Association of plasma ceramide with decline in kidney function in patients with type 2 diabetes

Resham L. Gurung, M. Yiamunaa, Wai Kin Tham, Sylvia Liu, Huili Zheng, Janus Lee, Keven Ang, Markus Wenk, Tavintharan Subramaniam, Chee Fang Sum, Federico Torta, Jian Jun Liu, Su Chi Lim*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Circulating ceramide levels are dysregulated in kidney disease. However, their associations with rapid decline in kidney function (RDKF) and end-stage kidney disease (ESKD) in patients with type 2 diabetes (T2D) are unknown. In this prospective study of 1746 T2D participants, we examined the association of plasma ceramide Cer16:0, Cer18:0, Cer24:0, and Cer24:1 with RDKF, defined as an estimated glomerular filtration rate (eGFR) decline of 5 ml/ min/1.73 m2 per year or greater, and ESKD defined as eGFR <15/min/1.73 m2 for at least 3 months, on dialysis or renal death at follow-up. During a median follow-up period of 7.7 years, 197 patients experienced RDKF. Ceramide Cer24:0 (odds ratio [OR] = 0.71, 95% CI 0.56-0.90) and ratios Cer16:0/Cer24:0 (OR = 3.54 [1.70-7.35]), Cer18:0/Cer24:0 (OR = 1.89 [1.10-3.25]), and Cer24:1/Cer24:0 (OR = 4.01 [1.93-8.31]) significantly associated with RDKF in multivariable analysis; 124 patients developed ESKD. The ratios Cer16:0/Cer24:0 (hazard ratio [HR] = 3.10 [1.44-6.64]) and Cer24:1/ Cer24:0 (HR = 4.66 [1.93-11.24]) significantly associated with a higher risk of ESKD. The Cer24:1/Cer24:0 ratio traditional risk factors by small but statistically sig0.022). A high ceramide risk score also associated with RDKF (OR = 2.28 [1.26-4.13]) compared to lower risk score. In conclusion, specific ceramide levels and their ratios are associated with RDKF and conferred in patients with T2D.
Original languageEnglish
Article number100552
Number of pages11
JournalJournal of Lipid Research
Volume65
Issue number6
DOIs
Publication statusPublished - Jun 2024
Externally publishedYes

Keywords

  • Ceramide ratio
  • Ceramide score
  • Diabetes kidney disease
  • End-stage kidney disease

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