0.2660.009610.1870.149710.1930.107
Mandibular arc900.2270.031940.2060.047590.1650.211690.1920.114
Lip-chin distance900.0430.685940.1290.216610.0670.610710.0990.413
Wrist circumference87−0.0870.424910.1560.140590.2710.038680.3390.005
Waist circumference910.0040.973950.2160.035610.2000.122690.2080.087
Hip circumference910.0740.486950.1950.058610.1080.409690.2010.098
Thigh circumference91−0.2180.038950.0420.684610.1080.406710.1100.359
Calf circumference91−0.1430.176950.0730.482610.1330.308710.1190.324
Ankle circumference91−0.0570.590950.2260.028610.0550.671710.2870.015
Foot length84−0.0090.939870.1740.107590.0030.985680.3000.013
Foot breadth85−0.0240.826880.1490.166600.3210.012690.2870.017
Measure residualized on body height
Head circumference910.0420.694950.1040.317610.0850.516710.1300.279
Bitragion head arc910.1590.133950.1270.219610.1400.280710.2340.050
Sagittal head arc91−0.2000.05895−0.3120.002610.0970.457710.1550.197
Mandibular arc900.2440.020940.2090.043590.1550.242690.1580.194
Lip-chin distance900.0390.718940.1280.219610.0580.654710.0840.487
Wrist circumference87−0.0970.369910.1540.145590.2560.050680.3320.006
Waist circumference91−0.0120.907950.2070.045610.1980.126690.1920.114
Hip circumference910.0690.518950.2220.030610.0550.674690.1410.246
Thigh circumference91−0.2160.040950.0540.602610.0210.872710.0700.561
Calf circumference91−0.1440.173950.0830.425610.0980.453710.1000.406
Ankle circumference91−0.0700.507950.2290.026610.0190.886710.2600.028
Foot length84−0.0120.915870.1770.101590.0140.918680.3190.008
Foot breadth85−0.0400.713880.1490.166600.3020.019690.2870.017
P < 0.05 in bold. Significant positive correlation, significant negative correlation.
Table A3. Spearman correlations of body measurements with total lifetime drinking and daily ethanol intake in male and female alcohol-dependent in-patients.
Table A3. Spearman correlations of body measurements with total lifetime drinking and daily ethanol intake in male and female alcohol-dependent in-patients.
MalesFemales
Total Lifetime DrinkingDaily Ethanol IntakeTotal Lifetime DrinkingDaily Ethanol Intake
NρPNρPNρPNρP
Absolute measure
Body height870.0010.993850.1420.19657−0.0510.705550.0600.664
Body weight870.0730.504850.0990.368570.1880.162550.0750.587
Head circumference87−0.0740.49385−0.0510.64359−0.0460.728570.0590.660
Bitragion head arc870.0610.575850.0590.593590.0560.674570.0260.847
Sagittal head arc87−0.0710.513850.0640.561590.1980.134570.1280.341
Mandibular arc86−0.1440.18684−0.1890.08557−0.1150.39355−0.2720.045
Lip-chin distance86−0.2280.03584−0.1880.08659−0.1880.15557−0.0800.553
Wrist circumference830.0180.870810.0680.546580.0420.75656−0.0390.773
Waist circumference870.0970.370850.0050.963580.2190.099560.1340.323
Hip circumference870.0950.383850.0720.512580.1080.422560.0060.963
Thigh circumference87−0.0350.745850.0400.718590.0660.618570.1030.444
Calf circumference87−0.0190.860850.0730.506590.0470.72157−0.0590.661
Ankle circumference87−0.1500.16685−0.0440.692590.0840.52657−0.0640.638
Foot length79−0.0870.444770.1080.348570.1440.284550.1410.306
Foot breadth80−0.0280.80878−0.0060.960580.0520.70156−0.0150.914
Measure divided by body height
Head circumference87−0.0580.59585−0.1850.09157−0.0460.73355−0.0380.783
Bitragion head arc870.0990.36085−0.0540.621570.0750.57755−0.0090.951
Sagittal head arc87−0.0730.50185−0.0360.741570.1560.248550.0700.614
Mandibular arc86−0.1540.15684−0.2420.02755−0.1290.34953−0.3010.029
Lip-chin distance86−0.2040.05984−0.2110.05457−0.2010.13455−0.1110.419
Wrist circumference830.0460.68181−0.0200.862560.0360.79454−0.0980.482
Waist circumference870.1140.29585−0.0120.913560.1820.180540.0930.505
Hip circumference870.1290.233850.0410.707560.1100.41954−0.0320.819
Thigh circumference870.0100.924850.0170.874570.0000.997550.0330.812
Calf circumference870.0000.997850.0460.677570.0550.68655−0.1170.394
Ankle circumference87−0.1400.19685−0.1300.235570.0920.49555−0.1270.354
Foot length79−0.0680.549770.0210.857540.1320.341520.1260.375
Foot breadth800.0390.73478−0.0930.417550.0440.75153−0.1170.406
Measure residualized on body height
Head circumference87−0.0770.47785−0.1200.27557−0.0800.556550.0180.898
Bitragion head arc870.0690.525850.0090.934570.0580.666550.0030.980
Sagittal head arc87−0.0720.509850.0070.946570.1970.142550.1350.327
Mandibular arc86−0.1510.16684−0.2260.03955−0.1540.26153−0.3060.026
Lip-chin distance86−0.2070.05684−0.1890.08557−0.2090.11955−0.1160.400
Wrist circumference830.0350.75281−0.0130.908560.0370.78454−0.0940.501
Waist circumference870.1150.29085−0.0090.936560.1930.154540.1190.393
Hip circumference870.0990.361850.0670.545560.0900.511540.0080.954
Thigh circumference87−0.0250.822850.0380.731570.0370.784550.0910.508
Calf circumference87−0.0030.979850.0620.573570.0520.70055−0.0790.566
Ankle circumference87−0.1580.14485−0.1090.320570.0970.47355−0.0860.534
Foot length79−0.0680.554770.0200.862540.1330.339520.1110.434
Foot breadth800.0460.68478−0.0670.562550.0320.81453−0.1070.446
P < 0.05 in bold. Significant negative correlation.
Table A4. Inter-correlations between absolute male body measurements (alcohol-dependent in-patients bottom left, healthy control subjects top right).
Table A4. Inter-correlations between absolute male body measurements (alcohol-dependent in-patients bottom left, healthy control subjects top right).
NBody height133133133133133132128133133133132131105107
ρ0.2640.2270.2320.2950.1410.1460.189−0.0970.0900.0290.0650.3350.6100.474
P0.0020.0090.0070.0010.1050.0950.0330.2690.3030.7410.461<0.001<0.001<0.001
N106Body weight133133133133132128133133133132131105107
ρ0.3680.2590.0740.0260.2040.1660.6260.8180.8740.6980.6750.4670.2130.360
P<0.0010.0030.3950.7650.0190.057<0.001<0.001<0.001<0.001<0.001<0.0010.029<0.001
N107106Head circum-ference133133133132128133133133132131105107
ρ0.1750.4530.5000.4750.1520.2710.3190.1830.2290.2060.3040.4080.3380.264
P0.071<0.001<0.001<0.0010.0810.002<0.0010.0350.0080.017<0.001<0.001<0.0010.006
N107106107Bitragion head arc133133132128133133133132131105107
ρ0.3260.1680.3900.393−0.0130.1380.143−0.0040.0440.0380.0460.1980.3510.215
P0.0010.085<0.001<0.0010.8800.1150.1070.9610.6120.6610.6000.023<0.0010.026
N107106107107Sagittal head arc133132128133133133132131105107
ρ0.2850.0310.2880.3410.0400.1620.020−0.0940.0110.0810.1200.2480.2190.111
P0.0030.7490.003<0.0010.6470.0630.8190.2810.9010.3530.1710.0040.0250.255
N106105106106106Mandi-bular arc132128133133133132131105107
ρ0.1150.4110.2830.161−0.0850.3300.3030.1950.1620.0890.2450.3480.2130.128
P0.239<0.0010.0030.0990.389<0.0010.0010.0240.0620.3060.005<0.0010.0290.188
N106105106106106105Lip-chin distance127132132132131130104106
ρ0.0010.1870.2840.094−0.2590.3970.2390.1270.1400.1900.2290.2010.2820.229
P0.9900.0550.0030.3390.007<0.0010.0070.1470.1100.0290.0080.0220.0040.018
N102101102102102101101Wrist circum-ference128128128127126101103
ρ0.3370.6920.4140.2220.0010.4670.3370.5030.5520.4590.4830.5350.1870.361
P0.001<0.001<0.0010.0250.995<0.0010.001<0.001<0.001<0.001<0.001<0.0010.061<0.001
N106105106106106105105102Waist circum-ference133133132131105107
ρ0.1690.8860.3950.183−0.0810.4550.2590.5690.7780.5810.5310.3140.0130.135
P0.084<0.001<0.0010.0610.407<0.0010.008<0.001<0.001<0.001<0.001<0.0010.8930.165
N106105106106106105105102106Hip circum-ference133132131105107
ρ0.2630.8780.4570.228−0.0120.4350.2420.6230.8390.7680.6250.3770.0880.229
P0.007<0.001<0.0010.0190.905<0.0010.013<0.001<0.001<0.001<0.001<0.0010.3710.018
N106105106106106105105102106106Thigh circum-ference132131105107
ρ0.1600.8310.4260.012−0.0330.4280.2910.5950.7250.7080.6730.319−0.0670.157
P0.101<0.001<0.0010.9020.739<0.0010.003<0.001<0.001<0.001<0.001<0.0010.4950.107
N106105106106106105105102106106106Calf circum-ference131104106
ρ0.1260.7240.2850.0770.0240.3360.1550.5600.5800.5690.7060.4170.0540.348
P0.199<0.0010.0030.4300.807<0.0010.115<0.001<0.001<0.001<0.001<0.0010.587<0.001
N106105106106106105105102106106106106Ankle circum-ference103105
ρ0.3230.6260.4240.264−0.0600.3470.3810.5800.5740.5780.5390.5820.4970.565
P0.001<0.001<0.0010.0060.543<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
N99989999999898959898989898Foot length105
ρ0.6900.4970.2530.2930.2390.2450.2620.4800.3540.4250.3540.3300.5440.527
P<0.001<0.0010.0120.0030.0170.0150.009<0.001<0.001<0.001<0.0010.001<0.001<0.001
N10099100100100999995999999999999Foot breadth
ρ0.2930.5630.3680.234−0.0340.2640.2530.6020.4430.4820.4310.4720.6360.494
P0.003<0.001<0.0010.0190.7390.0080.012<0.001<0.001<0.001<0.001<0.001<0.001<0.001
Spearman correlations. P < 0.05 in bold.
Table A5. Inter-correlations between absolute female body measurements (alcohol-dependent in-patients bottom left, healthy control subjects top right).
Table A5. Inter-correlations between absolute female body measurements (alcohol-dependent in-patients bottom left, healthy control subjects top right).
NBody height106107107107106107103107107106107107100101
ρ0.1680.3040.0790.2880.0780.0700.196−0.0570.0510.0180.0320.3360.6100.267
P0.0850.0010.4210.0030.4290.4720.0470.5630.6030.8520.743<0.001<0.0010.007
N75Body weight10610610610510610210610610510610699100
ρ0.2460.3440.020−0.0100.5000.2520.5330.8420.8980.8480.8210.5960.2910.510
P0.034<0.0010.8410.922<0.0010.009<0.001<0.001<0.001<0.001<0.001<0.0010.003<0.001
N7777Head circum-ference107107106107103107107106107107100101
ρ0.2340.4320.6120.4330.2190.2580.2200.2140.3190.3120.2630.3350.3300.381
P0.041<0.001<0.001<0.0010.0240.0070.0260.0270.0010.0010.006<0.0010.001<0.001
N777779Bitragion head arc107106107103107107106107107100101
ρ0.2210.1900.4050.3820.1420.242−0.003−0.0160.0150.0910.0280.1390.1000.258
P0.0540.097<0.001<0.0010.1460.0120.9780.8670.8750.3510.7760.1540.3230.009
N77777979Sagittal head arc106107103107107106107107100101
ρ0.0800.2270.3520.311−0.0520.214−0.094−0.1640.0100.070−0.0440.0350.2210.173
P0.4890.0470.0010.0050.5950.0270.3430.0920.9200.4770.6520.7210.0270.083
N7575777777Mandibu-lar arc10610310610610510610699100
ρ0.1460.4590.2780.2950.0390.3040.2990.4340.5080.4580.4130.4330.1940.360
P0.213<0.0010.0140.0090.7380.0020.002<0.001<0.001<0.001<0.001<0.0010.055<0.001
N777779797977Lip-chin distance103107107106107107100101
ρ−0.1030.0890.188−0.039−0.4430.2060.2160.2760.2250.2260.1670.1040.1660.099
P0.3750.4420.0960.733<0.0010.0730.0280.0040.0200.0200.0850.2870.0980.323
N73737575757375Wrist circum-ference1031031021031039697
ρ0.3040.7420.3110.2070.0880.4930.2110.4220.4940.4330.4490.5140.2440.268
P0.009<0.0010.0070.0750.451<0.0010.069<0.001<0.001<0.001<0.001<0.0010.0170.008
N7575777777757773Waist circum-ference107106107107100101
ρ0.0040.8390.3250.1780.0440.4270.2000.6410.7320.6540.6850.4060.0680.258
P0.969<0.0010.0040.1210.702<0.0010.082<0.001<0.001<0.001<0.001<0.0010.5010.009
N757577777775777377Hip circum-ference106107107100101
ρ0.0310.8780.3970.199−0.0020.4470.2400.6840.8610.8420.7460.5940.1870.394
P0.794<0.001<0.0010.0830.986<0.0010.035<0.001<0.001<0.001<0.001<0.0010.063<0.001
N77777979797779757777Thigh circum-ference10610699100
ρ0.1840.8210.3090.0550.0610.3970.1440.6320.6140.7280.7540.5460.2240.454
P0.109<0.0010.0060.6280.596<0.0010.207<0.001<0.001<0.001<0.001<0.0010.026<0.001
N7777797979777975777779Calf circum-ference107100101
ρ0.1640.7880.2630.1480.1870.4770.0330.7020.6030.7420.7750.5920.1710.470
P0.154<0.0010.0190.1940.098<0.0010.776<0.001<0.001<0.001<0.001<0.0010.088<0.001
N777779797977797577777979Ankle circum-ference100101
ρ0.4260.6810.2350.1720.1080.452−0.0030.7360.5260.5860.5870.7500.5370.538
P<0.001<0.0010.0370.1300.345<0.0010.980<0.001<0.001<0.001<0.001<0.001<0.001<0.001
N74747676767476727575767676Foot length100
ρ0.7220.3870.3280.2250.1460.174−0.0010.4690.2170.2230.2490.3880.5820.405
P<0.0010.0010.0040.0510.2080.1380.993<0.0010.0610.0550.0300.001<0.001<0.001
N7575777777757773767677777777Foot breadth
ρ0.2660.5410.1980.2160.1170.3140.0270.6260.3750.4080.3790.6420.6450.567
P0.021<0.0010.0850.0590.3120.0060.817<0.0010.001<0.0010.001<0.001<0.001<0.001
Spearman correlations. P < 0.05 in bold.
Table A6. Inter-correlations between male body measurements divided by height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
Table A6. Inter-correlations between male body measurements divided by height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
NHead circum-ference133133133132128133133133132131105107
ρ0.6420.4880.2530.2990.4970.4310.4490.4210.5110.5020.3210.383
P<0.001<0.0010.003<0.001<0.001<0.001<0.001<0.001<0.001<0.0010.001<0.001
N107Bitragion head arc133133132128133133133132131105107
ρ0.5470.4860.0850.1720.2970.2270.2370.2300.2290.3360.2800.255
P<0.001<0.0010.3330.0490.0010.0090.0060.0080.008<0.0010.0040.008
N107107Sagittal head arc133132128133133133132131105107
ρ0.4590.3740.0640.1960.1560.1010.1620.2220.2320.2460.0800.084
P<0.001<0.0010.4670.0240.0790.2460.0630.0100.0070.0050.4160.390
N106106106Mandibular arc132128133133133132131105107
ρ0.3900.183−0.0040.3380.3970.2970.2840.1940.3620.3740.2080.151
P<0.0010.0610.964<0.001<0.0010.0010.0010.025<0.001<0.0010.0330.121
N106106106105Lip-chin distance127132132132131130104106
ρ0.3600.198−0.1470.4340.2530.2170.2240.2810.2980.2410.2420.141
P<0.0010.0420.132<0.0010.0040.0120.0100.0010.0010.0060.0130.149
N102102102101101Wrist circum-ference128128128127126101103
ρ0.3880.195−0.0390.4490.3780.6020.6440.5100.5900.6010.2710.404
P<0.0010.0500.694<0.001<0.001<0.001<0.001<0.001<0.001<0.0010.006<0.001
N106106106105105102Waist circum-ference133133132131105107
ρ0.3500.198−0.0850.4020.2750.5590.8100.6330.6230.4890.1810.352
P<0.0010.0410.388<0.0010.004<0.001<0.001<0.001<0.001<0.0010.065<0.001
N106106106105105102106Hip circum-ference133132131105107
ρ0.3660.199−0.0470.4080.2830.5730.8420.7830.6940.5190.1420.348
P<0.0010.0410.631<0.0010.003<0.001<0.001<0.001<0.001<0.0010.149<0.001
N106106106105105102106106Thigh circum-ference132131105107
ρ0.3980.0190.0040.4160.2900.5750.7120.7090.7140.452−0.0590.263
P<0.0010.8490.971<0.0010.003<0.001<0.001<0.001<0.001<0.0010.5470.006
N106106106105105102106106106Calf circum-ference131104106
ρ0.3300.1580.0760.3220.1820.5980.6250.5860.6950.5330.0880.439
P0.0010.1070.4390.0010.062<0.001<0.001<0.001<0.001<0.0010.376<0.001
N106106106105105102106106106106Ankle circum-ference103105
ρ0.4340.260−0.0450.4440.4520.5840.5320.5440.5340.6310.3990.526
P<0.0010.0070.644<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
N9999999898959898989898Foot length105
ρ0.1960.1400.0680.3320.3730.3700.3120.3540.2900.2960.5230.356
P0.0520.1660.5050.001<0.001<0.0010.002<0.0010.0040.003<0.001<0.001
N100100100999995999999999999Foot breadth
ρ0.4110.2820.0400.2710.2920.5380.3510.4030.3730.4720.6290.436
P<0.0010.0040.6950.0070.003<0.001<0.001<0.001<0.001<0.001<0.001<0.001
Spearman correlations. P < 0.05 in bold.
Table A7. Inter-correlations between female body measurements divided by height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
Table A7. Inter-correlations between female body measurements divided by height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
NHead circum-ference107107106107103107107106107107100101
ρ0.7680.5180.3750.3220.3630.3960.4450.4570.4470.4790.3290.594
P<0.001<0.001<0.0010.001<0.001<0.001<0.001<0.001<0.001<0.0010.001<0.001
N77Bitragion head arc107106107103107107106107107100101
ρ0.6180.5370.3440.3570.2030.2490.2790.3350.3010.3790.2600.512
P<0.001<0.001<0.001<0.0010.0390.0100.004<0.0010.002<0.0010.009<0.001
N7777Sagittal head arc106107103107107106107107100101
ρ0.5820.4800.0920.270−0.032−0.0270.1550.1950.1010.0940.1480.303
P<0.001<0.0010.3460.0050.7460.7820.1110.0450.3030.3340.1420.002
N757575Mandibular arc10610310610610510610699100
ρ0.4440.4130.2070.4020.3610.5090.5910.5430.5130.5590.2670.491
P<0.001<0.0010.074<0.001<0.001<0.001<0.001<0.001<0.001<0.0010.008<0.001
N77777775Lip-chin distance103107107106107107100101
ρ0.3880.222−0.1100.3640.2780.3330.3270.2910.2550.2230.2950.272
P<0.0010.0520.3400.0010.005<0.0010.0010.0020.0080.0210.0030.006
N7373737173Wrist circum-ference1031031021031039697
ρ0.4210.2710.2920.4820.2870.5140.5520.5150.5170.5790.2200.361
P<0.0010.0200.012<0.0010.014<0.001<0.001<0.001<0.001<0.0010.032<0.001
N757575737571Waist circum-ference107106107107100101
ρ0.3860.2820.1960.4840.2560.6320.7610.6710.7240.5790.2010.467
P0.0010.0140.092<0.0010.027<0.001<0.001<0.001<0.001<0.0010.045<0.001
N75757573757175Hip circum-ference106107107100101
ρ0.5060.3230.2190.5370.2900.7680.8890.8270.7620.6970.2420.527
P<0.0010.0050.059<0.0010.012<0.001<0.001<0.001<0.001<0.0010.015<0.001
N7777777577737575Thigh circum-ference10610699100
ρ0.2710.0770.1180.3840.2040.6530.6530.7390.7850.6730.2890.558
P0.0170.5080.3080.0010.075<0.001<0.001<0.001<0.001<0.0010.004<0.001
N777777757773757577Calf circum-ference107100101
ρ0.3090.1950.2530.4550.0950.7010.6110.7520.7350.7170.2370.620
P0.0060.0900.026<0.0010.411<0.001<0.001<0.001<0.001<0.0010.018<0.001
N77777775777375757777Ankle circum-ference100101
ρ0.2290.1680.0730.4350.1160.6990.5480.6640.5570.7250.4450.615
P0.0450.1450.530<0.0010.315<0.001<0.001<0.001<0.001<0.001<0.001<0.001
N7474747274707373747474Foot length100
ρ0.1730.1490.1370.1220.0980.3620.2180.2920.1140.3630.4640.453
P0.1400.2060.2460.3060.4080.0020.0640.0120.3320.001<0.001<0.001
N757575737571747475757574Foot breadth
ρ0.3480.4040.2670.3920.1380.6240.4040.4770.3440.6050.6010.463
P0.002<0.0010.0210.0010.239<0.001<0.001<0.0010.002<0.001<0.001<0.001
Spearman correlations. P < 0.05 in bold.
Table A8. Inter-correlations between male body measurements residualized on height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
Table A8. Inter-correlations between male body measurements residualized on height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
NHead circum-ference133133133132128133133133132131105107
ρ0.4590.3840.1250.2460.3900.2750.2320.2280.3330.3790.3360.226
P<0.001<0.0010.1530.005<0.0010.0010.0070.008<0.001<0.001<0.0010.019
N107Bitragion head arc133133132128133133133132131105107
ρ0.3090.323−0.0400.0970.1420.0630.0470.0480.0410.1760.2270.101
P0.001<0.0010.6510.2690.1090.4700.5910.5840.6420.0440.0200.300
N107107Sagittal head arc133132128133133133132131105107
ρ0.2390.251−0.0150.1360.013−0.073−0.0230.0690.0740.1300.035−0.041
P0.0130.0090.8640.1200.8810.4030.7940.4320.4010.1380.7250.673
N106106106Mandibular arc132128133133133132131105107
ρ0.3070.086−0.1390.3200.3550.2450.1560.0960.2910.3050.2020.096
P0.0010.3830.156<0.001<0.0010.0040.0730.2730.001<0.0010.0390.326
N106106106105Lip-chin distance127132132132131130104106
ρ0.3550.089−0.2780.4200.2090.1580.1360.2040.2480.1810.2050.104
P<0.0010.3650.004<0.0010.0180.0700.1210.0190.0040.0390.0370.291
N102102102101101Wrist circum-ference128128128127126101103
ρ0.4040.112−0.1050.4340.3840.5780.5090.4180.5220.5330.2700.372
P<0.0010.2620.295<0.001<0.001<0.001<0.001<0.001<0.001<0.0010.006<0.001
N106106106105105102Waist circum-ference133133132131105107
ρ0.4010.152−0.1410.3980.2730.5490.7320.5510.5720.3990.1790.298
P<0.0010.1200.149<0.0010.005<0.001<0.001<0.001<0.001<0.0010.0680.002
N106106106105105102106Hip circum-ference133132131105107
ρ0.3500.151−0.0960.3500.2120.4940.7960.7630.6120.3970.0710.233
P<0.0010.1220.326<0.0010.030<0.001<0.001<0.001<0.001<0.0010.4740.016
N106106106105105102106106Thigh circum-ference132131105107
ρ0.381−0.042−0.0890.3700.2640.5220.7150.7090.6660.362−0.1220.152
P<0.0010.6710.365<0.0010.007<0.001<0.001<0.001<0.001<0.0010.2160.117
N106106106105105102106106106Calf circum-ference131104106
ρ0.2820.066−0.0100.2980.1600.5730.6090.5450.6890.4470.0420.356
P0.0030.5020.9200.0020.104<0.001<0.001<0.001<0.001<0.0010.669<0.001
N106106106105105102106106106106Ankle circum-ference103105
ρ0.3960.168−0.1710.3980.4350.5620.5400.5010.5190.6160.3820.495
P<0.0010.0850.080<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
N9999999898959898989898Foot length105
ρ0.1900.0820.0180.3060.3700.3700.3030.2840.2600.2930.5050.356
P0.0600.4190.8560.002<0.001<0.0010.0020.0050.0100.003<0.001<0.001
N100100100999995999999999999Foot breadth
ρ0.3040.166−0.0850.2210.2570.5190.3670.3410.3170.4480.5840.428
P0.0020.0990.4000.0280.010<0.001<0.0010.0010.001<0.001<0.001<0.001
Spearman correlations. P < 0.05 in bold.
Table A9. Inter-correlations between female body measurements residualized on height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
Table A9. Inter-correlations between female body measurements residualized on height (alcohol-dependent in-patients bottom left, healthy control subjects top right).
NHead circum-ference107107106107103107107106107107100101
ρ0.6520.3720.2190.2650.2310.2670.2900.3010.2450.2960.2100.354
P<0.001<0.0010.0240.0060.0190.0050.0020.0020.0110.0020.036<0.001
N77Bitragion head arc107106107103107107106107107100101
ρ0.3800.3880.2050.2830.0600.0950.0230.1020.0640.1980.1650.324
P0.001<0.0010.0350.0030.5490.3320.8110.2960.5150.0410.1010.001
N7777Sagittal head arc106107103107107106107107100101
ρ0.3510.303−0.0560.187−0.170−0.1480.0000.067−0.057−0.0750.0610.111
P0.0020.0070.5670.0540.0860.1280.9960.4930.5630.4410.5480.269
N757575Mandibular arc10610310610610510610699100
ρ0.2940.2680.0490.3500.3340.4780.4690.4430.4380.4970.2360.404
P0.0110.0200.676<0.0010.001<0.001<0.001<0.001<0.001<0.0010.019<0.001
N77777775Lip-chin distance103107107106107107100101
ρ0.2790.054−0.3390.2910.2550.2990.2030.2130.1700.1450.2790.190
P0.0140.6430.0030.0110.0090.0020.0360.0280.0800.1370.0050.057
N7373737173Wrist circum-ference1031031021031039697
ρ0.2910.1200.1800.4290.2580.4990.4580.4010.4520.5210.2170.324
P0.0120.3100.128<0.0010.028<0.001<0.001<0.001<0.001<0.0010.0330.001
N757575737571Waist circum-ference107106107107100101
ρ0.3040.1630.0950.4170.2130.6200.6950.6220.6840.5070.2010.413
P0.0080.1620.418<0.0010.066<0.001<0.001<0.001<0.001<0.0010.045<0.001
N75757573757175Hip circum-ference106107107100101
ρ0.3820.2070.0350.4460.2100.6710.8630.8380.7220.5890.1350.354
P0.0010.0740.767<0.0010.071<0.001<0.001<0.001<0.001<0.0010.181<0.001
N7777777577737575Thigh circum-ference10610699100
ρ0.207−0.0230.0300.2960.0990.5410.5900.7270.7460.5620.1930.410
P0.0710.8440.7960.0100.392<0.001<0.001<0.001<0.001<0.0010.055<0.001
N777777757773757577Calf circum-ference107100101
ρ0.2140.1100.1880.4130.0320.6550.5850.7470.7400.6430.1740.509
P0.0620.3420.101<0.0010.784<0.001<0.001<0.001<0.001<0.0010.083<0.001
N77777775777375757777Ankle circum-ference100101
ρ0.1570.1150.0580.3880.0320.6390.5110.6340.5420.7250.4320.533
P0.1720.3180.6150.0010.783<0.001<0.001<0.001<0.001<0.001<0.001<0.001
N7474747274707373747474Foot length100
ρ0.2120.1800.1760.1300.1120.4030.2470.2940.0980.3690.4740.453
P0.0700.1250.1340.2750.3420.0010.0350.0120.4090.001<0.001<0.001
N757575737571747475757574Foot breadth
ρ0.1530.2400.1320.3310.0880.5850.3710.3780.2630.5590.5690.506
P0.1900.0380.2580.0040.452<0.0010.0010.0010.022<0.001<0.001<0.001
Spearman correlations. P < 0.05 in bold.

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Table 1. Demographic characteristics of male and female alcohol-dependent in-patients (ADP) and healthy control subjects (HCS).
Table 1. Demographic characteristics of male and female alcohol-dependent in-patients (ADP) and healthy control subjects (HCS).
MalesFemalesADP versus HCSMales versus Females
ADP (N = 113)HCS (N = 133)ADP (N = 87)HCS (N = 107)MalesFemalesADPHCS
NM/FIQRNM/FIQRNM/FIQRNM/FIQRU2PU2PU2PU2P
Age (years)1134840531334838568748425510749395573690.79445420.77245020.30869540.762
The age of onset of regular alcohol drinking
(i.e., daily over at least 7 days) (years)
92261934 - 67332341 - 21520.001
The age of first in-patient treatment due to alcohol problems (years)96363047 - 77403246 - 32560.179
Total lifetime drinking (kg)887053641838 - 62332174747 - 1485<0.001
Daily ethanol intake (g/d since onset)8614080310 - 606530120 - 1400<0.001
Previous withdrawal treatments (n)896212 - 585211 - 25470.892
Alcohol concentration at admission (‰)1081.70.52.4 - 851.20.11.8 - 36960.020
AUDIT score - 125436 - 96324 4295<0.001
Active smokers (%)10478 13322 7877 10719 74<0.00162<0.001<10.878<10.552
Active and ex-smokers (%)10192 13359 7585 10548 31<0.00127<0.00120.15430.070
CDT (nephelometry, %)1132.81.94.01321.51.31.7871.91.62.51071.51.31.61636<0.0011415<0.0013003<0.00166920.486
12-month alcohol-related readmissions
Readmission rate (%)11358 - 8741 - 50.024
Latency (days)11328557≥365 - 87≥36597≥365 - 41420.042
Total number113103 - 87002 - 41750.051
24-month alcohol-related readmissions
Readmission rate (%)11367 - 8753 - 40.039
Latency (days)11328557≥730 - 8762590≥730 - 41360.047
Total number113204 - 87103 - 40140.021
The table shows medians (M) or relative frequencies (F), interquartile ranges (IQR), and results of Mann-Whitney U tests or χ2 tests. AUDIT: Alcohol Use Disorders Identification Test; CDT: carbohydrate-deficient transferrin. P < 0.05 in bold.
Table 2. Differences in body measurements between alcohol-dependent in-patients (ADP) and healthy control subjects (HCS) and between males and females (Mann-Whitney U tests).
Table 2. Differences in body measurements between alcohol-dependent in-patients (ADP) and healthy control subjects (HCS) and between males and females (Mann-Whitney U tests).
MalesFemalesADP versus HCSMales versus Females
ADPHCSADPHCSMalesFemalesADPHCS
NMIQRNMIQRNMIQRNMIQRUPUPUPUP
Absolute measure
Body height107176.8172.0181.0133179.1173.8184.177164.5162.0169.0107165.6161.5169.156680.00740640.876943<0.001 *864<0.001 *
Body weight10679.368.786.613387.481.097.27766.759.879.810668.059.379.34115<0.001 *40780.9932484<0.001 *2260<0.001 *
Head circumference10757.556.258.913358.457.259.47955.054.056.510756.054.557.354360.00231980.0051348<0.001 *2626<0.001 *
Bitragion head arc10736.735.637.513337.436.538.77935.534.536.310736.035.037.45149<0.00133180.0122444<0.001 *4149<0.001 *
Sagittal head arc10736.035.037.713335.634.537.07935.034.036.110734.533.036.063190.13639000.3672814<0.0015030<0.001
Mandibular arc10624.023.025.213324.022.526.07722.221.323.010622.421.023.669050.78539070.6211501<0.001 *3694<0.001 *
Lip-chin distance1065.54.96.01325.65.46.0795.04.45.51075.04.75.553030.00134460.0312731<0.001 *3758<0.001 *
Wrist circumference10217.716.818.412817.917.218.67516.015.516.810315.814.916.757610.12633820.1561037<0.001 *1825<0.001 *
Waist circumference10693.087.8103.513396.089.5104.87787.078.093.510784.072.792.761980.10935650.1192545<0.001 *3498<0.001 *
Hip circumference10694.288.8100.0133102.098.0107.07796.090.8106.0107101.295.0106.83076<0.001 *31300.00534240.06363420.148
Thigh circumference10655.250.858.513360.557.864.67956.553.762.010660.557.064.03043<0.001 *30000.00132940.01366270.426
Calf circumference10636.835.438.913239.537.741.57936.033.839.210737.335.039.53785<0.001 *36470.11036570.1413999<0.001 *
Ankle circumference10626.225.327.213126.625.927.97924.223.125.810724.623.625.457200.02041070.7411922<0.001 *2313<0.001 *
Foot length9926.125.127.010526.926.027.67724.023.124.710024.123.525.03625<0.00134130.195805<0.001 *733<0.001 *
Foot breadth1009.79.410.110710.19.810.4789.18.89.51019.28.99.43375<0.001 *39300.9781559<0.001 *725<0.001 *
Measure divided by body height
Head circumference1070.330.320.331330.320.320.33770.330.320.341070.340.330.3568460.61431420.00630360.0023505<0.001 *
Bitragion head arc1070.210.200.211330.210.200.22770.220.210.221070.220.210.2363940.17732510.0152492<0.001 *3940<0.001 *
Sagittal head arc1070.210.200.211330.200.190.21770.210.200.221070.210.200.2253130.00139330.60129120.0013829<0.001 *
Mandibular arc1060.140.130.141330.140.130.14750.130.130.141060.140.130.1466650.47037310.48235510.22269060.788
Lip-chin distance1060.030.030.031320.030.030.03770.030.030.031070.030.030.0358430.02932990.02136340.20663820.200
Wrist circumference1020.100.100.101280.100.100.10730.100.090.101030.100.090.1063660.74633430.21127610.0044722<0.001
Waist circumference1060.530.500.581330.530.500.59750.520.470.571070.510.440.5767020.51335440.18036540.35555690.004
Hip circumference1060.530.500.561330.570.540.60750.590.540.641070.610.570.663669<0.001 *30950.0091974<0.001 *4140<0.001 *
Thigh circumference1060.310.290.331330.340.320.36770.340.330.371060.360.340.393603<0.001 *29760.0021868<0.001 *4234<0.001 *
Calf circumference1060.210.200.221320.220.210.23770.220.210.241070.230.210.244762<0.001 *34920.07830780.00560780.064
Ankle circumference1060.150.140.151310.150.140.15770.150.140.151070.150.140.1665350.43739430.61940360.89867690.650
Foot length990.150.140.151050.150.150.15740.140.140.151000.150.140.1545260.11128430.0092525<0.00141580.010
Foot breadth1000.060.050.061070.060.050.06750.060.050.061010.060.050.0642960.01437590.93236290.71545940.062
Measure residualized on body height
Head circumference1070.08−0.460.661330.26−0.190.7377−0.46−1.000.24107−0.15−0.530.6062410.10229760.0012674<0.001 *56150.005
Bitragion head arc107−0.09−0.750.301330.25−0.440.9177−0.28−0.990.27107−0.01−0.680.7855090.00331950.00936500.18764530.215
Sagittal head arc1070.15−0.490.78133−0.09−0.800.45770.06−0.620.65107−0.05−0.760.5757690.01237830.34537920.35868730.649
Mandibular arc1060.10−0.240.531330.13−0.570.7575−0.22−0.540.15106−0.17−0.730.4368380.69137560.52728430.00159230.034
Lip-chin distance1060.12−0.830.771320.29−0.240.9177−0.37−1.060.28107−0.12−0.800.5756680.01233030.02232880.02553900.002
Wrist circumference1020.28−0.110.611280.18−0.100.5873−0.02−0.180.22103−0.13−0.510.3264090.81233340.20126230.0014477<0.001 *
Waist circumference106−0.01−0.430.631330.10−0.360.8475−0.18−0.880.35107−0.42−1.210.3765310.32935170.15733170.0584872<0.001 *
Hip circumference106−0.57−0.99−0.021330.19−0.200.6375−0.30−0.900.551070.17−0.420.733080<0.001 *29990.00432380.03467620.508
Thigh circumference106−0.61−1.29−0.111330.20−0.250.7977−0.37−0.820.351060.25−0.260.793061<0.001 *28970.00130650.00469820.900
Calf circumference106−0.34−0.830.221320.22−0.230.7477−0.29−0.880.431070.06−0.540.584173<0.001 *35270.09639100.62856780.009
Ankle circumference1060.00−0.350.481310.15−0.250.4177−0.22−0.580.15107−0.19−0.450.2561670.13939570.64732290.0165040<0.001
Foot length99−0.02−0.550.721050.23−0.351.0874−0.38−0.970.181000.04−0.650.5045470.12328660.01126280.00142700.021
Foot breadth100−0.07−0.690.681070.32−0.151.0275−0.19−0.810.51101−0.14−0.770.3640560.00337550.92333450.2223389<0.001 *
Medians (M), interquartile ranges (IQR), absolute body weight in kg, absolute length dimensions in cm, P < 0.05 after adjustment using the false discovery rate is colored and indicates the following direction: ADP < HCS, ADP > HCS, males > females, males < females. * P < 0.05 after Bonferroni correction.
Table 3. Differences in body measurements between alcohol-dependent in-patients (ADP) without and those with prospective 12-month alcohol-related readmission.
Table 3. Differences in body measurements between alcohol-dependent in-patients (ADP) without and those with prospective 12-month alcohol-related readmission.
12-Month Readmission in Male ADP12-Month Readmission in Female ADP
NoYes NoYes
NMIQRNMIQRUPNMIQRNMIQRUP
Absolute measure
Body height46177.7173.0181.061176.2171.0181.412000.20145164.3160.5169.032164.8163.0169.26280.339
Body weight4574.268.183.36180.271.890.410980.0794768.257.976.73065.760.581.36500.562
Head circumference4657.356.258.06157.556.459.012090.2214754.554.056.03255.553.757.05930.111
Bitragion head arc4637.036.037.76136.335.437.511400.0974735.534.536.23235.535.036.56400.260
Sagittal head arc4636.035.037.46136.034.737.713810.8904734.833.036.03235.234.136.36080.149
Mandibular arc4624.223.425.56023.622.825.011200.0964722.021.023.03022.322.023.15820.194
Lip-chin distance465.54.96.0605.55.05.813060.635475.04.25.5325.04.65.57100.668
Wrist circumference4417.716.518.25817.716.918.511310.3274615.915.516.82916.115.516.55900.401
Waist circumference4692.086.497.76095.688.3105.511150.0914587.081.093.53286.877.0101.07130.938
Hip circumference4692.688.099.46095.390.0100.812010.2524596.591.7103.03295.289.8108.17170.971
Thigh circumference4652.949.856.56056.653.560.29110.0034756.053.062.53256.954.061.07090.668
Calf circumference4636.234.537.96037.435.839.79980.0154735.833.339.23236.834.239.46860.506
Ankle circumference4626.025.027.06026.525.527.511090.0844724.123.026.03224.523.825.36720.423
Foot length4126.025.027.25826.125.326.811830.9664523.722.724.73224.123.524.86040.229
Foot breadth429.79.510.0589.79.410.211800.788469.18.89.5329.18.99.57310.959
Measure divided by body height
Head circumference460.320.310.33610.330.320.3410710.036450.330.320.34320.330.320.357050.877
Bitragion head arc460.210.200.21610.210.200.2213040.531450.220.210.22320.220.210.227050.873
Sagittal head arc460.200.200.21610.210.200.2112850.456450.210.200.22320.210.200.226940.784
Mandibular arc460.140.130.15600.140.130.1412550.426450.130.130.14300.130.130.146280.611
Lip-chin distance460.030.030.03600.030.030.0313570.883450.030.030.03320.030.030.036890.749
Wrist circumference440.100.090.10580.100.100.1010340.102440.100.090.10290.100.090.106200.839
Waist circumference460.510.490.56600.540.510.5910260.024430.540.490.57320.510.460.596630.785
Hip circumference460.520.490.56600.540.520.5710760.052430.600.540.64320.570.540.646600.764
Thigh circumference460.300.280.32600.320.300.34811<0.001450.340.330.37320.340.330.376900.753
Calf circumference460.210.190.22600.210.200.239390.005450.220.200.24320.220.210.246770.653
Ankle circumference460.150.140.15600.150.140.1610170.021450.150.140.15320.150.140.157140.946
Foot length410.150.140.15580.150.140.1510500.323420.140.140.15320.150.140.156120.513
Foot breadth420.050.050.06580.060.050.0610920.379430.060.050.06320.060.050.066030.363
Measure residualized on body height
Head circumference46−0.14−0.500.40610.23−0.380.7611040.05945−0.58−1.020.0732−0.34−0.900.396090.251
Bitragion head arc460.01−0.450.3161−0.26−0.990.2911730.14745−0.49−0.990.3232−0.23−0.950.276770.653
Sagittal head arc460.15−0.440.78610.16−0.540.7713510.74145−0.02−0.620.62320.08−0.580.696370.391
Mandibular arc460.12−0.210.74600.05−0.350.3812090.27645−0.33−0.690.1730−0.18−0.460.156100.482
Lip-chin distance460.07−0.861.02600.13−0.670.5213450.82345−0.36−1.230.2832−0.39−0.870.356810.687
Wrist circumference440.05−0.180.52580.33−0.030.6610400.11144−0.04−0.160.24290.01−0.400.226280.910
Waist circumference46−0.19−0.490.34600.10−0.310.8910450.03243−0.05−0.600.3432−0.30−0.970.696640.793
Hip circumference46−0.68−1.11−0.0760−0.42−0.920.0911890.22243−0.28−0.900.3732−0.38−0.870.776820.949
Thigh circumference46−0.98−1.43−0.4260−0.42−0.820.148910.00245−0.42−0.840.5132−0.30−0.730.346770.653
Calf circumference46−0.61−1.210.0160−0.22−0.600.409640.00845−0.42−0.920.4332−0.09−0.870.446630.552
Ankle circumference46−0.10−0.390.28600.15−0.260.6810410.03145−0.22−0.640.2032−0.21−0.530.137040.865
Foot length41−0.03−0.790.51580.09−0.480.8610540.33842−0.44−0.930.0932−0.07−1.190.216220.585
Foot breadth42−0.40−0.690.72580.10−0.730.6611080.44243−0.19−0.700.5432−0.31−0.940.276230.486
Medians (M), interquartile ranges (IQR), absolute body weight in kg, absolute length dimensions in cm, P < 0.05 after adjustment using the false discovery rate is colored and indicates the following direction: ADP without 12-month readmission < ADP with 12-month readmission (no P < 0.05 after Bonferroni correction).
Table 4. Differences in body measurements between alcohol-dependent in-patients (ADP) without and those with prospective 24-month alcohol-related readmission.
Table 4. Differences in body measurements between alcohol-dependent in-patients (ADP) without and those with prospective 24-month alcohol-related readmission.
24-Month Readmission in Male ADP24-Month Readmission in Female ADP
NoYes NoYes
NMIQRNMIQRUPNMIQRNMIQRUP
Absolute measure
Body height36178.1174.4181.271176.2171.0181.09730.04435164.1160.0169.242165.0163.0169.06000.167
Body weight3574.267.981.97180.069.189.910340.1613767.257.976.74066.661.280.56750.507
Head circumference3657.356.158.07157.556.359.011350.3433754.854.056.04255.253.456.87070.490
Bitragion head arc3637.036.037.87136.535.537.510770.1843735.534.336.04235.535.036.56660.274
Sagittal head arc3635.934.937.67136.035.037.712130.6653735.033.136.04235.134.036.36910.397
Mandibular arc3624.423.525.57024.022.625.09770.0583722.021.023.04022.321.423.16480.345
Lip-chin distance365.54.96.1705.54.95.810990.280375.04.25.5425.04.45.57650.901
Wrist circumference3417.616.518.26817.716.918.510460.4333615.815.216.83916.015.516.56130.342
Waist circumference3692.087.397.47095.288.0105.010580.1783587.076.893.54286.878.094.06980.701
Hip circumference3692.688.399.47095.389.2100.511120.3223596.589.0106.04296.090.8106.07270.931
Thigh circumference3652.950.056.87056.152.060.09340.0293756.053.162.04256.654.061.07380.702
Calf circumference3636.234.338.07037.035.839.39990.0813736.033.839.24236.234.039.07620.883
Ankle circumference3626.025.327.07026.325.427.411310.3873724.023.026.04224.523.825.56990.440
Foot length3326.225.227.26626.025.126.810130.5703523.622.524.74224.123.125.05810.114
Foot breadth349.79.410.0669.89.410.29990.371369.18.79.5429.18.99.57320.806
Measure divided by body height
Head circumference360.320.310.33710.330.320.349060.014350.340.320.34420.330.320.346670.483
Bitragion head arc360.210.200.21710.210.200.2212310.757350.220.210.22420.220.210.227060.763
Sagittal head arc360.200.200.21710.210.200.2110550.141350.210.200.23420.210.200.226860.613
Mandibular arc360.140.130.15700.140.130.1411330.397350.130.130.14400.130.130.146750.787
Lip-chin distance360.030.030.03700.030.030.0311940.660350.030.030.03420.030.030.037200.874
Wrist circumference340.100.090.10680.100.100.108940.063340.100.090.10390.100.090.106380.782
Waist circumference360.510.480.55700.540.500.599480.037330.540.470.57420.510.470.586690.794
Hip circumference360.520.490.56700.540.520.579780.059330.600.540.64420.580.540.636530.669
Thigh circumference360.300.280.32700.320.300.347870.002350.340.330.37420.340.330.376860.613
Calf circumference360.200.190.22700.210.200.238930.014350.220.200.24420.220.210.237180.858
Ankle circumference360.150.140.15700.150.140.169780.059350.150.140.15420.150.140.157270.931
Foot length330.150.140.15660.150.140.159290.235320.140.140.15420.150.140.155500.183
Foot breadth340.050.050.06660.060.050.068660.062330.060.050.06420.060.050.066160.411
Measure residualized on body height
Head circumference36−0.14−0.480.37710.20−0.410.7910050.07135−0.58−1.020.2442−0.41−1.000.257120.810
Bitragion head arc360.01−0.600.3171−0.26−0.930.3011400.36335−0.50−1.030.3442−0.23−0.900.186980.701
Sagittal head arc36−0.16−0.540.80710.17−0.340.7711500.399350.02−0.700.65420.06−0.580.687110.806
Mandibular arc360.17−0.210.73700.05−0.460.4010790.22735−0.33−0.640.1740−0.18−0.490.156530.614
Lip-chin distance360.11−0.851.03700.12−0.760.5411600.50535−0.35−1.180.2842−0.45−1.050.397230.898
Wrist circumference34−0.02−0.200.51680.31−0.020.659070.07734−0.01−0.180.2839−0.04−0.260.226450.842
Waist circumference36−0.18−0.540.32700.06−0.370.869700.05333−0.04−0.880.3442−0.28−0.880.586760.852
Hip circumference36−0.73−1.09−0.0870−0.43−0.940.0811040.29633−0.35−0.960.4142−0.30−0.760.646890.966
Thigh circumference36−0.98−1.43−0.4170−0.48−1.060.089140.02135−0.42−0.840.5142−0.32−0.740.356970.694
Calf circumference36−0.62−1.210.0470−0.28−0.620.359460.03635−0.35−1.050.6142−0.19−0.880.387350.996
Ankle circumference36−0.05−0.370.31700.07−0.270.5810340.13135−0.21−0.700.2942−0.23−0.490.137200.874
Foot length33−0.09−0.810.40660.12−0.480.929280.23232−0.45−0.95−0.01420.04−1.130.235610.226
Foot breadth34−0.48−0.690.49660.12−0.630.738880.08933−0.21−0.700.6242−0.16−0.870.286510.654
Medians (M), interquartile ranges (IQR), absolute body weight in kg, absolute length dimensions in cm, P < 0.05 after adjustment using the false discovery rate is colored and indicates the following direction: ADP without 24-month readmission < ADP with 24-month readmission (no P < 0.05 after Bonferroni correction).
Table 5. Spearman correlations of absolute body measurements with days to first and number of alcohol-related readmissions in alcohol-dependent in-patients (ADP).
Table 5. Spearman correlations of absolute body measurements with days to first and number of alcohol-related readmissions in alcohol-dependent in-patients (ADP).
Male ADP 12-Month ReadmissionMale ADP 24-Month Readmission Female ADP 12-Month ReadmissionFemale ADP 24-Month Readmission
Latency (Days)NumberLatency (Days)NumberLatency (Days)NumberLatency (Days)Number
NρPρPρPρPNρPρPρPρP
Absolute measure
Body height1070.0910.349−0.0820.4000.1220.210−0.1310.17977−0.0410.7220.1230.286−0.0980.3990.1520.187
Body weight106−0.1500.1260.1750.072−0.1400.1520.1880.05477−0.0280.8070.1020.379−0.0620.5920.1040.368
Head circumference107−0.1310.1780.1400.151−0.1260.1960.1600.09979−0.1320.2450.1670.141−0.0900.4330.1490.189
Bitragion head arc1070.1950.044−0.1790.0650.1900.050−0.1470.13179−0.0580.6140.0730.525−0.0370.7430.0990.385
Sagittal head arc107−0.0060.9520.1200.217−0.0190.8480.1620.09579−0.1780.1160.2060.069−0.1690.1370.1920.090
Mandibular arc1060.1220.212−0.1410.1490.1410.151−0.1420.14777−0.0780.5030.1150.319−0.0580.6180.1020.376
Lip-chin distance1060.0400.686−0.0940.3390.0600.542−0.1330.17479−0.0400.7240.0020.9860.0080.945−0.0200.865
Wrist circumference102−0.1210.2250.1100.270−0.1160.2440.1200.23075−0.0490.6790.1030.378−0.0960.4110.1110.342
Waist circumference106−0.1060.2790.1420.147−0.0960.3260.1460.135770.0430.7080.0110.9280.0100.9300.0440.706
Hip circumference106−0.0950.3340.1270.196−0.0910.3510.1510.123770.0500.666−0.0120.9200.0350.761−0.0290.801
Thigh circumference106−0.2600.0070.2740.004−0.2400.0130.2570.00879−0.0550.6280.1180.301−0.0800.4840.0950.405
Calf circumference106−0.2700.0050.1990.041−0.2490.0100.1810.06379−0.0500.6600.1240.276−0.0500.6640.0600.598
Ankle circumference106−0.1230.2100.1400.153−0.0970.3220.0870.37679−0.0620.5880.1180.302−0.0900.4310.0940.408
Foot length99−0.0300.7650.0060.953−0.0090.929−0.0260.79777−0.0880.4490.1850.108−0.1500.1930.2150.061
Foot breadth100−0.1100.2760.0390.700−0.1310.1950.0920.363780.0620.5880.0020.9870.0150.899−0.0040.974
Measure divided by body height
Head circumference107−0.1840.0580.2000.038−0.2030.0360.2600.00777−0.0440.702−0.0160.8910.0240.837−0.0480.676
Bitragion head arc1070.1080.267−0.1010.3000.0790.416−0.0400.686770.0130.911−0.0600.6050.0580.614−0.0510.660
Sagittal head arc107−0.0400.6840.1450.136−0.0690.4780.2240.02077−0.1000.3860.0600.605−0.0540.6420.0260.824
Mandibular arc1060.0410.674−0.0790.4230.0500.612−0.0640.51775−0.0310.7920.0250.8330.0000.9970.0100.931
Lip-chin distance1060.0220.826−0.0630.5200.0300.764−0.0830.39777−0.0470.6870.0000.9990.0020.985−0.0190.869
Wrist circumference102−0.1750.0790.1590.109−0.1870.0600.1870.060730.0340.7760.0100.9330.0100.934−0.0040.973
Waist circumference106−0.1510.1230.1830.060−0.1490.1280.1920.049750.0650.577−0.0330.7770.0640.584−0.0220.852
Hip circumference106−0.1610.1000.1800.064−0.1640.0930.2110.030750.0540.644−0.0370.7500.0520.659−0.0620.598
Thigh circumference106−0.3080.0010.315