Ceramides versus standard methods in prediction of subclinical atherosclerosis

Ceramides are a heterogeneous group of bioactive membrane sphingolipids that play specialized regulatory roles in cellular metabolism depending on their characteristic fatty acyl chain lengths and subcellular distribution. Ceramides have emerged as promising biomarkers for cardiovascular diseases.

Within the prospective Kardiovize study based in Brno, Czech Republic, we aimed to develop two carotid intima-media thickeness (CIMT) prediction models using available variables. One model incorporated, in addition to sex and age, conventional biomarkers (total cholesterol, triglycerides, lipid-lowering therapy), while the other included blood concentrations of selected ceramides. Lipids species were measured by a hyphenated mass spectrometry technique.

A total of 139 men (mean age 61.8 ± 16.4) and 222 women (63.9 ± 14.8) were included in the present study. Both approaches yielded almost identical coefficients of determination (54.6 % vs 55.0%) with good classification abilities (weighted kappa 0.69 vs 0.71) in both models. The ceramide (d18:1/18:0) shows a strong negative association with CIMT (β = -1.39, P=0.04), while (d18:1/24:1) shows a positive association with carotid intima-media thickness (β=0.20, P=0.002).

The tested ceramides were able to predict subclinical atherosclerosis by carotid intima-media thickness with comparable accuracy to a combination of routinely tested lipids.