Joint association of plasma ceramide and renal function with coronary artery lesion severity: The CRUISE-MET study

作者：Qiang Chen, Yike Li, Haoming He, Yingying Xie, Dongliang Fu, Ruilong Gao, Nan Li, Sunjin Fu, Mu Yuan, Yuxuan Sun, Zixuan Yang, Jiahui Zhou, Xu Li, Yanxiang Gao, Jingang Zheng · 发表于：Journal of clinical lipidology · 年份：2025 · DOI：10.1016/j.jacl.2025.09.002 · 被引用次数：4 · 研究领域：Sphingolipid Metabolism and Signaling、Dialysis and Renal Disease Management、Metabolomics and Mass Spectrometry Studies

BACKGROUND: Ceramides and chronic kidney disease (CKD) independently promote atherosclerosis, yet their synergistic effect remains underexplored. This study systematically investigates their combined impact on coronary lesion severity. METHOD: This cross-sectional analysis included coronary artery disease (CAD) patients from the CRUISE-MET trial (NCT06383208). Six ceramide species: Cer (18:1/16:0), Cer (18:1/18:0), Cer (18:1/20:0), Cer (18:1/22:0), Cer (18:1/24:0), and Cer (18:1/24:1), were quantified via ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry. Baseline SYNTAX score (bSS) > 22 defined complex CAD. CKD was classified based on both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). The combined and mediating effects of ceramides and renal dysfunction on coronary lesion complexity were further evaluated. RESULT: Among 691 CAD patients, those with complex lesions exhibited elevated UACR, Cer (18:1/16:0), Cer (18:1/18:0), Cer (18:1/24:1), and decreased eGFR (all P < .05). Cer (18:1/16:0) demonstrated the strongest correlation with bSS (r = 0.186, P < .001) and highest predictive accuracy (area under the curve = 0.616). Multivariable-adjusted logistic regression revealed that per-SD increase in Cer (18:1/16:0) conferred 31% higher odds of complex CAD (odds ratio [OR] = 1.31, 95% CI: 1.08-1.59; P = .006), with the highest tertile showing 88% elevated risk (OR = 1.88, 95% CI: 1.18-3.01; P = .008). Synerg...