Journal of Lipid Research, Vol 31, 763-771, Copyright © 1990 by Lipid Research, Inc.
Abnormal urinary excretion of unsaturated dicarboxylic acids in patients with medium-chain acyl-CoA dehydrogenase deficiency
KY Tserng, SJ Jin, DS Kerr and CL Hoppel
Veterans Administration Medical Center, Cleveland, OH 44106.
Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the most
frequently described metabolic disorder of fatty acid oxidation in humans.
Acute episodes are usually characterized biochemically by the appearance of
nonketotic dicarboxylic aciduria. In addition, other abnormal metabolites,
such as suberylglycine, n-hexanoylglycine, 3- phenylpropionylglycine, and
octanoylcarnitine, are excreted in the urine. Urinary organic acids were
determined using dual capillary column gas-liquid chromatography and
gas-liquid chromatography/mass spectrometry. In three cases of MCAD
deficiency we observed a disproportionate increase in the excretion of
unsaturated dicarboxylic acids compared to either fasting control children
with expected ketotic dicarboxylic aciduria or patients with nonketotic
dicarboxylic aciduria not associated with MCAD deficiency. The most
significant increase was in the urinary excretion of cis-4-decendioic acid.
Additionally, the urinary excretions of cis-3-octenedioic and
cis-5-decenedioic acids were slightly decreased whereas the excretion of
cis-5-dodecenedioic acid was increased. These data are consistent with the
notion that as a result of MCAD deficiency the metabolic oxidation of
unsaturated fatty acids such as linoleate and oleate is inhibited more than
saturated fatty acids.