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HelpEpic Code LAB1230708 Free Fatty Acids, Total, Serum
Additional Codes
Mayo Code: NEFA
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Evaluation of metabolic status of patients with endocrinopathies
Monitoring of control of diabetes mellitus
Monitoring the effects of therapeutic diet/exercise lifestyle changes
Specimen Type
SerumSpecimen Required
Patient Preparation:
1. Fasting-overnight (12-14 hours).
2. Patient must not consume any alcohol for 24 hours before the specimen is collected.
3. Patient should not be receiving therapeutic heparin.
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge within 45 minutes of collection and aliquot 1 mL of serum into a plastic vial.
2. Immediately freeze specimen.
COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen | 7 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Day(s) Performed
Monday through Friday
Reference Values
≥18 years: 0.00-0.72 mmol/L
Reference values have not been established for patients who are <18 years of age.
Clinical Information
Elevated serum concentrations of nonesterified fatty acids (NEFA) are associated with cardiovascular disease, metabolic syndrome, obesity, and type 2 diabetes mellitus. NEFA are causally linked with insulin resistance and inflammation of vascular endothelium.
Cautions
Patients receiving therapeutic heparin are unsuitable for this analysis. Heparin causes the release of free fatty acids by stimulating the activity of lipoprotein lipase, which causes triglycerides associated with blood lipoproteins to release free fatty acids.
In order to eliminate the generation of free fatty acids from triglycerides by serum lipases (causing erroneous elevations), serum should be frozen as soon as possible after it is collected and shipped frozen.
Interpretation
Abnormally high levels of free fatty acids are associated with uncontrolled diabetes mellitus and with conditions that involve excessive release of a lipoactive hormone such as epinephrine, norepinephrine, glucagon, thyrotropin, and adrenocorticotropin.
Reporting Name
Free Fatty Acids, Total, SMethod Name
Enzymatic Colorimetric
Method Description
In the presence of adenosine triphosphate and coenzyme A (CoA), serum non-esterified fatty acids form acyl-CoA, adenosine monophosphate and pyrophosphate when treated with acylCoA synthetase. The acylCoA is then oxidized by adding acylCoA oxidase to produce hydrogen peroxide, which in the presence of added peroxidase allows for the oxidative condensation of 3-methyl-N- ethyl-N-(beta-hydroxyethyl)-aniline with 4-aminoantipyrine to form a purple colored end product.(Package insert: HR Series NEFA-HR(2). Fujifilm Healthcare Americas Corporation; 22.01.20K08 12/2021)
CPT Code Information
82725
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| NEFA | Free Fatty Acids, Total, S | 15066-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| NEFA | Free Fatty Acids, Total, S | 15066-4 |
Report Available
1 to 3 daysTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.Clinical Reference
1. Boden G. Obesity and free fatty acids. Endocrinol Metab Clin North Am. 2008;37(3):635-646, viii-ix. doi:10.1016/j.ecl.2008.06.007
2. Haus JM, Soloman TP, Marchetti CM, Edmison JM, Gonzalez F, Kirwan JP. Free fatty acid-induced hepatic insulin resistance is attenuated following lifestyle intervention in obese individuals with impaired glucose tolerance. J Clin Endocrinol Metab. 2010;95(1):323-327. doi: 10.1210/jc.2009-1101
3.Imrie H, Abbas A, Kearney M. Insulin resistance, lipotoxicity and endothelial dysfunction. Biochim Biophys Acta. 2010;1801 (3):320-326. doi:10.1016/j.bbalip.2009.09.025
4. Marusic M, Paic M, Knobloch M, Liberati Prso AM. NAFLD, Insulin Resistance, and Diabetes Mellitus Type 2. Can J Gastroenterol Hepatol. 2021;2021:6613827. doi:10.1155/2021/6613827
Forms
If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.