Qing Li1, Xu Wang1, Juan Pang1, Yuan Zhang2, Hanyue Zhang1, Zhongliang Xu1, Qian Chen3, Wenhua Ling4. 1. Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong Province, 510080, China. 2. Evaluation Department of Guangdong Medical Academic Communicate Center, Guangzhou, Guangdong Province, 510180, China. 3. Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, 510120, China. 4. Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong Province, 510080, China; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, Guangdong Province, 510080, China. Electronic address: lingwh@mail.sysu.edu.cn.
Abstract
BACKGROUND AND AIMS: The relationship between ceramides and the risk of mortality among patients with coronary artery disease (CAD) is currently relatively sparse. This prospective study aimed to clarify whether plasma ceramides are associated with greater risks of cardiovascular and all-cause mortality among CAD patients. METHODS: Ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was used to measure plasma ceramides, C16:0, C18:0, C24:0, and C24:1, in 1704 CAD patients. Cox regression models were used to estimate the association between ceramides and the risk of cardiovascular and all-cause mortality. RESULTS: During the median 9.3-year follow-up, 396 all-cause deaths occurred, of which 253 were cardiovascular deaths. Plasma C16:0, C18:0 and C24:1 ceramides and their ratios with C24:0 ceramide were significantly associated with increased risk of cardiovascular and all-cause mortality. After multivariable adjusted, for 1-SD increases of C16:0/C24:0, C18:0/C24:0, and C24:1/C24:0 ratios, the risk of cardiovascular mortality increased by 27%, 35%, and 21%, and the risk of all-cause mortality increased by 29%, 28%, and 24%, respectively. Patients with higher ceramide risk score had 1.81-fold (95%CI, 1.24-2.64) and 1.95-fold (95%CI, 1.43-2.65) risk of cardiovascular and all-cause mortality, respectively, compared to patients with lower ceramide risk score. The risks of cardiovascular and all-cause mortality increased by 9% for 1-point increment in the ceramide risk score. Subgroup analyses did not substantially modify the results. CONCLUSIONS: Our study documented that distinct ceramides were significantly associated with the risks of cardiovascular and all-cause mortality in CAD patients. Further studies are warranted to determine the clinical diagnostic value of distinct ceramides in identifying patients at risk of mortality.
BACKGROUND AND AIMS: The relationship between ceramides and the risk of mortality among patients with coronary artery disease (CAD) is currently relatively sparse. This prospective study aimed to clarify whether plasma ceramides are associated with greater risks of cardiovascular and all-cause mortality among CAD patients. METHODS: Ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was used to measure plasma ceramides, C16:0, C18:0, C24:0, and C24:1, in 1704 CAD patients. Cox regression models were used to estimate the association between ceramides and the risk of cardiovascular and all-cause mortality. RESULTS: During the median 9.3-year follow-up, 396 all-cause deaths occurred, of which 253 were cardiovascular deaths. Plasma C16:0, C18:0 and C24:1 ceramides and their ratios with C24:0 ceramide were significantly associated with increased risk of cardiovascular and all-cause mortality. After multivariable adjusted, for 1-SD increases of C16:0/C24:0, C18:0/C24:0, and C24:1/C24:0 ratios, the risk of cardiovascular mortality increased by 27%, 35%, and 21%, and the risk of all-cause mortality increased by 29%, 28%, and 24%, respectively. Patients with higher ceramide risk score had 1.81-fold (95%CI, 1.24-2.64) and 1.95-fold (95%CI, 1.43-2.65) risk of cardiovascular and all-cause mortality, respectively, compared to patients with lower ceramide risk score. The risks of cardiovascular and all-cause mortality increased by 9% for 1-point increment in the ceramide risk score. Subgroup analyses did not substantially modify the results. CONCLUSIONS: Our study documented that distinct ceramides were significantly associated with the risks of cardiovascular and all-cause mortality in CAD patients. Further studies are warranted to determine the clinical diagnostic value of distinct ceramides in identifying patients at risk of mortality.
Authors: Rebekah J Nicholson; Annelise M Poss; J Alan Maschek; James E Cox; Paul N Hopkins; Steven C Hunt; Mary C Playdon; William L Holland; Scott A Summers Journal: J Clin Endocrinol Metab Date: 2021-07-13 Impact factor: 6.134