Impact of Albuminuria‐Lowering Treatments on Cardiovascular Predictive Ceramides in Diabetes: Post Hoc Analysis of the ROTATE Trials
Authors' conclusion
Our exploratory findings suggest that certain albuminuria-lowering drugs may affect ceramide levels as a secondary effect.
Study context
- Population
- Adults with T1D (26) or T2D (37) with urine albumin-creatinine ratio (UACR) 30–500 mg/g26 T1D, 37 T2D
- Comparison
- Telmisartan vs empagliflozin vs linagliptin vs baricitinib
- Primary endpoint
- Change in cardiovascular disease (CVD)-related ceramides (Cer16, Cer18, Cer20, Cer22, Cer24, Cer24:1) with each treatment
- Follow-up
- 4 weeks
Methodological detailspost hoc analysis, randomized crossover, 4-week periods with 4-week washout, exploratory
- Post hoc analysis
- Randomized crossover
- 4-week periods with 4-week washout
- Exploratory
Primary result
As reported in the abstract
Change in ceramides from baseline
Reduction of Cer22 from baseline
22.6%
95% CI −33.58 to −9.79P = 0.001
Linagliptin
Reduction of Cer24 from baseline
25.7%
95% CI −38.94 to −9.69P = 0.003
Linagliptin
Reduction of Cer24:1 from baseline
19.6%
95% CI −31.34 to −5.95P = 0.007
Linagliptin
Linagliptin
- Cer22 reduction
- 22.6%
- Cer24 reduction
- 25.7%
- Cer24:1 reduction
- 19.6%
Linagliptin
Cer22 reduction22.6%
Cer24 reduction25.7%
Cer24:1 reduction19.6%
Further findings
Baseline ceramides, T2D vs T1D
- T2D had greater levels of Cer22 and Cer24 than T1D
Original publication
Impact of Albuminuria‐Lowering Treatments on Cardiovascular Predictive Ceramides in Diabetes: Post Hoc Analysis of the ROTATE Trials. Diabetes Obes Metab. Published 28 July 2026. doi:10.
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