Rigamonti Antonello E, Dei Cas Michele, Caroli Diana, Bondesan Adele, Cella Silvano G, Paroni Rita, Sartorio Alessandro
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20129 Milan, Italy.
Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy.
Int J Mol Sci. 2023 Aug 5;24(15):12452. doi: 10.3390/ijms241512452.
Ceramide risk score (CERT1, ceramide test 1), based on specific ceramides (Cers) and their corresponding ratios in the plasma, has been reported as a promising biochemical marker for primary and secondary prediction of cardiovascular disease (CVD) risk in different populations of patients. Thus far, limited attention has been paid to metabolic syndrome, a condition considered at high CVD risk. The aim of the present study was to evaluate CERT1 in a group of obese subjects without (OB-MetS-) and with (OB-MetS+) metabolic syndrome (according to the International Diabetes Federation (IDF) diagnostic criteria), compared to an age- and sex-matched normal-weight (NW) group. In all participants, plasma levels of Cer 16:0, Cer 18:0, Cer 24:1, and Cer 24:0 were measured, and the corresponding ratios Cer 16:0/24:0, Cer 18:0/24:0, and Cer 24:1/24:0 were calculated together with CERT1. Subjects with obesity showed higher CERT1 values than the NW group ( < 0.05), with no difference between OB-MetS- and OB-MetS+ groups. Waist circumference (WC), homeostatic model assessment of insulin-resistance (HOMA-IR) (surrogates of IDF diagnostic criteria for metabolic syndrome), and C reactive protein (CRP) (a marker of inflammation) were predictors of CERT1 ( < 0.05), with the contribution of the other IDF criteria such as arterial hypertension and dyslipidemia being negligible. Adjustment for WC resulted in a loss of the difference in CERT1 between OB-MetS- and NW subjects, with the combination of WC and HOMA-IR or CRP as covariates being necessary to yield the same effect for the difference in CERT1 between OB-MetS+ and NW subjects. Importantly, an association was found between CERT1 and vascular age (VA) ( < 0.05). Proportions of NW, OB-MetS- and OB-MetS+ subjects appeared to be distributed according to the CERT1-based risk groups (i.e., low, moderate, increased, and high risk; < 0.05), with some OB-MetS- subjects included in the increased/high-risk group and some OB-MetS+ in the low/moderate-risk one. In conclusion, the clinical diagnosis of metabolic syndrome seems to be inaccurate to assess CVD risk in the obese population; however, further studies are needed before considering CERT1 as an additional or substitutive biochemical marker in clinical practice.
神经酰胺风险评分（CERT1，神经酰胺检测1）基于血浆中特定神经酰胺（Cers）及其相应比例，已被报道为不同患者群体中心血管疾病（CVD）风险的一级和二级预测的有前景的生化标志物。迄今为止，对代谢综合征（一种被认为具有高CVD风险的病症）的关注有限。本研究的目的是评估一组无代谢综合征（OB-MetS-）和有代谢综合征（OB-MetS+）的肥胖受试者（根据国际糖尿病联盟（IDF）诊断标准）中的CERT1，并与年龄和性别匹配的正常体重（NW）组进行比较。在所有参与者中，测量了神经酰胺16:0、神经酰胺18:0、神经酰胺24:1和神经酰胺24:0的血浆水平，并计算了相应的比例神经酰胺16:0/24:0、神经酰胺18:0/24:0和神经酰胺24:1/24:0以及CERT1。肥胖受试者的CERT值高于NW组（<0.05），OB-MetS-组和OB-MetS+组之间无差异。腰围（WC）、胰岛素抵抗的稳态模型评估（HOMA-IR）（代谢综合征IDF诊断标准的替代指标）和C反应蛋白（CRP）（炎症标志物）是CERT1的预测因子（<0.05），而动脉高血压和血脂异常等其他IDF标准的贡献可忽略不计。对WC进行调整导致OB-MetS-组和NW受试者之间CERT1的差异消失，需要将WC与HOMA-IR或CRP作为协变量相结合才能使OB-MetS+组和NW受试者之间CERT1的差异产生相同效果。重要的是，发现CERT1与血管年龄（VA）之间存在关联（<0.05）。NW、OB-MetS-和OB-MetS+受试者的比例似乎根据基于CERT1的风险组分布（即低、中、增加和高风险；<0.05），一些OB-MetS-受试者被纳入增加/高风险组，一些OB-MetS+受试者被纳入低/中风险组。总之，代谢综合征的临床诊断似乎在评估肥胖人群的CVD风险方面不准确；然而，在将CERT1视为临床实践中的额外或替代生化标志物之前，还需要进一步研究。
