Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Influence of having a male twin on body mass index and risk for dyslipidemia in middle-aged and old women



Animal experiments suggest that exposure to elevated levels of androgens during development by means of so-called hormonal programming causes metabolic aberrations at adulthood. An indirect strategy to address the possible importance of such an influence also in humans would be to study female dizygotic twins, presuming that those with a twin brother—due to diffusion of testosterone—have been exposed to higher androgen levels prenatally.


We have compared 8409 women with a male twin with 9166 women with a dizygotic female twin with respect to self-reported indices of anthropometry and metabolic aberrations at age 42 or older.


Body mass index (BMI), body weight and rate of dyslipidemia were moderately, but significantly, higher in women from opposite-sexed (OS) twin pairs; splitting for age revealed this difference to be present in those 60 years of age only.


The results (i) support the notion that comparisons of women with a twin brother with women from same-sexed twin pairs may be used to shed light on possible long-term effects of interindividual variations in early androgen exposure, and (ii) suggest that the effects of early androgen exposure on metabolism previously observed in animal experiments are of relevance also for humans.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM . Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia 1993; 36: 62–67.

    Article  CAS  Google Scholar 

  2. de Rooij SR, Painter RC, Holleman F, Bossuyt PM, Roseboom TJ . The metabolic syndrome in adults prenatally exposed to the Dutch famine. Am J Clin Nutr 2007; 86: 1219–1224.

    Article  CAS  Google Scholar 

  3. Ismail-Beigi F, Catalano PM, Hanson RW . Metabolic programming: fetal origins of obesity and metabolic syndrome in the adult. Am J Physiol Endocrinol Metab 2006; 291: E439–E440.

    Article  CAS  Google Scholar 

  4. Knickmeyer RC, Baron-Cohen S . Fetal testosterone and sex differences in typical social development and in autism. J Child Neurol 2006; 21: 825–845.

    Article  Google Scholar 

  5. Baron-Cohen S, Knickmeyer RC, Belmonte MK . Sex differences in the brain: implications for explaining autism. Science 2005; 310: 819–823.

    Article  CAS  Google Scholar 

  6. Abbott DH, Barnett DK, Bruns CM, Dumesic DA . Androgen excess fetal programming of female reproduction: a developmental aetiology for polycystic ovary syndrome? Hum Reprod Update 2005; 11: 357–374.

    Article  CAS  Google Scholar 

  7. Nilsson C, Niklasson M, Eriksson E, Bjorntorp P, Holmang A . Imprinting of female offspring with testosterone results in insulin resistance and changes in body fat distribution at adult age in rats. J Clin Invest 1998; 101: 74–78.

    Article  CAS  Google Scholar 

  8. Alexanderson C, Eriksson E, Stener-Victorin E, Lystig T, Gabrielsson B, Lonn M et al. Postnatal testosterone exposure results in insulin resistance, enlarged mesenteric adipocytes, and an atherogenic lipid profile in adult female rats: comparisons with estradiol and dihydrotestosterone. Endocrinology 2007; 148: 5369–5376.

    Article  CAS  Google Scholar 

  9. Demissie M, Lazic M, Foecking EM, Aird F, Dunaif A, Levine JE . Transient prenatal androgen exposure produces metabolic syndrome in adult female rats. Am J Physiol Endocrinol Metab 2008; 295: E262–E268.

    Article  CAS  Google Scholar 

  10. Eisner JR, Dumesic DA, Kemnitz JW, Colman RJ, Abbott DH . Increased adiposity in female rhesus monkeys exposed to androgen excess during early gestation. Obes Res 2003; 11: 279–286.

    Article  Google Scholar 

  11. Abbott DH, Tarantal AF, Dumesic DA . Fetal, infant, adolescent and adult phenotypes of polycystic ovary syndrome in prenatally androgenized female rhesus monkeys. Am J Primatol 2009; 71: 776–784.

    Article  CAS  Google Scholar 

  12. Dempsey PJ, Townsend GC, Richards LC . Increased tooth crown size in females with twin brothers: Evidence for hormonal diffusion between human twins in utero. Am J Hum Biol 1999; 11: 577–586.

    Article  Google Scholar 

  13. Voracek M, Dressler SG . Digit ratio (2D:4D) in twins: heritability estimates and evidence for a masculinized trait expression in women from opposite-sex pairs. Psychol Rep 2007; 100: 115–126.

    Article  Google Scholar 

  14. Cohen-Bendahan CC, Buitelaar JK, van Goozen SH, Orlebeke JF, Cohen-Kettenis PT . Is there an effect of prenatal testosterone on aggression and other behavioral traits? A study Comparing Same-Sex and Opposite-Sex Twin Girls Horm Behav 2005; 47: 230–237.

    CAS  PubMed  Google Scholar 

  15. Cohen-Bendahan CC, Buitelaar JK, van Goozen SH, Cohen-Kettenis PT . Prenatal exposure to testosterone and functional cerebral lateralization: a study in same-sex and opposite-sex twin girls. Psychoneuroendocrinology 2004; 29: 911–916.

    Article  CAS  Google Scholar 

  16. Resnick SM, Gottesman II, McGue M . Sensation seeking in opposite-sex twins: an effect of prenatal hormones? Behav Genet 1993; 23: 323–329.

    Article  CAS  Google Scholar 

  17. Culbert KM, Breedlove SM, Burt SA, Klump KL . Prenatal hormone exposure and risk for eating disorders: a comparison of opposite-sex and same-sex twins. Arch Gen Psychiatry 2008; 65: 329–336.

    Article  Google Scholar 

  18. Henderson BA, Berenbaum SA . Sex-typed play in opposite-sex twins. Dev Psychobiol 1997; 31: 115–123.

    Article  CAS  Google Scholar 

  19. Loehlin JC, Martin NG . Dimensions of psychological masculinity-femininity in adult twins from opposite-sex and same-sex pairs. Behav Genet 2000; 30: 19–28.

    Article  CAS  Google Scholar 

  20. Rose RJ, Kaprio J, Winter T, Dick DM, Viken RJ, Pulkkinen L et al. Femininity and fertility in sisters with twin brothers: prenatal androgenization? Cross-sex socialization? Psychol Sci 2002; 13: 263–267.

    Article  Google Scholar 

  21. Lichtenstein P, Sullivan PF, Cnattingius S, Gatz M, Johansson S, Carlstrom E et al. The Swedish twin registry in the third millennium: an update. Twin Res Hum Genet 2006; 9: 875–882.

    Article  Google Scholar 

  22. Lichtenstein P, De Faire U, Floderus B, Svartengren M, Svedberg P, Pedersen NL . The Swedish twin registry: a unique resource for clinical, epidemiological and genetic studies. J Intern Med 2002; 252: 184–205.

    Article  CAS  Google Scholar 

  23. Orlebeke JF, van Baal GC, Boomsma DI, Neeleman D . Birth weight in opposite sex twins as compared to same sex dizygotic twins. Eur J Obstet Gynecol Reprod Biol 1993; 50: 95–98.

    Article  CAS  Google Scholar 

Download references


This study was sponsored by the Swedish Research Council (grants no 6178 and 12206), Torsten and Ragnar Söderberg's Foundation, Bertil Hållstens Foundation/Swedish Brain Foundation, the Swedish Brain Power Initiative, Novo Nordisk Foundation, the Swedish Diabetes Association Research Foundation and the Swedish Knowledge Foundation through the Industrial PhD programme in Medical Bioinformatics at the Strategy and Development Office at Karolinska Institutet. Funding for the STR has been provided by the Swedish Department of Higher Education.

Author information

Authors and Affiliations


Corresponding author

Correspondence to E Eriksson.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Alexanderson, C., Henningsson, S., Lichtenstein, P. et al. Influence of having a male twin on body mass index and risk for dyslipidemia in middle-aged and old women. Int J Obes 35, 1466–1469 (2011).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • twins
  • hormonal programming
  • body mass index

This article is cited by


Quick links