Correlation between serum ceramide levels and traditional and non-traditional lipid profile parameters in patients with acute coronary syndrome: A cross-sectional study

Abstract

Objective: This study evaluated circulating ceramides and their association with traditional lipids and the triglyceride-to-HDL-cholesterol (TG/HDL-C) ratio in acute coronary syndrome (ACS) patients versus healthy controls.
Methods: Cross-sectional study of 100 ACS patients and 50 age-/sex-matched controls. Serum ceramides measured by ELISA. Lipid profile (total cholesterol, TG, HDL-C, LDL-C, VLDL) was assessed enzymatically. TG/HDL-C ratio calculated. Group comparisons used t-tests; correlations used Pearson.
Results: Ceramides were higher in ACS patients than controls (765.7 ± 88.2 vs. 241.7 ± 9.9 pg/mL; p < 0.001). Patients showed an atherogenic profile: higher total cholesterol (190.3 ± 51.1 vs. 152.5 ± 50.4 mg/dL), TG (170.1 ± 92.2 vs. 94.7 ± 46.5), LDL-C (120.6 ± 46.6 vs. 98.3 ± 22.7), VLDL (32.2 ± 13.6 vs. 26.3 ± 6.7), and lower HDL-C (34.8 ± 14.9 vs. 49.8 ± 4.9) (all p < 0.001). TG/HDL-C ratio was markedly higher in patients (6.40 ± 6.51 vs. 1.45 ± 0.89; p < 0.001). Ceramides correlated moderately with TG (r = 0.375) and TG/HDL-C (r = 0.375), and strongly negatively with HDL-C (r = –0.513) (all p < 0.001).
Conclusions: Circulating ceramides are significantly associated with atherogenic lipids and TG/HDL-C ratio in ACS patients, suggesting their potential as integrative biomarkers of lipid dysregulation. Prospective studies are needed to establish ceramides’ clinical utility in cardiovascular risk stratification.