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Peer-reviewedCC BY 4.0International Journal of Molecular Sciences

Sphingolipid Dysregulation in Type 2 Diabetes and Its Microvascular Complications

  1. 1Department of Reproductive and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China

Abstract

Sphingolipids arestructural components of cell membranes and bioactive mediators governing cellular metabolism and intercellular communication. Beyond their classical roles in insulin sensitivity and glucose/lipid homeostasis, ceramide, sphingosine-1-phosphate (S1P), sphingomyelin and glycosphingolipids coordinate through lipid rafts, extracellular vesicles, organelle contact sites and circulating carriers to facilitate signaling among pancreas, liver, adipose tissue, vascular endothelium and kidney. This review summarizes literature on how dietary and endogenous sphingolipids contribute to T2DM and its microvascular complications. Preclinical studies, mainly in cultured cells and rodent models, indicate that overnutrition with excess take of saturated and industrial trans fats promotes ceramide accumulation, which impairs AKT/AMPK signaling, enhancing hepatic gluconeogenesis and β-cell dysfunction, whereas S1P exerts protective metabolic and vascular effects. Whether these mechanisms are similarly dominant in humans remains to be established. Chain-length-specific ceramides generated by distinct ceramide synthases (CerS1–6) determine organelle and intercellular responses in experimental models. In human observational studies, ceramide/S1P ratios and selected sphingolipid species have been associated with metabolic risk, but their diagnostic and risk-stratification value requires clinical validation. We further discuss nutritional patterns, antidiabetic and lipid-lowering agents, and emerging nanomedicine or exosome-based strategies that restore sphingolipid balance. Targeting compartment- and chain-length-specific sphingolipid signaling may provide more precise therapeutic opportunities for T2DM and its complications.

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BibTeX
@article{wen2026sphingolipid,
  title = {{Sphingolipid Dysregulation in Type 2 Diabetes and Its Microvascular Complications}},
  author = {Ya Wen and Yayun Lin and Yi Liu and Li Zhao},
  journal = {International Journal of Molecular Sciences},
  year = {2026},
  month = oct,
  doi = {10.3390/ijms27209043},
  url = {https://www.mdpi.com/1422-0067/27/20/9043},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Sphingolipid Dysregulation in Type 2 Diabetes and Its Microvascular Complications
AU  - Ya Wen
AU  - Yayun Lin
AU  - Yi Liu
AU  - Li Zhao
PY  - 2026
DA  - 2026/10/12
JO  - International Journal of Molecular Sciences
DO  - 10.3390/ijms27209043
UR  - https://www.mdpi.com/1422-0067/27/20/9043
AB  - Sphingolipids arestructural components of cell membranes and bioactive mediators governing cellular metabolism and intercellular communication. Beyond their classical roles in insulin sensitivity and glucose/lipid homeostasis, ceramide, sphingosine-1-phosphate (S1P), sphingomyelin and glycosphingolipids coordinate through lipid rafts, extracellular vesicles, organelle contact sites and circulating carriers to facilitate signaling among pancreas, liver, adipose tissue, vascular endothelium and kidney. This review summarizes literature on how dietary and endogenous sphingolipids contribute to T2DM and its microvascular complications. Preclinical studies, mainly in cultured cells and rodent models, indicate that overnutrition with excess take of saturated and industrial trans fats promotes ceramide accumulation, which impairs AKT/AMPK signaling, enhancing hepatic gluconeogenesis and β-cell dysfunction, whereas S1P exerts protective metabolic and vascular effects. Whether these mechanisms are similarly dominant in humans remains to be established. Chain-length-specific ceramides generated by distinct ceramide synthases (CerS1–6) determine organelle and intercellular responses in experimental models. In human observational studies, ceramide/S1P ratios and selected sphingolipid species have been associated with metabolic risk, but their diagnostic and risk-stratification value requires clinical validation. We further discuss nutritional patterns, antidiabetic and lipid-lowering agents, and emerging nanomedicine or exosome-based strategies that restore sphingolipid balance. Targeting compartment- and chain-length-specific sphingolipid signaling may provide more precise therapeutic opportunities for T2DM and its complications.
SN  - 1422-0067
ER  -