Clinics and Departments

Laboratory Services

Lab Dept:

Chemistry

Test Name:

FATTY ACID PROFILE, COMPREHENSIVE

General Information

Lab Order Codes:

FAPC

Synonyms:

Fatty Acid Profile, Comprehensive (C8-C26), Serum

CPT Codes:

82544 – Column chromatography/mass spectrometry, analyte not elsewhere specified; stable isotope dilution, multiple analytes, quantitative, single stationary and mobile phase

Test Includes:

See Reference Range

Logistics

Test Indications:

Useful for monitoring patients undergoing diet therapy for mitochondrial or peroxisomal disorders (possibly inducing essential fatty acid deficiency (EFAD) in response to restricted fat intake). Monitoring treatment of EFAD. Monitoring the response to provocative tests (fasting tests, loading tests). Complete evaluation of patients enrolled in clinical studies.

Lab Testing Sections:

Chemistry - Sendouts

Referred to:

Mayo Medical Laboratories (MML Test: 82042/FAPCP)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

 

Test Availability:

Daily, 24 hours

Turnaround Time:

3 - 7 days, test set up Monday - Friday

Special Instructions:

See Patient Preparation

Specimen

Specimen Type:

Blood

Container:

Red top tube

Draw Volume:

1.5 mL (Minimum: 0.5 mL) blood

Processed Volume:

0.5 mL (Minimum: 0.15 mL) serum

Collection:

Routine venipuncture

Special Processing:

Lab Staff: Centrifuge specimen and aliquot serum into a plastic screw- capped round bottom vial. Store and ship at frozen temperatures. Forward promptly.

Patient Preparation:

Overnight (12-14 hour) fast recommended. Patient must not consume any alcohol for 24 hours before the specimen is drawn.

Sample Rejection:

Specimens other than serum or plasma; anticoagulants other than EDTA or heparin; warm specimens

Interpretive

Reference Range:

Fatty Acid nmol/mL

<1 year

1 - 17 years

≥18 years

Octanoic Acid, C8:0

7 - 63

9 - 41

8 - 47

Decenoic Acid, C10:1

0.8 - 4.8

1.6 - 6.6

1.8 - 5.0

Decanoic Acid, C10:0

2 - 62

3 - 25

2 - 18

Lauroleic Acid, C12:1

0.6 - 4.8

1.3 - 5.8

1.4 - 6.6

Lauric Acid, C12:0

6 - 190

5 - 80

6 - 90

Tetradecadienoic Acid, C14:2

0.3 - 6.5

0.2 - 5.8

0.8 - 5.0

Myristoleic Acid, C14:1

1 - 46

1 – 31

3 - 64

Myristic Acid, C14:0

30 - 320

40 - 290

30 - 450

Hexadecadienoic Acid, C16:2

4 - 27

3 - 29

10 - 48

Hexadecenoic Acid, C16:1w9

21 - 69

24 - 82

25 - 105

Palmitoleic Acid, C16:1w7

20 - 1020

100 - 670

110 - 1130

Palmitic Acid, C16:0

720 - 3120

960 - 3460

1480 - 3730

γ-Linolenic Acid, C18:3w6

6 - 110

9 - 130

16 - 150

α-Linolenic Acid, C18:3w3

10 - 190

20 - 120

50 - 130

Linoleic Acid, C18:2w6

1-31 days

32 days – 11 months

1 - 17 years

≥18 years

350 - 2660

1000 - 3000

1600 - 3500

2270 - 3850

Oleic Acid, C18:1w9

250 - 3500

350 - 3500

650 - 3500

Vaccenic Acid, C18:1w7

140 - 720

320 - 900

280 - 740

Stearic Acid, C18:0

270 - 1140

280 - 1170

590 - 1170

EPA, C20:5w3

2 - 60

8 - 90

14 - 100

Arachidonic Acid, C20:4w6

110 - 1110

350 - 1030

520 - 1490

Mead Acid, C20:0:3w9

1 - 31 days

32 days – 11 months

≥1year

 

8 - 60

3 - 24

7 - 30

h-γ-Linolenic Acid, C20:3w6

30 - 170

60 - 220

50 - 250

Arachidic Acid, C20:0

30 - 120

30 - 90

50 - 90

DHA, C22:6w3

10 - 220

30 - 160

30 - 250

DPA, C22:5w6

3 - 70

10 - 50

10 - 70

DPA, C22:5w3

6 - 110

30 - 270

20 - 210

DTA, C22:4w6

2 - 50

10 - 40

10 - 80

Docosenoic Acid, C22:1

<1 year

≥1year

2 - 20

4 - 13

Docosanoic Acid, C22:0

All ages

0.0 - 96.3

Nervonic Acid, C24:1

30 - 150

50 - 130

60 - 100

Tetracosanoic Acid, C24:0

All ages

0.0 - 91.4

Hexacosenoic Acid, C26:1

0.2 - 2.1

≥1year

0.3 - 0.7

Hexacosanoic Axid, C26:0

All ages

0.00 - 1.30

Pristanic Acid, C15:0(CH3)4

1 day – 4 months: 0.00 – 0.60nmol/mL
5-8 months: 0.00 – 0.84 nmol/mL
9-12 months: 0.00 – 0.77 nmol/mL
13-23 months: 0.00 – 1.47 nmol/mL
> or =2 years: 0.00 – 2.98 nmol/mL

Phytanic Acid, C16:0(CH3)4

1 day – 4 months: 0.00 – 5.28 nmol/mL
5-8 months: 0.00 – 5.70 nmol/mL
9-12 months: 0.00 – 4.40 nmol/mL
13-23 months: 0.00 – 8.62 nmol/mL
> or =2 years: 0.00 – 9.88 nmol/mL

Triene Tetraene Ratio

1 – 31 days

32 days – 17 years

≥18 years

0.017 - 0.083

0.013 - 0.050

0.010 - 0.038

Values Expressed as mmol/L

       

Total Saturated Acid

1.2 - 4.6

1.4 - 4.9

2.5 - 5.5

Total Monounsaturated Acid

0.3 - 4.6

0.5 - 4.4

1.3 - 5.8

Total Polyunsaturated Acid

1.1 - 4.9

1.7 - 5.3

3.2 - 5.8

Total w3

0.0 - 0.4

0.1 - 0.5

0.2 - 0.5

Total w6

0.9 - 4.4

1.6 - 4.7

3.0 - 5.4

Total Fatty Acids

3.3 - 14.0

4.4 - 14.3

7.3 - 16.8

Interpretation: An increased triene/tetraene ration is consistent with essential fatty acid deficiency.

Fatty acid oxidation disorders are recognized on the basis of disease-specific patterns that are correlated to the results of other inestigations in plasma (carnitine, acylcarnitines) and urine (organic acids, acylglycines).

Increased concentrations of serum very long-chain fatty acids (VLCFA) C24:0 and C26:0 are seen in peroxisomal disorders, X-linked adrenoleukodystrophy, adenomyeloneuropathy, and Zellweger syndrome (cerebrohepatorenal syndrome).

Increased concentrations of serum phytanic acid (along with normal pristanic acid concentrations) are seen in Refsum disease (phyanase deficiency). Serum phytanic acid concentration also may be increased in other peroxisomal disorders and, when combined with the VLCFA, pristanoic acid and pipecolic acid allow differential diagnosis of peroxisomal disorders.

Critical Values:

N/A

Limitations:

For nutritional assessment, a 12-14 hour fast is required; however, infants or persons suspected of having fatty acid oxidation disorder should not fast before testing owing to the possibility of acute metabolic decompensation. Instead, collect the specimen after the longest fast possible, just before feeding. In the case of a patient on total parenteral nutrition (TPN), specimen can be drawn as normal.

Methodology:

Gas chromatography/Mass spectrometry (GC-MS), Stable isotope dilution analysis

References:

Mayo Medical Laboratories October 2014

Updates:

12/15/2005: Reference range updates.
12/23/2010: Units update



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