Due to the involvement of ceramides in several molecular mechanisms underlying atherosclerosis, including the demonstration of high levels of ceramides in atherosclerotic plaques, and the ability of ceramides to promote endothelial uptake of LDL-C, superoxide anion production, inflammation, and apoptosis [19], CERT1 might be a valuable tool to better stratify subjects with obesity according to the individual CVD risk independently from the diagnosis of metabolic syndrome. This evidence concerns the gene CERT1 and obesity due to melanocortin 4 receptor deficiency.