Earlobe　crease　(ELC)　has　been　considered　as　a　skin　sign　of　atherosclerosis,　and　its　pathophysiological　mechanism　is　still　unclear.　Our　study　aims　to　test　the　hypothesis　that　ELC　patients　with　lower　serum　levels　of　the　age-suppressing　hormone　Klotho,　which　is　not　only　associated　with　premature　aging　but　also　with　endothelial　dysfunction,　may　be　associated　with　atherosclerosis.A　total　of　135　patients　aged　40-68　years　underwent　coronary　angiography.　According　to　the　presence　or　absence　of　coronary　heart　disease　(CAD)　and　ELC,　they　were　divided　into　three　groups:　CAD　group　and　ELC　group　(ELC　group,　n　=　45);　no　ELC　group　(non-ELC　group,　n　=　45).　There　was　no　ELC　or　CAD　in　the　control　group　(control　group,　n　=　45).　Serum　Klotho　concentration　was　obtained　by　enzyme-linked　immunosorbent　assay　(ELISA).The　Klotho　level　in　the　ELC　group　was　365.6　±　38.1　pg/mL,　while　the　Klotho　level　in　the　non-ELC　group　was　568.8　±　44.9　pg/mL.　It　is　worth　noting　that　the　Klotho　level　of　the　ELC　group　was　significantly　lower　than　that　of　the　non-ELC　group　(P　＜　0.001).　The　serum　Klotho　level　of　the　control　group　was　higher　than　that　of　the　non-ELC　group　(593.3±45.3　vs　568.8±44.9　pg/mL,　P　=　0.702),　but　the　difference　was　not　statistically　significant.　Multiple　logistic　regression　analysis　showed　that　the　Klotho　level　is　a　parameter　that　affects　the　appearance　of　ELC.Serum　Klotho　levels　were　considerably　lower　in　patients　with　ELC.　We　concluded　that　the　perturbations　of　Klotho　in　patients　might　be　associated　with　ELC　and　with　CAD.