Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

Earlobe crease

 

White matter hyperintensities severity and progression are not related to earlobe crease presence. A cross-sectional and longitudinal prospective study in community-dwelling older adults. La severidad y progresión de hiperintensidades de la sustancia blanca no están relacionados con la presencia del pliegue del lóbulo de la oreja. Un estudio transversal y longitudinal prospectivo en una población de adultos mayores

Background: Earlobe crease (ELC) has been associated with coronary atherosclerosis. Recently, ELC has been associated with white matter hyperintensities (WMH) of presumed vascular origin. However, the results are heterogeneous among studies. We aimed to assess whether ELC is associated with WMH severity and progression in community-dwelling older adults.

Methods: Atahualpa Project Cohort participants received earlobe photographs and brain MRIs to assess the association between ELC and WMH severity, as well as the relationship between ELC and WMH progression using ordinal logistic and Poisson regression models, respectively.

Results: The cross-sectional component of the study included 359 individuals aged ≥60 years. ELC was present in 175 subjects. On MRI, 107 participants did not have WMH, 174 had mild, 56 had moderate, and 22 had severe WMH. A multivariate ordinal logistic regression model did not show a significant association between the main variables investigated (OR: 0.72; 95% C.I.: 0.48 – 1.06). The longitudinal component included 252 individuals, 126 of whom had ELC and 103 had WMH progression. A Poisson regression model showed no association between ELC and WMH progression (IRR: 1.02; 95% C.I.: 0.69 – 1.51).

Conclusions: ELC is not related to WMH severity and progression in the study population.

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The Utility Of Earlobe Crease For The Detection Of Sub-Clinical Atherosclerosis. La Utilidad Del Pliegue Del Lóbulo de la Oreja Para la Detección de Aterosclerosis Subclínica.

Traditionally a crease in the ear has been considered a visible marker of atherosclerosis. There is strong evidence of its association with coronary heart disease (CHD) revealed in several retrospective and prospective studies. However, the usefulness of the earlobe crease (ELC) as a marker of atherosclerotic diseases of other vascular beds, especially in the intracranial or extracranial carotid vasculature, is not clear. A non-systematic search of studies evaluating the association between ELC and atherosclerosis was performed. Observational studies that explored the association of ELC with atherosclerosis in many vascular beds were reviewed. Most studies presented methodological limitations, selection bias, and relatively small sample sizes. Discrepancies were found between studies, mainly due to the interaction of age in the association pathway. In a population cohort study, age was the main modifier of the effect of ELC with atherosclerosis in different vascular beds. The role of ELC as a marker of atherosclerosis remains unclear, at least for extra-coronary atherosclerosis.

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Intracranial Atherosclerosis And The Earlobe Crease (Frank’s Sign). A Population Study. Aterosclerosis Intracraneal y Pliegue Auricular (Signo De Frank). Estudio Poblacional.

Background: The earlobe crease (ELC) has been linked to coronary artery disease and other vascular conditions, but there is no information on its association with intracranial atherosclerosis. Objective: This study aimed to assess the association between high calcium content in the carotid siphons (as a surrogate of intracranial atherosclerosis) and ELC in communitydwelling adults living in rural Ecuador. Methods: Atahualpa residents aged ≥40 years underwent head CT to estimate calcium content in the carotid siphons, and visual inspection of both earlobes to evaluate the presence of ELC. The association between both variables was assessed by logistic regression models, after adjusting for demographics and cardiovascular risk factors. Results: Of 651 enrolled individuals (mean age: 59.7±12.8 years; 54% women), 225 (35%) had ELC, and 143 (22%) had high calcium content in the carotid siphons. Univariate logistic regression showed a borderline (non-significant) association between high calcium content in the carotid siphons and ELC presence (OR: 1.44; 95% C.I.: 0.99 – 2.12; p=0.057), which disappeared when age (OR: 0.98; 95% C.I.: 0.65 – 1.48; p=0.923) and other covariables (OR: 0.97; 95% C.I.: 0.63 – 1.49; p=0.890) were added to the model. Conclusion: This population study shows no association between high calcium content in the carotid siphons and ELC presence.

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