MONDAY, Jan. 26, 2026 (HealthDay News) -- For adults with asthma, sphingolipid-to-steroid ratios are robustly associated with the five-year risk for exacerbation, according to a study published online Jan. 19 in Nature Communications.Yulu Chen, Ph.D., from Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues analyzed data from three asthma cohorts (2,513 adult participants) combining up to 25 years of electronic medical records with sequential metabolomic studies to develop and replicate a predictive model for risk for asthma exacerbation. Asthma-associated biochemical pathways were identified via global circulatory metabolomics, and targeted mass spectrometry methods were applied to quantify selected steroids, sphingolipids, and microbial-derived metabolites.The researchers observed a robust association between sphingolipid-to-steroid ratios and five-year exacerbation risk. Based on these findings, a simple five-year predictive model of asthma exacerbations was derived and replicated using 21 sphingolipid-to-steroid ratios, which outperformed current clinical measures (area under the receiver operating characteristic curve, 0.90 and 0.89 for the discovery and replication cohorts, respectively)."Our findings solve a critical unmet need," coauthor Jessica A. Lasky-Su, Sc.D., also from Brigham and Women's Hospital and Harvard Medical School, said in a statement. "By measuring the balance between specific sphingolipids and steroids in the blood, we can identify high-risk patients with 90 per cent accuracy, allowing clinicians to intervene before an attack occurs."One author disclosed ties to Precion and TruDiagnostic.Abstract/Full Text.Sign up for our weekly HealthDay newsletter