Type of test Blood

Normal findings

Low ceramide risk score Test explanation and related physiology Plasma ceramides are new biomarkers for predicting cardio vascular (CV) disease. Ceramides are complex lipids that are important in maintaining cell membrane integrity, the cellular stress response, inflammatory signaling, and cell death. Synthesis of ceramides occurs in all tissues. Elevated concentrations of ceramides are associated with atherosclerotic plaque forma tion, ischemic heart disease, myocardial infarction, hypertension, stroke, type 2 diabetes mellitus, and metabolic syndromes. Even after these new markers have been adjusted for age, gender, smoking status, and serum biomarkers (e.g., low-density lipoprotein [LDL] and high-density lipoprotein [HDL] cholesterol, C-reactive protein [CRP], and Lp-PLA2), ceramides continue to be associated with the risk of CV disease. Therefore plasma ceramides are predictors of future adverse CV events as described in the table below in which a risk score is based on the absolute levels of the ceramides and analytic mathematical divisions of those levels.

Ceramides as Predictors of Adverse CV Events

Three specific ceramides have been identified as highly linked to CV disease and insulin resistance: Cer16:0, Cer18:0, and Cer24:1. Plasma ceramides can predict adverse CV events within 1 to 5 years depending on existence of other cardiac disease. Plasma ceramides can be reduced by treatment with simvastatin, rosuvastatin, and ezetimibe. Because these scores improve within a few weeks of treatment, knowing their ceramide scores may improve patient motivation and therapeutic compliance.

Procedure and patient care

• See inside front cover for Routine Blood Testing.

• Fasting: no

 • Blood tube commonly used: lavender

Abnormal findings

 Increased risk for CV event.