We are pleased our recent editorial1 stimulated further discussion on the potential association between asthma and obesity. We used the literature examining the association between earlobe creases and ischemic heart disease as an example of how statistical "associations" may be shown, on further study, to be the result of previously unrecognized or unappreciated cofactors. As pointed out by Dr Cheng, a large study in China performed by Hu and colleagues2 showed that it is age, and not coronary artery disease, that is predictive of the presence of earlobe creases. We continue to believe that a similar, perhaps unappreciated, cofactor is the link between the association of asthma with obesity reported by Camargo et al.3 Hopefully, their initial work will be further investigated in a more diverse population of stringently defined subjects with asthma to confirm or refute the proposed association.
Wilson MM, Irwin RS. More Research Needed on the Association Between Diagonal Earlobe Crease and Coronary Artery Disease—Reply. Arch Intern Med. 2000;160(15):2393. doi: