Metabolomics & Nutrition AC

Acylcarnitine Profile.

Quantitative profiling of 23 acylcarnitine species covering short-, medium-, and long-chain forms. Performed by LC-MS/MS from dried blood spot.

Quick Reference
Method
LC-MS/MS
Sample Types
DBS
Analytes

23 acylcarnitines

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What does this test assess?

This panel enables detection and monitoring of inborn errors of metabolism affecting fatty acid oxidation, organic acid metabolism, and the carnitine shuttle system.

Clinical indications include:

  • Newborn screening for fatty acid oxidation disorders
  • Diagnosis and monitoring of organic acidurias
  • Detection of primary and secondary carnitine deficiencies
  • Monitoring of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency
  • Assessment of mitochondrial fatty acid oxidation capacity
  • Differential diagnosis of hypoglycaemia and metabolic crises

Measured analytes

Analyte / GroupComponentsClinical Significance
Free carnitine (C0) L-carnitine Carrier molecule for fatty acid transport into mitochondria
Short-chain (C2–C5) Acetylcarnitine, propionylcarnitine, and others Reflect short-chain fatty acid and organic acid metabolism
Medium-chain (C6–C12) Hexanoylcarnitine through dodecanoylcarnitine Elevated in MCAD and other medium-chain oxidation defects
Long-chain (C14–C18:1) Palmitoylcarnitine, oleoylcarnitine, and others Elevated in VLCAD, LCHAD, and carnitine transport defects

About acylcarnitines

Acylcarnitines are formed when carnitine conjugates with acyl-CoA intermediates of fatty acid and organic acid metabolism. Their profile in blood provides a metabolic snapshot of mitochondrial function, particularly fatty acid beta-oxidation.

23

Individual acylcarnitine species measured simultaneously

NBS

Core component of expanded newborn screening programmes

Mito

Reflects mitochondrial fatty acid oxidation capacity

Acylcarnitine profiling is a cornerstone of newborn screening programmes worldwide. Characteristic elevations of specific acylcarnitine species can identify disorders such as medium-chain acyl-CoA dehydrogenase (MCAD) deficiency, very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency, and multiple acyl-CoA dehydrogenase deficiency (MADD) before clinical symptoms manifest.

Beyond newborn screening, acylcarnitine profiling supports diagnosis of organic acidurias, carnitine transport defects, and secondary carnitine deficiency associated with medications such as valproic acid or pivalic acid-containing antibiotics.

Analytical technique

The test is performed using flow-injection analysis with tandem mass spectrometry (FIA-MS/MS), the standard approach used in newborn screening laboratories worldwide. Butylated acylcarnitine esters are analysed by precursor ion and neutral loss scanning, providing rapid, multiplexed quantification of all 23 species.

Sample information

DBS is the standard matrix for acylcarnitine profiling, enabling integration with existing newborn screening workflows and remote collection for monitoring purposes.

Literature

  1. Rinaldo P, et al. “Acylcarnitine profile analysis.” Genetics in Medicine, 2008, 10(2):151-156. 10.1097/GIM.0b013e318160834f
  2. Chace DH, et al. “Rapid diagnosis of MCAD deficiency: quantitative analysis of octanoylcarnitine and other acylcarnitines in newborn blood spots by tandem mass spectrometry.” Clinical Chemistry, 1997, 43(11):2106-2113.

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