Recent studies have suggested that specific plasma ceramides are independently associated with atherosclerosis and cardiovascular diseases, but it is currently unknown whether plasma ceramide levels are associated with ischemic stroke. Here, we examined whether ceramides were associated with both ischemic stroke risk and clinical severity at admission. We measured three previously identified high-risk plasma ceramide molecules [Cer(d18:1/16:0), Cer(d18:1/22:0), and Cer(d18:1/24:0)] in 202 patients with acute ischemic stroke and 202 age and sex matched control cases. Plasma ceramides levels were measured by a targeted liquid chromatography-tandem mass spectrometry assay at baseline. The median age of the 202 stroke patients was 66 (interquartile range [IQR], 58-75) years and 54.0 % were men. Plasma levels of C16:0, C22:0, and C24:0 ceramides in stroke patients were significantly higher than in those control cases (P < 0.001, all). In multivariate logistic regression analysis adjusted for other risk factors, higher levels of C16:0, C22:0, and C24:0 ceramides were associated with higher risk of ischemic stroke (odd ratio [OR] for one IQR increase: 2.15[1.42-2.99]; 2.90[2.13-4.01] and 1.29[1.10-1.69]; respectively). At admission, 103 patients (51.0 %) had a minor stroke (NIHSS < 6). In these patients, plasma levels of C16:0, C22:0, and C24:0 ceramides were lower than that observed in patients with moderate-to-high clinical severity (P < 0.001, all). In multivariate logistic regression analysis adjusted for other risk factors, higher levels of C16:0, C22:0, and C24:0 ceramides were associated with higher risk of moderate-to-high stroke (OR for one IQR increase: 2.96 [2.05-4.22], 3.03 [2.01-4.25] and 1.72 [1.25-3.31], respectively). An elevated plasma levels of ceramides were predictors of both risk and severity at admission in ischemic stroke patients. The underlying mechanisms of these associations remain to be investigated.

中文翻译：

---

血浆神经酰胺水平与缺血性中风风险和临床严重程度有关。

最近的研究表明，特定的血浆神经酰胺与动脉粥样硬化和心血管疾病独立相关，但目前尚不清楚血浆神经酰胺水平是否与缺血性中风有关。在这里，我们检查了神经酰胺是否与入院时缺血性卒中风险和临床严重程度有关。我们在 202 名患有急性缺血性卒中和 202 名年龄和性别匹配的对照病例。血浆神经酰胺水平通过靶向液相色谱-串联质谱法测定基线水平。202 名中风患者的中位年龄为 66（四分位距 [IQR]，58-75）岁，54.0% 为男性。C16:0、C22:0 和 C24 的血浆水平：中风患者的 0 神经酰胺显着高于那些对照病例（P < 0.001，全部）。在针对其他危险因素调整的多变量逻辑回归分析中，较高水平的 C16:0、C22:0 和 C24:0 神经酰胺与较高的缺血性卒中风险相关（一个 IQR 增加的奇数比 [OR]：2.15[1.42- 2.99]；分别为 2.90[2.13-4.01] 和 1.29[1.10-1.69]）。入院时，103 名患者 (51.0%) 有轻微卒中 (NIHSS < 6)。在这些患者中，C16:0、C22:0 和 C24:0 神经酰胺的血浆水平低于在具有中度至高度临床严重程度的患者中观察到的水平（P < 0.001，全部）。在针对其他风险因素调整的多变量逻辑回归分析中，较高水平的 C16:0、C22:0 和 C24:0 神经酰胺与较高的中至高度卒中风险相关（一个 IQR 增加的 OR：2. 96 [2.05-4.22]、3.03 [2.01-4.25] 和 1.72 [1.25-3.31]）。升高的血浆神经酰胺水平是缺血性卒中患者入院时风险和严重程度的预测因子。这些关联的潜在机制仍有待研究。