Plasma Ceramides Predict All-Cause and Cause-Specific Mortality in Individuals With Type 2 Diabetes
Authors' conclusion
CERT1 score predicts mortality risk independent of clinical cardiorenal risk factors. Further studies are warranted to elucidate the mechanistic linkage between ceramide and mortality, especially noncardiovascular mortality.
Study context
- Population
- Outpatients with T2D in a regional hospital and a primary care facility in Singapore; plasma ceramides (d18:1/16:0, d18:1/18:0, d18:1/24:0, d18:1/24:1) measured by mass spectrometry252 deaths
- Participants
- 1,903 outpatients
- Exposure
- High Cardiovascular Event Risk Test (CERT1) score vs low score
- Outcome
- All-cause and cause-specific mortality
- Follow-up
- Median 9.3 years
Main finding
As reported in the abstract
All-cause death · median 9.3 years
Adjusted hazard ratio (95% CI)
CERT1 per 1-unit incrementcontinuous variable; 8% increased risk
1.08(1.04–1.13)
Per 1-unit increment, as printed
- High CERT1 vs Low score · adjusted for cardiorenal risk factors incl. eGFR and albuminuria
- fold increased risk 1.86 (95% CI 1.30–3.65)
Observational data: associations, not effects.
Further findings
Noncardiovascular death
| aHR (CI) | ||
|---|---|---|
| CERT1Remained significant | 2.12 (1.32–3.42) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Cardiovascular death
| aHR (CI) | ||
|---|---|---|
| CERT1After adjustment for kidney measurements | 1.41 (0.78–2.56) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | Delta AUC (CI) |
|---|---|
| Prediction of 10-year all-cause death: CERT1 added to RECODe mortality risk engine · 10 yearsRECODe + CERT1 vs RECODe · AUC 0.810 to 0.823; significantly improved | 0.013 (0.005–0.022) |
Original publication
Plasma Ceramides Predict All-Cause and Cause-Specific Mortality in Individuals With Type 2 Diabetes. J Clin Endocrinol Metab. Published 8 June 2024. doi:10.
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