Fatty Acids, Free (Nonester)

Serum, frozen

1 mL

0.2 mL (Note: This volume does not allow for repeat testing.)

Red-top tube or gel-barrier tube

Sample should be collected in the early morning after a 12-hour fast. Blood for the NEFA procedure should be collected after an overnight fast because the level of circulating nonesterified fatty acids is strongly influenced by food ingestion. If the patient has not properly fasted, the determined level of NEFA will be elevated and not directly comparable to a normal range derived from fasting normal controls.

Knowledge of the level of nonesterified fatty acids (NEFA) in blood plasma can be helpful in the diagnosis and management of certain diseases and disorders of metabolism and in the evaluation of prospective causes of hyperlipoproteinemia. A disorder of disease that causes excessive release of a lipoactive hormone (epinephrine, ACTH, GH, etc) can induce an elevation of blood level of fatty acids. A sustained release of fatty acids from adipose cells in excess of energy needs can contribute to the development of secondary hyperlipoproteinemia.

Spectrophotometry

See table.

Plasma or serum NEFA is the portion of the total fatty acid pool that circulates in immediate readiness for metabolic needs. NEFA can be absorbed readily by muscle, heart, brain, and other organs as an energy source whenever insufficient quantities of glucose limit the usual carbohydrate energy source. In all probability, both glucose and NEFA are simultaneously taken up from the blood, even under normal conditions. When blood glucose levels are high, the NEFA level falls, and vice versa, emphasizing the reciprocal withdrawal of stored energy, under the simultaneous control of insulin and epinephrine. In acute starvation, the NEFA level may rise as much as three times the normal values.