High hexacosanoic acid levels are associated with coronary artery disease

Aims Levels of saturated very long chain fatty acids (VLCFAs) are associated with coronary risk factors, including metabolic syndrome (MS), atherogenic lipoproteins, and systemic inflammation. However, the relationship between circulating levels of saturated VLCFA and coronary artery disease (CAD) remains unclear. Method We enrolled 100 consecutive CAD patients and 40 age-, gender-, and body mass index (BMI)-matched healthy control subjects. The levels of hexacosanoic acid (C26:0), a VLCFA, in whole blood were measured by gas–liquid chromatography mass spectrometry. Results C26:0 levels were significantly higher in the CAD group than in the control group (2.42 ± 0.32 vs. 2.27 ± 0.24 μg/ml, P = 0.01) and positively correlated with BMI ( r = 0.23, P = 0.008), triglyceride levels ( r = 0.22, P = 0.01), and hypertension ( P = 0.01). CAD patients with MS showed the highest C26:0 levels adjusted by hematocrit. Furthermore, adjusted C26:0 levels in CAD patients without MS were higher than those in controls ( P = 0.02), suggesting that C26:0 levels increased with the presence of CAD independent of MS. Our multivariate analysis revealed that high C26:0 levels in whole blood is an independent marker for CAD even after adjustment for age, gender, BMI, lipid profiles, fasting plasma glucose, and blood pressure. Conclusion High C26:0 levels in whole blood may be an independent marker for identifying the risks of CAD.