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Test Code LAB2667 Fatty Acid Profile, Comprehensive (C8-C26), Serum

Additional Codes

FAPCP

Useful For

Monitoring patients undergoing diet therapy for mitochondrial or peroxisomal disorders (possibly inducing essential fatty acid deficiency in response to restricted fat intake) using serum specimens

 

Monitoring treatment of essential fatty acid deficiency

 

Monitoring the response to provocative tests (fasting tests, loading tests)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Ordering Guidance


This test is not the recommended initial screening test for evaluating patients with possible peroxisomal disorders, single-enzyme defects of peroxisomal metabolism such as X-linked adrenoleukodystrophy, or peroxisomal biogenesis disorders (Zellweger syndrome spectrum). For these purposes, the preferred tests are either POXP / Fatty Acid Profile, Peroxisomal (C22-C26), Plasma or POX / Fatty Acid Profile, Peroxisomal (C22-C26), Serum.



Necessary Information


1. Patient's age is required.

2. Include information regarding treatment, family history, and tentative diagnosis.



Specimen Required


Patient Preparation:

1. For nutritional assessment, patient should fast overnight (12-14 hours); for patients with a suspected fatty acid oxidation disorder, collect immediately before to next feeding as fasting is contraindicated.

2. Patient must not consume any alcohol for 24 hours before the specimen collection.

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red Top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.


Specimen Minimum Volume

0.15 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 92 days
  Refrigerated  72 hours

Reference Values

Octanoic Acid, C8:0

<1 year: 7-63 nmol/mL

1-17 years: 9-41 nmol/mL

≥18 years: 8-47 nmol/mL

 

Decenoic Acid, C10:1

<1 year: 0.8-4.8 nmol/mL

1-17 years: 1.6-6.6 nmol/mL

≥18 years: 1.8-5.0 nmol/mL

 

Decanoic Acid, C10:0

<1 year: 2-62 nmol/mL

1-17 years: 3-25 nmol/mL

≥18 years: 2-18 nmol/mL

 

Lauroleic Acid, C12:1

<1 year: 0.6-4.8 nmol/mL

1-17 years: 1.3-5.8 nmol/mL

≥18 years: 1.4-6.6 nmol/mL

 

Lauric Acid, C12:0

<1 year: 6-190 nmol/mL

1-17 years: 5-80 nmol/mL

≥18 years: 6-90 nmol/mL

 

Tetradecadienoic Acid, C14:2

<1 year: 0.3-6.5 nmol/mL

1-17 years: 0.2-5.8 nmol/mL

≥18 years: 0.8-5.0 nmol/mL

 

Myristoleic Acid, C14:1

<1 year: 1-46 nmol/mL

1-17 years: 1-31 nmol/mL

≥18 years: 3-64 nmol/mL

 

Myristic Acid, C14:0

<1 year: 30-320 nmol/mL

1-17 years: 40-290 nmol/mL

≥18 years: 30-450 nmol/mL

 

Hexadecadienoic Acid, C16:2

<1 year: 4-27 nmol/mL

1-17 years: 3-29 nmol/mL

≥18 years: 10-48 nmol/mL

 

Hexadecenoic Acid, C16:1w9

<1 year: 21-69 nmol/mL

1-17 years: 24-82 nmol/mL

≥18 years: 25-105 nmol/mL

 

Palmitoleic Acid, C16:1w7

<1 year: 20-1,020 nmol/mL

1-17 years: 100-670 nmol/mL

≥18 years: 110-1,130 nmol/mL

 

Palmitic Acid, C16:0

<1 year: 720-3,120 nmol/mL

1-17 years: 960-3,460 nmol/mL

≥18 years: 1,480-3,730 nmol/mL

 

Gamma-Linolenic Acid, C18:3w6

<1 year: 6-110 nmol/mL

1-17 years: 9-130 nmol/mL

≥18 years: 16-150 nmol/mL

 

Alpha-Linolenic Acid, C18:3w3

<1 year: 10-190 nmol/mL

1-17 years: 20-120 nmol/mL

≥18 years: 50-130 nmol/mL

 

Linoleic Acid, C18:2w6

≤31 days: 350-2,660 nmol/mL

32 days-11 months: 1,000-3,300 nmol/mL

1-17 years: 1,600-3,500 nmol/mL

≥18 years: 2,270-3,850 nmol/mL

 

Oleic Acid, C18:1w9

<1 year: 250-3,500 nmol/mL

1-17 years: 350-3,500 nmol/mL

≥18 years: 650-3,500 nmol/mL

 

Vaccenic Acid, C18:1w7

<1 year: 140-720 nmol/mL

1-17 years: 320-900 nmol/mL

≥18 years: 280-740 nmol/mL

 

Stearic Acid, C18:0

<1 year: 270-1,140 nmol/mL

1-17 years: 280-1,170 nmol/mL

≥18 years: 590-1,170 nmol/mL

 

EPA, C20:5w3

<1 year: 2-60 nmol/mL

1-17 years: 8-90 nmol/mL

≥18 years: 14-100 nmol/mL

 

Arachidonic Acid, C20:4w6

<1 year: 110-1,110 nmol/mL

1-17 years: 350-1,030 nmol/mL

≥18 years: 520-1,490 nmol/mL

 

Mead Acid, C20:3w9

≤31 days: 8-60 nmol/mL

32 days-11 months: 3-24 nmol/mL

≥1 year: 7-30 nmol/mL

 

Homo-Gamma-Linolenic Acid, C20:3w6

<1 year: 30-170 nmol/mL

1-17 years: 60-220 nmol/mL

≥18 years: 50-250 nmol/mL

 

Arachidic Acid, C20:0

<1 year: 30-120 nmol/mL

1-17 years: 30-90 nmol/mL

≥18 years: 50-90 nmol/mL

 

DHA, C22:6w3

<1 year: 10-220 nmol/mL

1-17 years: 30-160 nmol/mL

≥18 years: 30-250 nmol/mL

 

DPA, C22:5w6

<1 year: 3-70 nmol/mL

1-17 years: 10-50 nmol/mL

≥18 years: 10-70 nmol/mL

 

DPA, C22:5w3

<1 year: 6-110 nmol/mL

1-17 years: 30-270 nmol/mL

≥18 years: 20-210 nmol/mL

 

DTA, C22:4w6

<1 year: 2-50 nmol/mL

1-17 years: 10-40 nmol/mL

≥18 years: 10-80 nmol/mL

 

Docosenoic Acid, C22:1

<1 year: 2-20 nmol/mL

≥1 year: 4-13 nmol/mL

 

Docosanoic Acid, C22:0

0.0-96.3 nmol/mL

 

Nervonic Acid, C24:1

<1 year: 30-150 nmol/mL

1-17 years: 50-130 nmol/mL

≥18 years: 60-100 nmol/mL

 

Tetracosanoic Acid, C24:0

0.0-91.4 nmol/mL

 

Hexacosenoic Acid, C26:1

<1 year: 0.2-2.1 nmol/mL

≥1 year: 0.3-0.7 nmol/mL

 

Hexacosanoic Acid, C26:0

0.00-1.30 nmol/mL

 

Pristanic Acid, C15:0(CH3)4

≤4 months: 0.00-0.60 nmol/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

≥2 years: 0.00-2.98 nmol/mL

 

Phytanic Acid, C16:0(CH3)4

≤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

≥2 years: 0.00-9.88 nmol/mL

 

Triene/Tetraene Ratio

≤31 days: 0.017-0.083

32 days-17 years: 0.013-0.050

≥18 years: 0.010-0.038

 

Total Saturated Acid

<1 year: 1.2-4.6 mmol/L

1-17 years: 1.4-4.9 mmol/L

≥18 years: 2.5-5.5 mmol/L

 

Total Monounsaturated Acid

<1 year: 0.3-4.6 mmol/L

1-17 years: 0.5-4.4 mmol/L

≥18 years: 1.3-5.8 mmol/L

 

Total Polyunsaturated Acid

<1 year: 1.1-4.9 mmol/L

1-17 years: 1.7-5.3 mmol/L

≥18 years: 3.2-5.8 mmol/L

 

Total w3

<1 year: 0.0-0.4 mmol/L

1-17 years: 0.1-0.5 mmol/L

≥18 years: 0.2-0.5 mmol/L

 

Total w6

<1 year: 0.9-4.4 mmol/L

1-17 years: 1.6-4.7 mmol/L

≥18 years: 3.0-5.4 mmol/L

 

Total Fatty Acids

<1 year: 3.3-14.0 mmol/L

1-17 years: 4.4-14.3 mmol/L

≥18 years: 7.3-16.8 mmol/L

Day(s) Performed

Monday through Friday

CPT Code Information

82725

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FAPCP Fatty Acid Profile, Comprehensive,S 43674-1

 

Result ID Test Result Name Result LOINC Value
16965 Octanoic Acid, C8:0 35145-2
16966 Decenoic Acid, C10:1 35147-8
16967 Decanoic Acid, C10:0 35146-0
16968 Lauroleic Acid, C12:1 35151-0
16969 Lauric Acid, C12:0 35150-2
16970 Tetradecadienoic Acid, C14:2 35148-6
16971 Myristoleic Acid, C14:1 35158-5
16972 Myristic Acid, C14:0 35157-7
16973 Hexadecadienoic Acid, C16:2 35154-4
16974 Hexadecenoic Acid, C16:1w9 35155-1
16975 Palmitoleic Acid, C16:1w7 35162-7
16976 Palmitic Acid, C16:0 35161-9
16977 g-Linolenic Acid, C18:3w6 35163-5
16978 a-Linolenic Acid, C18:3w3 35164-3
16979 Linoleic Acid, C18:2w6 35165-0
16980 Oleic Acid, C18:1w9 35166-8
16981 Vaccenic Acid, C18:1w7 35167-6
16982 Stearic Acid, C18:0 35149-4
16983 EPA, C20:5w3 35173-4
16984 Arachidonic Acid, C20:4w6 35168-4
16985 Mead Acid, C20:3w9 35172-6
16986 h-g-Linolenic Acid, C20:3w6 35171-8
16987 Arachidic Acid, C20:0 35169-2
16988 DHA, C22:6w3 35174-2
16989 DPA, C22:5w6 35181-7
16990 DPA, C22:5w3 35180-9
16991 DTA, C22:4w6 35182-5
16992 Docosenoic Acid, C22:1 35160-1
16993 Docosanoic Acid, C22:0 30194-5
16994 Nervonic Acid, C24:1w9 35170-0
16995 Tetracosanoic Acid, C24:0 30195-2
16996 Hexacosenoic Acid, C26:1 33036-5
16997 Hexacosanoic Acid, C26:0 30197-8
16998 Pristanic Acid, C15:0(CH3)4 22761-1
16999 Phytanic Acid, C16:0(CH3)4 22671-2
17000 Triene Tetraene Ratio 35411-8
17001 Total Saturated 35175-9
17002 Total Monounsaturated 35176-7
17003 Total Polyunsaturated 35177-5
17004 Total w3 35178-3
17005 Total w6 35179-1
17006 Total Fatty Acids 24461-6
17056 Interpretation 59462-2

Interpretation

An increased triene:tetraene ratio 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 investigations 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, adrenomyeloneuropathy, and Zellweger syndrome (cerebrohepatorenal syndrome).

 

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

Method Description

Quantitation of fatty acids of specific chain lengths is performed as follows: a 2-step, acid-base hydrolysis is followed by hexane extraction and derivatization with pentafluorobenzyl bromide. Separation and detection are accomplished by capillary gas chromatography electron-capture negative ion-mass spectrometry. Quantitation is based on analysis in the selected ion-monitoring mode by using 13 stable isotope-labeled internal standards.(Lagerstedt SA, Hinrichs DR, Batt SM, Magera MJ, Rinaldo P, McConnell JP. Quantitative determination of plasma C8-C26 total fatty acids for the biochemical diagnosis of nutritional and metabolic disorders. Mol Genet Metab. 2001;73[1]:38-45, Gramlich L, Ireton-Jones C, Miles JM, Morrison M, Pontes-Arruda A. Essential fatty acid requirements and intravenous lipid emulsions. JPEN J Parenter Enteral Nutr. 2019;43[6]:697-707)

Report Available

3 to 5 days

Specimen Retention Time

2 months

Reject Due To

Gross hemolysis OK
Gross lipemia Reject
Gross icterus OK

Method Name

Gas Chromatography Mass Spectrometry (GC-MS) Stable Isotope Dilution

Secondary ID

82042