Research Article Details

Article ID: A52200
PMID: 30159588
Source: Diabetologia
Title: Relation of plasma ceramides to visceral adiposity, insulin resistance and the development of type 2 diabetes mellitus: the Dallas Heart Study.
Abstract: AIMS/HYPOTHESIS: Ceramides are sphingolipids that contribute to insulin resistance in preclinical studies. We hypothesised that plasma ceramides would be associated with body fat distribution, insulin resistance and incident type 2 diabetes in a multi-ethnic cohort. METHODS: A total of 1557 participants in the Dallas Heart Study without type 2 diabetes underwent measurements of metabolic biomarkers, fat depots by MRI and plasma ceramides by liquid chromatography-mass spectrometry. Diabetes outcomes were assessed after 7&#160;years. Associations of body fat and insulin resistance with ceramides at baseline and of ceramides with incident diabetes outcomes were analysed. RESULTS: The cohort had a mean age of 43&#160;years, with 58% women, 45% black participants and a mean BMI of 28&#160;kg/m2. Total cholesterol levels were associated with all ceramides, but higher triacylglycerols and lower HDL-cholesterol and adiponectin were associated only with saturated fatty acid chain ceramides (p&#8201;<&#8201;0.0003). After adjusting for clinical characteristics and total body fat, visceral adipose tissue was positively associated with saturated fatty acid ceramides (per SD, &#946;&#8201;=&#8201;0.16 to 0.18) and inversely associated with polyunsaturated fatty acid ceramides (&#946;&#8201;=&#8201;-0.14 to -0.16, p&#8201;<&#8201;0.001 for all). Lower-body subcutaneous fat showed an opposite pattern to that for visceral fat. HOMA-IR was positively associated with saturated (&#946;&#8201;=&#8201;0.08 to 0.09, p&#8201;<&#8201;0.001) and inversely with polyunsaturated ceramides (&#946;&#8201;=&#8201;-0.06 to -0.07, p&#8201;<&#8201;0.05). Ceramides were not associated with incident type 2 diabetes after adjustment for clinical factors. CONCLUSIONS/INTERPRETATION: Plasma ceramides demonstrate a biologically complex relationship with metabolic and imaging indicators of dysfunctional adiposity. The role of ceramides in a shared pathway of metabolic dysfunction linking visceral adiposity and insulin resistance requires further investigation.
DOI: 10.1007/s00125-018-4720-1