Test Code DBS575
Overview
Essential Fatty Acids
Fatty acids are essential to heart health. Balancing fatty acids can improve cholesterol and triglyceride levels, improve immune system function as well as reduce inflammation and rate of heart disease.1,2 The Essential Fatty Acids test measures the major fatty acids (FA) for the purposes of cardiovascular disease characterization and management.
References:
- Schaefer EJ. Lipoproteins, nutrition, and heart disease. Am J Clin Nutr. 2002;75(2):191-212.
- Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63 (25 Pt B):2960-2984.
Test Details
Essential Fatty Acids
Measures all the major fatty acids in plasma and reports:
- EPA
- DHA
- Omega-3 Fatty Acid Index
- Omega-6 Fatty Acid Index
- Omega-3/Omega-6 Ratio Index
- Monounsaturated Fatty Acid Index
- Arachidonic Acid (AA)
- AA/EPA Ratio
- EPA/AA Ratio Index
Methodology
Gas liquid column chromatography/mass spectrometry (GC/MS) after lipid extraction
Patient Preparation
9 hour fast prior to collection. Patient may drink water only. Fasting includes refraining from supplements, such as fish oil. Non-fasting samples will be rejected.
Preferred Specimen
Dried Blood collected on an AdvanceDx 100 card
Alternate Specimen
None
Transport Temperature
Room temperature
Stability
15 days at room temperature
Lab Values
Essential Fatty Acids
Test Name | Optimal | Borderline | Low |
Eicosapentaenoic Acid (EPA) | >50.0 | 20.0 – 50.0 | <20.0 pg/mL |
Docosahexaenoic Acid (DHA) | >100.0 | 60.0 – 100.0 | <60.0 pg/mL |
Omega-3 Fatty Acid Index | >4.50 | 2.50 – 4.50 | <2.50 % | EPA/AA Ratio | >0.17 | 0.07 – 0.17 | <0.07 |
AA/EPA Ratio | <5.88 | 5.88 – 14.29 | >14.29 |
Test Name | Low | Mid | High |
Omega-6 Fatty Acid Index | <39.0 | 39.0 – 43.0 | >43.0 % |
Arachidonic Acid (AA) | <250.0 | 250.0 – 320.0 | >320.0 µg/mL |
Omega-3/Omega-6 Ratio | < 0.07 | 0.07 – 0.10 | >0.10 |
Monounsaturated Fatty Acid Index | <20.0 | 20.0-23.0 | >23.0 % |
Clinical Significance
Essential Fatty Acids
- Monounsaturated Fatty Acid Index Includes:
- Palmitoleic (16:1n7)
- Oleic (18:1n9)
- Beneficial fat that lowers heart disease risk4
- Enhances LDL apoB-100 clearance relative to saturated fat1
References:
- Schaefer EJ. Lipoproteins, nutrition, and heart disease. Am J Clin Nutr. 2002;75(2):191-212.
- Mozaff arian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Eng J Med. 2006;354(15):1601-1613.
- Lichtenstein AH, Ausman LM, Jalbert SM, Schaefer EJ. Eff ects of diff erent forms of dietary hydrogenated fats on serum lipoprotein cholesterol levels. N Eng JMed. 1999;340(25):1933-1940.
- Estruch R, Ros E, Salas-Salvadó J, et al; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-1290.
- Saito Y, Yokoyama M, Origasa H, et al; JELIS Investigators. Eff ects of EPA on coronary artery disease in hypercholesterolemic patients with multiple risk factors: sub-analysis of primary prevention cases from the Japan EPA Lipid Intervention Study (JELIS). Atherosclerosis. 2008;200(1):135-140.
- Maki KC, Bays HE, Dicklin MR. Treatment options for the management of hypertriglyceridemia: strategies based on the best-available evidence. J Clin Lipidol. 2012;6(5):413-426.
- Fernandez ML , West KL. Mechanisms by which dietary fatty acids modulate plasma lipids. J Nutr. 2005;135(9):2075-2078.
- Superko R, Superko S, Nasir L, Agatston A, Garrett C. Omega-3 fatty acid blood levels: clinical significance and controversy. Circulation. 2013; 128(19):2154-2161.
Treatment Options
Essential Fatty Acids
- Choose poultry without skin, fish, low fat dairy products, and very lean cuts of meats. Replace butter with vegetable oil or tub margarine.
- Replace foods high in trans fats with trans fat free tub margarine and vegetable oils.
- Increase intake of olive oil and or canola oil in salads or use more of these oils in cooking.
- Increase intake of vegetable fats (nuts, seeds, canola, soybean or other oils) and decrease intake of animal fats (fatty meats, cheese, ice cream).
- Increase intake of oily fish such as salmon, herring, tuna, or mackerel, or take at least two fish oil or pure EPA capsules daily. Use of fish oil capsules has been associated with heart disease risk reduction. Doses of about 6 grams per day of fish oil or 4 grams of concentrated fish oil can also significantly lower triglyceride levels.