Cao Weiyin, Xu Xiuman, Wang Lixuan, Liu Chenchen, Fu Qin, Zhang Shiya, Xu Jiaping, Huang Zhichao, Cai Wu, You Shoujiang, Cao Yongjun
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China,
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Cerebrovasc Dis. 2024 Aug 13:1-11. doi: 10.1159/000540816.
The association between earlobe crease (ELC) and cerebral small vessel disease, including white matter hyperintensities (WMHs) and brain atrophy, is unclear, especially in the setting of acute ischemic stroke (AIS). Here, we aimed to investigate the association between ELC and WMHs as well as brain atrophy among AIS patients.
A total of 730 AIS patients from China were enrolled. Patients were divided into groups without and with ELC, unilateral and bilateral ELC according to pictures of bilateral ears. Logistic regression models were employed to assess the impact of ELC, bilateral ELC on WMHs, periventricular hyperintensities (PVHs), deep white matter hyperintensities (DWMHs), and brain atrophy, as measured by the Fazekas scale and global cortical atrophy scale, in brain magnetic resonance imaging.
There were 520 (71.2%) AIS patients with WMHs, 445 (61.0%) with PVH, 462 (63.3%) with DWMH, and 586 (80.3%) with brain atrophy. Compared to those without ELC, patients with ELC were significantly associated with an increased risk of PVH (odds ratio [OR] 1.79; 95% confidence interval [CI], 1.15-2.77) and brain atrophy (OR: 6.18; 95% CI: 3.60-10.63) but not WMHs and DWMH. The presence of bilateral ELC significantly increased the odds of WMHs (OR: 1.60; 95% CI: 1.00-2.56), PVH (OR: 1.87; 95% CI: 1.18-2.96), and brain atrophy (OR: 8.50; 95% CI: 4.62-15.66) when compared to individuals without ELC. Furthermore, we discovered that the association between bilateral ELC and WMHs, PVH, and DWMH was significant only among individuals aged ≤68 (median age) years (all p trend ≤0.041). However, this association was not observed in patients older than 68 years.
In Chinese AIS patients, the presence of the visible aging sign, ELC, especially bilateral ELC, showed independent associations with both WMHs and brain atrophy, particularly among those younger than 68 years old.
耳垂褶皱（ELC）与脑小血管疾病（包括白质高信号（WMHs）和脑萎缩）之间的关联尚不清楚，尤其是在急性缺血性卒中（AIS）的情况下。在此，我们旨在研究AIS患者中ELC与WMHs以及脑萎缩之间的关联。
共纳入730例来自中国的AIS患者。根据双耳图片，将患者分为无ELC组和有ELC组、单侧ELC组和双侧ELC组。采用逻辑回归模型评估ELC、双侧ELC对脑磁共振成像中WMHs、脑室周围高信号（PVHs）、深部白质高信号（DWMHs）以及脑萎缩的影响，脑萎缩通过Fazekas量表和整体皮质萎缩量表进行测量。
有520例（71.2%）AIS患者存在WMHs，445例（61.0%）存在PVH，462例（63.3%）存在DWMH，586例（80.3%）存在脑萎缩。与无ELC的患者相比，有ELC的患者发生PVH（比值比[OR]1.79；95%置信区间[CI]，1.15 - 2.77）和脑萎缩（OR：6.18；95%CI：3.60 - 10.63）的风险显著增加，但与WMHs和DWMH无关。与无ELC的个体相比，双侧ELC的存在显著增加了WMHs（OR：1.60；95%CI：1.00 - 2.56）、PVH（OR：1.87；95%CI：1.18 - 2.96）和脑萎缩（OR：8.50；95%CI：4.62 - 15.66）的几率。此外，我们发现双侧ELC与WMHs、PVH和DWMH之间的关联仅在年龄≤68岁（中位年龄）的个体中显著（所有p趋势≤0.041）。然而，在68岁以上的患者中未观察到这种关联。
在中国AIS患者中，可见的衰老体征ELC的存在，尤其是双侧ELC，与WMHs和脑萎缩均显示出独立关联，特别是在68岁以下的患者中。
