The Role of Ceramides in Metabolic and Cardiovascular Diseases

Ceramides are bioactive sphingolipids increasingly recognized as mediators of cardiometabolic disease and residual cardiovascular risk. Accumulating evidence from experimental and clinical studies indicates that specific ceramide species contribute to insulin resistance, endothelial dysfunction, myocardial injury, and adverse cardiovascular outcomes. In particular, long-chain ceramides (C16:0, C18:0, C20:0 Cer) are consistently associated with myocardial infarction, heart failure, and cardiovascular mortality, whereas very-long-chain ceramides (C22:0, C24:0 Cer) exhibit neutral or potentially protective associations. This narrative review integrates biochemical, experimental, and clinical evidence to examine…