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HelpTest Code PFAPC Fatty Acid Profile, Comprehensive (C8-C26), Plasma
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 plasma specimens
Monitoring treatment of essential fatty acid deficiency
Monitoring the response to provocative tests (fasting tests, loading tests)
Method Name
Gas Chromatography-Mass Spectrometry (GC-MS) Stable Isotope Dilution Analysis
Reporting Name
Fatty Acid Profile, Comprehensive, PSpecimen Type
PlasmaOrdering 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 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: Green top (sodium heparin)
Acceptable: Lavender top (EDTA) or green top (lithium heparin)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot plasma into plastic vial.
Specimen Minimum Volume
0.15 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma | 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
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 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 phytanic acid (along with normal pristanic acid concentrations) are seen in Refsum disease (phytanase deficiency). Phytanic acid concentration also may be increased in other peroxisomal disorders and, when combined with the VLCFA, pristanic acid, and pipecolic acid, allows differential diagnosis of peroxisomal disorders.
Clinical Reference
1. Vannice G, Rasmussen H. Position of the Academy of Nutrition and Dietetics: Dietary fatty acids for healthy adults. J Acad Nutr Diet. 2014;114(1):136-153
2. Rinaldo P, Matern D, Bennett MJ. Fatty acid oxidation disorders. Annu Rev Physiol. 2002;64:477-502
3. Jeppesen PB, Christensen MS, Hoy CE, Mortensen PB. Essential fatty acid deficiency in patients with severe fat malabsorption. Am J Clin Nutr. 1997;65(3):837-843
4. VerHoeven NM, Jakobs C. Human metabolism of phytanic acid and pristanic acid. Prog Lipid Res. 2001;40(6):453-466
5. Luszczki E, Boakye F, Zielinska M, et al. Vegan diet: nutritional components, implementation, and effects on adults' health. Front Nutr. 2023 9;10:1294497. doi:10.3389/fnut.2023.1294497
6. Spector AA, Kim HY. Discovery of essential fatty acids. J. Lipid Res. 2015;56(1):11-21
Day(s) Performed
Monday through Friday
Report Available
3 to 5 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82725
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PFAPC | Fatty Acid Profile, Comprehensive, P | 43674-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36595 | Octanoic Acid, C8:0 | 35145-2 |
| 36596 | Decenoic Acid, C10:1 | 35147-8 |
| 36597 | Decanoic Acid, C10:0 | 35146-0 |
| 36598 | Lauroleic Acid, C12:1 | 35151-0 |
| 36599 | Lauric Acid, C12:0 | 35150-2 |
| 36600 | Tetradecadienoic Acid, C14:2 | 35148-6 |
| 36601 | Myristoleic Acid, C14:1 | 35158-5 |
| 36602 | Myristic Acid, C14:0 | 35157-7 |
| 36603 | Hexadecadienoic Acid, C16:2 | 35154-4 |
| 36604 | Hexadecenoic Acid, C16:1w9 | 35155-1 |
| 36605 | Palmitoleic Acid, C16:1w7 | 35162-7 |
| 36606 | Palmitic Acid, C16:0 | 35161-9 |
| 36607 | g-Linolenic Acid, C18:3w6 | 35163-5 |
| 36608 | a-Linolenic Acid, C18:3w3 | 35164-3 |
| 36609 | Linoleic Acid, C18:2w6 | 35165-0 |
| 36610 | Oleic Acid, C18:1w9 | 35166-8 |
| 36611 | Vaccenic Acid, C18:1w7 | 35167-6 |
| 36612 | Stearic Acid, C18:0 | 35149-4 |
| 36613 | EPA, C20:5w3 | 35173-4 |
| 36614 | Arachidonic Acid, C20:4w6 | 35168-4 |
| 36615 | Mead Acid, C20:3w9 | 35172-6 |
| 36616 | h-g-Linolenic Acid, C20:3w6 | 35171-8 |
| 36617 | Arachidic Acid, C20:0 | 35169-2 |
| 36618 | DHA, C22:6w3 | 35174-2 |
| 36619 | DPA, C22:5w6 | 35181-7 |
| 36620 | DPA, C22:5w3 | 35180-9 |
| 36621 | DTA, C22:4w6 | 35182-5 |
| 36622 | Docosenoic Acid, C22:1 | 35160-1 |
| 36623 | Docosanoic Acid, C22:0 | 30194-5 |
| 36624 | Nervonic Acid, C24:1w9 | 35170-0 |
| 36625 | Tetracosanoic Acid, C24:0 | 30195-2 |
| 36626 | Hexacosenoic Acid, C26:1 | 33036-5 |
| 36627 | Hexacosanoic Acid, C26:0 | 30197-8 |
| 36628 | Pristanic Acid, C15:0(CH3)4 | 22761-1 |
| 36629 | Phytanic Acid, C16:0(CH3)4 | 22671-2 |
| 36630 | Triene Tetraene Ratio | 35411-8 |
| 36631 | Total Saturated | 35175-9 |
| 36632 | Total Monounsaturated | 35176-7 |
| 36633 | Total Polyunsaturated | 35177-5 |
| 36634 | Total w3 | 35178-3 |
| 36635 | Total w6 | 35179-1 |
| 36636 | Total Fatty Acids | 24461-6 |
| 36637 | Interpretation (PFAPC) | 59462-2 |