Zora Biosciences Oy, Espoo, Finland.
Department of Laboratory Medicine and Pathology and Department of Cardiovascular Diseases Mayo Clinic College of Medicine, Rochester, MN, United States.
Front Endocrinol (Lausanne). 2020 Sep 29;11:570628. doi: 10.3389/fendo.2020.570628. eCollection 2020.
Ceramides are bioactive lipids that have an important role in many cellular functions such as apoptosis and inflammation. During the past decade emerging clinical data have shown that ceramides are not only of great biochemical interest but may also have diagnostic utility. Ceramides have shown independent predictive value for negative cardiovascular outcomes as well as for the onset of type 2 diabetes. Based on abundant published data, risk score using the concentrations of circulating ceramides have been developed and adapted for routine clinical practice. Currently serum ceramides are used clinically as efficient risk stratifiers for primary and secondary prevention of atherosclerotic cardiovascular disease (CVD). A direct cause-effect relationship between CVD and ceramide has not been established to date. As ceramide-specific medications are being developed, conventional strategies such as lipid lowering agents and lifestyle interventions can be used to reduce overall risk. Ceramides can identify a very high-risk coronary heart disease category of patients in need for more intense medical attention, specifically those patients at higher risk as highlighted in the 2019 European Society of Cardiology guidelines for stable chronic coronary syndrome patients. In addition, the ceramide risk score may be used as a decision-making tool in primary prevention patients with moderate CVD risk. Finally, the ceramide risk score may have a unique utility as a motivational tool to increase patient's adherence to medical therapy and lifestyle changes.
神经酰胺是具有重要生物学功能的脂质，在细胞凋亡和炎症等多种细胞功能中发挥作用。在过去十年中，新出现的临床数据表明，神经酰胺不仅具有重要的生化意义，而且可能具有诊断价值。神经酰胺对心血管不良结局和 2 型糖尿病的发生具有独立的预测价值。基于丰富的已发表数据，已经开发并适用于常规临床实践的使用循环神经酰胺浓度的风险评分。目前，血清神经酰胺已被临床用于动脉粥样硬化性心血管疾病（CVD）一级和二级预防的有效风险分层。迄今为止，尚未确定 CVD 与神经酰胺之间存在直接的因果关系。随着神经酰胺特异性药物的开发，可使用降脂药物和生活方式干预等常规策略来降低总体风险。神经酰胺可以识别需要更密切医疗关注的极高危冠心病患者，特别是在 2019 年欧洲心脏病学会稳定型慢性冠状动脉综合征患者指南中强调的高危患者。此外，神经酰胺风险评分可作为中等 CVD 风险的一级预防患者的决策工具。最后，神经酰胺风险评分可能具有独特的作用，可作为一种激励工具，提高患者对药物治疗和生活方式改变的依从性。
