Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2026.005

Ceramides versus standard methods in prediction of subclinical atherosclerosis

Janula Stromska1, 2, 4, Geraldo Neto1, Irma Magaly Rivas-Serna1, Juan Pablo Gonzalez-Rivas1, 3, Manlio Vinciguerra6, 7, Roman Panovsky1, 2, 5, Radim Brat4, Jiri Plasek8
1 International Clinical Research Center (ICRC), St. Anne's University Hospital Brno, Brno, Czech Republic
2 Faculty of Medicine, Masaryk University, Brno, Czech Republic
3 Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA
4 Cardiac Surgery Center, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava-Poruba, Czech Republic
5 1st Department of Internal Medicine/ Cardioangiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Pekarska 53, 656 91, Brno, Czech Republic
6 Department of Translational Stem Cell Biology, Research Institute, Medical University of Varna, Varna, Bulgaria
7 Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
8 Center for Research on Internal Medicine and Cardiovascular diseases, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic

Background: Ceramides are a heterogeneous group of bioactive membrane sphingolipids that play specialized regulatory roles in cellular metabolism depending on their characteristic fatty acyl chain lengths and subcellular distribution. Ceramides have emerged as promising biomarkers for cardiovascular diseases.

Methods: Within the prospective Kardiovize study based in Brno, Czech Republic, we aimed to develop two carotid intima-media thickeness (CIMT) prediction models using available variables. One model incorporated, in addition to sex and age, conventional biomarkers (total cholesterol, triglycerides, lipid-lowering therapy), while the other included blood concentrations of selected ceramides. Lipids species were measured by a hyphenated mass spectrometry technique.

Results: A total of 139 men (mean age 61.8 ± 16.4) and 222 women (63.9 ± 14.8) were included in the present study. Both approaches yielded almost identical coefficients of determination (54.6 % vs 55.0%) with good classification abilities (weighted kappa 0.69 vs 0.71) in both models. The ceramide (d18:1/18:0) shows a strong negative association with CIMT (β = -1.39, P=0.04), while (d18:1/24:1) shows a positive association with carotid intima-media thickness (β=0.20, P=0.002).

Conclusion: The tested ceramides were able to predict subclinical atherosclerosis by carotid intima-media thickness with comparable accuracy to a combination of routinely tested lipids.

Keywords: cardiovascular diseases, carotid intima-media thickness, ceramides, risk factors, subclinical atherosclerosis

Received: November 16, 2025; Revised: February 15, 2026; Accepted: February 26, 2026; Prepublished online: March 24, 2026 

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