In patients with comorbid acute coronary syndrome and type 2 diabetes mellitus (ACS-DM), their circulating ceramide levels, including Cer(d18:1/16:0), Cer(d18:1/18:0), and Cer(d18:1/24:1), were higher compared with acute coronary syndrome (ACS) patients. This evidence concerns the gene CBLN1 and acute coronary syndrome.