In patients with HIV-lipodystrophy, low expression of IL-18 mRNA in skeletal muscle correlated to high levels of ceramides (Rp = -0.56; p = 0.038) (Fig 3A) and high levels of sphingosine-1P (IL-18 mRNA Rp = -0.54, p = 0.046) (Fig 3C). Here, IL18 is linked to lipodystrophy.