Consistent with our findings of an inverse association between SM (16:0), CER (24:1), and SM (24:1) and SMI, another recent study found that increased plasma CER (16:0), CER (24:0), SM (16:0), and SM (24:1) levels were a defining feature of the mouse and human cancer cachexia models; authors suggested that these sphingolipids may contribute to tissue wasting and skeletal muscle atrophy by inhibiting the anabolic signals.34 This evidence concerns the gene CBLN1 and cancer.