Prevalence of Earlobe Creases and Their Association With History of Cardiovascular Disease in Patients Undergoing Hemodialysis: A Cross‐Sectional Study

Abstract

Earlobe creases are surrogate markers for high risk of cardiovascular disease. There is no data concerning earlobe creases among hemodialysis patients, who have an increased risk of cardiovascular disease. A cross-sectional study was conducted to determine the prevalence of earlobe creases and their association with prevalent cardiovascular disease among hemodialysis patients. Patients undergoing hemodialysis were recruited from five outpatient hemodialysis centers. Both earlobes were photographed during a dialysis session with the patient in a supine position and the photos evaluated independently by two experienced nephrologists blinded to the participants' clinical characteristics. Prevalent cardiovascular diseases were defined as a history of myocardial infarction, cerebrovascular accident, or peripheral vascular disease. Sensitivity, specificity, and positive and negative predictive values for detection of prevalent cardiovascular disease were calculated. Logistic analysis was used to examine the association between earlobe creases and prevalent cardiovascular disease. Earlobe creases were identified in 24.5% of 330 hemodialysis patients (200 men; mean age, 67.8 years). The prevalence of earlobe creases increased with age for men (P for trend <0.0001), but not for women (P for trend = 0.07). Sensitivity, specificity, and positive and negative predictive values were 30.9% (95% confidence interval, 21.9-41.6), 77.5% (71.9-82.3), 30.9% (21.9-41.6), and 77.5% (71.9-82.3), respectively. Multivariate logistic analyses indicated the prevalence of earlobe crease was not associated with prevalent cardiovascular diseases. The prevalence is similar to that previously reported for Japanese individuals not undergoing dialysis. No association between earlobe creases and prevalent cardiovascular diseases was identified.

The Association between Earlobe Creases and Cardiovascular Events in Japanese Hemodialysis Patients: A Prospective Cohort Study

“…The presence of ELC, which can be assessed easily without any test, might function as a visible prompt for both physicians and patients to screen for CVD. We previously reported a cross-sectional study showing that the prevalence of ELC was not associated with prevalent CVD in Japanese hemodialysis patients (15). However, survivor bias may have affected the results of that study.…”

“…This study was conducted as a follow-up to a previously reported cross-sectional study (15); a detailed description of this cohort has been previously published. In brief, individuals undergoing hemodialysis were recruited from five outpatient hemodialysis centers in Niigata, Japan, between February and November 2012.…”

“…The predictor variable was the presence of ELC at baseline, as defined according to previously reported methods (15). In brief, bilateral earlobe photographs were taken by one researcher with the patient in a supine position during a dialysis session.…”

Briefly Noted

“…No association with cardiac disease was found. Earlobe photos were examined independently of clinical data by two nephrologists …”

“…Earlobe photos were examined independently of clinical data by two nephrologists. 18 Richard A. Sherman…”