SMPD3 and fatty liver disease: Moreover, researchers have reported that ceramide is elevated in the plasma of obese patients with T2D,42 and chronic elevation of tissue ceramides leads to persistent impairment of metabolic homeostasis, thereby driving insulin resistance and hepatic steatosis.43 Reasonably, the regulatory effect of miR-1249-3p on SMPD3 in T2D requires further investigation.