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Updated: Sep 30, 2025

Novel In Vivo Micro-Computed Tomography Imaging Techniques for Assessing the Progression of Non-Alcoholic Fatty Liver Disease
Published on: March 24, 2023
Associations of NAFLD with circulating ceramides and impaired glycemia
Meghana D Gadgil1, Monika Sarkar2, Caroline Sands3
1Division of General Internal Medicine, Department of Medicine, University of California, 1545 Divisadero Street, Suite 320, San Francisco, CA 94143-0320, United States.
Aim:
Determine the association of circulating ceramides with NAFLD and glycemic impairment.
Methods:
Sample: 669 participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort aged 40-84 years without cardiovascular disease, cirrhosis, or significant alcohol intake.
Clinical Measures:
Computed tomography scans at baseline for hepatic attenuation. Fasting serum specimens at baseline and after 5 years. Lipidomics: LC-MS-based analysis of 19 known ceramide signals.
Statistical Analysis:
Linear and logistic regression models of log-transformed ceramides, hepatic attenuation and glucose adjusted for age, sex, calories, study site, BMI, exercise, diet quality, alcohol, saturated fat, lipid-lowering medications and fasting glucose.
Results:
Average age was 55 years, 44% were women, mean BMI was 25.9 kg/m2, and 8% had NAFLD. In adjusted models, Cer(d16:1/20:0) and Cer(d18:1/18:0) were associated with lower mean hepatic attenuation (increased liver fat) (β -4.29; 95% CI [-5.98, -2.59]) and (β -3.40; 95% CI [-5.11, -1.70]), and LacCer(d18:1/16:0) with higher attenuation (β 4.44; 95% CI [2.15, 6.73]). All three ceramides partially mediated the relationship between hepatic attenuation and fasting glucose by 16%, 11% and 5%, respectively, after 5-years.
Conclusions:
Three circulating ceramides were strongly associated with NAFLD and fasting glucose after 5 years, and partially mediated this association.
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