Fatty Acid Provile, Essential

Last Modified: 9/22/2021 12:12:09 PM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:

1. Fasting overnight (12-14 hours).

2. Patient must not consume any alcohol for 24 hours before the specimen is drawn.
Specimen Requirements:

1.0 mL Serum from a Red Top Tube in a Plastic Vial
Collection Instructions: Centrifuge within 45 minutes of draw

Order Must include: 
1. Patient's age is required.
2. Include information regarding treatment, family history, and tentative diagnosis.
Minimum Volume: 0.15 mL Serum
Transport & Storage: Temperature/Stability: 24 hours Refrigerated
90 days Frozen
Rejection Criteria: Lipemic
Reference Range:

Lauric Acid, C12:0

<1 year: 6-190 nmol/mL
1-17 years: 5-80 nmol/mL
> or =18 years: 6-90 nmol/mL

Myristic Acid, C14:0

<1 year: 30-320 nmol/mL
1-17 years: 40-290 nmol/mL
> or =18 years: 30-450 nmol/mL

Hexadecenoic Acid, C16:1w9

<1 year: 21-69 nmol/mL
1-17 years: 24-82 nmol/mL
> or =18 years: 25-105 nmol/mL

Palmitoleic Acid, C16:1w7

<1 year: 20-1,020 nmol/mL
1-17 years: 100-670 nmol/mL
> or =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
> or =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
> or =18 years: 16-150 nmol/mL

Alpha-Linolenic Acid, C18:3w3

<1 year: 10-190 nmol/mL
1-17 years: 20-120 nmol/mL
> or =18 years: 50-130 nmol/mL

Linoleic Acid, C18:2w6
< or =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
> or =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
> or =18 years: 650-3,500 nmol/mL 

Vaccenic Acid, C18:1w7

<1 year: 140-720 nmol/mL
1-17 years: 320-900 nmol/mL
> or =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
> or =18 years: 590-1,170 nmol/mL

EPA, C20:5w3

<1 year: 2-60 nmol/mL
1-17 years: 8-90 nmol/mL
> or =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
> or =18 years: 520-1,490 nmol/mL

Mead Acid, C20:3w9

< or =31 days: 8-60 nmol/mL
32 days-11 months: 3-24 nmol/mL
1-17 years: 7-30 nmol/mL
> or =18 years: 7-30 nmol/mL

Homo-Gamma-Linolenic C20:3w6

<1 year: 30-170 nmol/mL
1-17 years: 60-220 nmol/mL
> or =18 years: 50-250 nmol/mL

Arachidic Acid, C20:0

<1 year: 30-120 nmol/mL
1-17 years: 30-90 nmol/mL
> or =18 years: 50-90 nmol/mL 

DHA, C22:6w3

<1 year: 10-220 nmol/mL
1-17 years: 30-160 nmol/mL
> or =18 years: 30-250 nmol/mL

DPA, C22:5w6

<1 year: 3-70 nmol/mL
1-17 years: 10-50 nmol/mL
> or =18 years: 10-70 nmol/mL

DPA, C22:5w3

<1 year: 6-110 nmol/mL
1-17 years: 30-270 nmol/mL
> or =18 years: 20-210 nmol/mL

DTA, C22:4w6

<1 year: 2-50 nmol/mL
1-17 years: 10-40 nmol/mL
> or =18 years: 10-80 nmol/mL

Docosenoic Acid, C22:1

<1 year: 2-20 nmol/mL
1-17 years: 4-13 nmol/mL
> or =18 years: 4-13 nmol/mL

Nervonic Acid, C24:1w9

<1 year: 30-150 nmol/mL
1-17 years: 50-130 nmol/mL
> or =18 years: 60-100 nmol/mL

Triene/Tetraene Ratio

< or =31 days: 0.017-0.083
32 days-17 years: 0.013-0.050
> or =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
> or =18 years: 2.5-5.5 mmol/

Total Monounsaturated Acid

<1 year: 0.3-4.6 mmol/L
1-17 years: 0.5-4.4 mmol/L
> or =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
> or =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
> or =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
> or =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
> or =18 years: 7.3-16.8 mmol/L
Critical Ranges:  
Test Comments:

Concentrations below the stated reference ranges are consistent with fatty acid deficiencies.

An increased triene:tetraene ratio is consistent with essential fatty acid deficiency.
Methodology: Gas Chromatography-Mass Spectrometry (GC-MS) Stable Isotope Dilution Analysis
Clinical Significance:

Useful for: Evaluating the nutritional intake and intestinal absorption of essential fatty acids
Identifying deficiency of essential and other nutritionally beneficial fatty acids
Monitoring treatment of patients with essential fatty acid deficiencies who are receiving linoleic acid (C18:2w6) and alpha-linolenic acid (C18:3w3)

Clinical Significance: 

Fats are important sources of energy for tissues and for the function and integrity of cellular membranes. Deficiencies are commonly caused by inadequate dietary intake of lipids due to an unbalanced diet, long-term parenteral nutrition, or by intestinal malabsorption. Linoleic acid, an omega-6 fatty acid, and alpha-linolenic acid, an omega-3 fatty acid, are considered essential fatty acids in that they cannot be made by the body and are essential components of the diet.The major clinical manifestations associated with essential fatty acid deficiency (EFAD) include dermatitis, increased water permeability of the skin, increased susceptibility to infection, and impaired wound healing. Biochemical abnormalities may be detected before the onset of recognizable clinical manifestations. EFAD can be detected by diminished levels of the essential fatty acids linoleic acid and alpha-linolenic acid, as well as by increases in the triene:tetraene ratio.Excess dietary fatty acids have been linked to the onset of cardiovascular disease. Elevated levels of linoleic acid can contribute to overproduction of the proinflammatory 2-series local hormones.
Documentation: 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, et al: Quantitative determination of plasma C8-C26 total fatty acids for the biochemical diagnosis of nutritional and metabolic disorders. Mol Genet Metab 2001;73:38-45)
Custom Panel: No

PRODUCTION SCHEDULE

Turn Around Time: 4 to 7 days not reported on Saturdays or Sundays
Days Performed: Monday, Tuesday, Wednesday, Thursday, Friday
Sites Performed: Mayo Laboratory
PHL Test Code: MSOT
EPIC Test Code:
Send Out Test Code: FAPEP
Alternate Test Names: C12-C22, Fatty Acid Profile, Essential; Polyunsaturated Fatty Acids; Triene:Tetraene Ratio
Included Tests:  
CPT Coding: 82542

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