Kamal Rida, Kausar Komal, Qavi Ahmed H, Minto Moeed H, Ilyas Fariha, Assad Salman, Shah Saeed U
Department of Medicine, Shifa College of Medicine, Islamabad, Pakistan.
Department of Medicine, Montefiore New Rochelle Hospital, Albert Einstein College of Medicine, New Rochelle, NY, USA.
Cureus. 2017 Feb 5;9(2):e1013. doi: 10.7759/cureus.1013.
To investigate the association between diagonal earlobe crease (DELC) and coronary artery disease (CAD). Limited data exists in South Asia and no prior studies have been performed in Pakistan to assess this relationship.
In this case-control study, 200 participants from December 2015 to March 2016 at Shifa International Hospital, Islamabad, Pakistan were enrolled. Consecutive non-probability sampling was used to recruit patients. Cases were enrolled from cardiac care unit (CCU) of the hospital with angiography-proven CAD. Controls were selected from surgical, medical and neurology units of the hospital if they had no previously established evidence or symptoms of CAD. Patients were evaluated in terms of age and any history of hypertension, diabetes and/or smoking. Cases and controls were examined separately by two investigators for the unilateral or bilateral presence of DELC of the lobular portion of either auricle. Patients with ear piercings were excluded from the study. The data was analyzed in statistical product and service solutions (SPSS) (IBM, Delaware, Chicago), and an online statistical software.
Out of the 200 patients, 126 (63%) were males and 74 (37%) were females. In the 100 cases, 76 had DELC and 24 had no crease whereas, among the 100 controls, 36 had DELC and 64 had no DELC (p <0.001, OR = 5.63, CI = 2.91-10.93). The prevalence of diseases such as hypertension, diabetes, smoking among the cases and controls were 66%, 53%, 27% and 27%, 18%, 25% respectively. The effect of hypertension and diabetes on the presence of DELC was statistically significant (p <0.05) but the impact of smoking on DELC presence was insignificant (p >0.05).
There is a significant association between DELC and CAD. This is the first case-control study from South Asia disclosing this important correlation. Our study also reports a high frequency of DELC in patients suffering from hypertension and diabetes mellitus. No association between smoking and DELC was found.
研究耳垂斜线纹（DELC）与冠状动脉疾病（CAD）之间的关联。南亚地区关于此方面的数据有限，且巴基斯坦此前尚未开展过评估这种关系的研究。
在这项病例对照研究中，纳入了2015年12月至2016年3月期间在巴基斯坦伊斯兰堡的希法国际医院的200名参与者。采用连续非概率抽样方法招募患者。病例组从医院心脏监护病房（CCU）中选取，这些患者经血管造影证实患有CAD。对照组从医院的外科、内科和神经科病房选取，前提是他们既往没有CAD的确切证据或症状。对患者进行年龄以及高血压、糖尿病和/或吸烟病史的评估。由两名研究人员分别对病例组和对照组进行检查，查看任一耳廓小叶部分是否存在单侧或双侧DELC。有耳洞的患者被排除在研究之外。数据在统计产品与服务解决方案（SPSS）（IBM，特拉华州，芝加哥）以及一款在线统计软件中进行分析。
200名患者中，126名（63%）为男性，74名（37%）为女性。在100例病例中，76例有DELC，24例没有耳垂纹；而在100名对照组中，36例有DELC，64例没有DELC（p<0.001，OR = 5.63，CI = 2.91 - 10.93）。病例组和对照组中高血压、糖尿病、吸烟等疾病的患病率分别为66%、53%、27%和27%、18%、25%。高血压和糖尿病对DELC存在的影响具有统计学意义（p<0.05），但吸烟对DELC存在的影响不显著（p>0.05）。
DELC与CAD之间存在显著关联。这是南亚地区首次揭示这种重要相关性的病例对照研究。我们的研究还报告了高血压和糖尿病患者中DELC的高发生率。未发现吸烟与DELC之间存在关联。
