Moreover, Q’ has been shown to be reduced in patients with CVD [27]: intriguingly, assessing LCAT activity either directly or with lipidomic ratios, we found that it was reduced in our early-stage naïve MetS patients with mild cardiovascular risk and without organ damage; and correlated with metabolic features: these findings therefore suggest that reduced LCAT activity is an early event associated with central obesity and insulin resistance, and that lipidomic ratios might serve in the future as potential predictive biomarkers of HDL function and/or cardiovascular risk. The gene discussed is LCAT; the disease is metabolic syndrome.