Clinical Information

MI-Heart Ceramides is a blood test that measures risk for adverse cardiovascular events and quantifies plasma ceramides. Plasma ceramides are predictors of adverse cardiovascular events resulting from unstable atherosclerotic plaque. Ceramides are complex lipids that play a central role in cell membrane integrity, cellular stress response, inflammatory signaling, and apoptosis. Synthesis of ceramides from saturated fats and sphingosine occurs in all tissues. Metabolic dysfunction and dyslipidemia results in accumulation of ceramides in tissues not suited for lipid storage. Elevated concentrations of circulating ceramides are associated with atherosclerotic plaque formation, ischemic heart disease, myocardial infarction, hypertension, stroke, type 2 diabetes mellitus, insulin resistance, and obesity.

Three specific ceramides have been identified as highly linked to cardiovascular disease and insulin resistance: N-palmitoyl-sphingosine (Cer16:0), N-stearoyl-sphingosine (Cer18:0), and N-nervonoyl-sphingosine(Cer24:1). A fourth ceramide, N-lignoceroyl-sphingosine (Cer24:0), is highly abundant in all individuals and is useful as a normalization factor for intra-individual variability of ceramide concentrations. Individuals with elevated plasma ceramides are at higher risk of major adverse cardiovascular events even after adjusting for age, gender, smoking status, and serum biomarkers such as low-density lipoprotein and high-density lipoprotein cholesterol, C-reactive protein and lipoprotein-associated phospholipase A2. Ceramide concentrations are reduced by current cardiovascular therapies including diet, exercise, statins, and proprotein convertase subtilisin/kexin type inhibitors.