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In a recent cross-sectional study, researchers at Washington University School of
Medicine in St. Louis have demonstrated that high levels of a specific protein- serum

circulating fatty acid synthase (cFAS) in the blood can serve as an important diagnostic
tool to assess debilitating CLTI. 4

Fatty acid synthase (FAS) is an essential enzyme that regulates de novo lipogenesis in
Chronic limb-threatening ischemia (CLTI) is a peripheral artery disease (PAD) condition, various organ systems of our body. High level of cFAS has been reported in patients with
5
characterized by severe lower extremity arterial insufficiency, pain, non-healing atherosclerotic carotid artery stenosis. 6
wounds/ulcers, and gangrene. It is reported that approximately 70% of patients with CLTI
1
may develop disease-related complications leading to extremity amputation. 2 This study evaluated the prevalence of elevated cFAS in patients with CLTI and its

accuracy as a biomarker. 4
In order to improve prognosis, the Global Vascular Guidelines have emphasized upon the
need for early diagnosis and aggressive medical management of patients with CLTI- Elevated cFAS content was found to be independently associated with CLTI and could

particularly those with cardiovascular risk factors such as type-2 diabetes (T2D). 3 detect the presence of CLTI with 83% accuracy. The serum FAS content was positively
4
correlated with FAS content in femoral artery plaque in patients with severe PAD 4

Thus, an accurate serum biomarker based diagnostic strategy that can identify PAD patients
having relatively higher risk of progression to CLTI is desirable. Currently, such blood tests are These results were independent of other risk factors such as concomitant type-2 diabetes

not available to identify and assess the severity of PAD. and smoking. 4

What’s new?

High circulating level of cFAS protein can serve as a novel serum-based biomarker

tool to facilitate earlier diagnosis and treatment of patients with severe peripheral

artery disease. 4

Reference:

1) Nehler MR, Duval S, Diao L, et al. Epidemiology of peripheral arterial disease and critical limb ischemia in an insured national population. J Vasc Surg.
2014;60(3):686-95.e2. doi:10.1016/j.jvs.2014.03.290

2) Peacock JM, Keo HH, Duval S, et al. The incidence and health economic burden of ischemic amputation in Minnesota, 2005-2008. Prev Chronic Dis.
2011;8(6):A141.
3) Conte MS, Bradbury AW, Kolh P, et al. Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia [published correction
appears in Eur J Vasc Endovasc Surg. 2020 Mar;59(3):492-493] [published correction appears in Eur J Vasc Endovasc Surg. 2020 Jul;60(1):158-159]. Eur J
Vasc Endovasc Surg. 2019;58(1S):S1-S109.e33. doi:10.1016/j.ejvs.2019.05.006
4) Tay S, De Silva GS, Engel CM, et al. Prevalence of elevated serum fatty acid synthase in chronic limb-threatening ischemia. Sci Rep. 2021;11(1):19272.
Published 2021 Sep 29. doi:10.1038/s41598-021-98479-7

5) Menendez JA, Vazquez-Martin A, Ortega FJ, Fernandez-Real JM. Fatty acid synthase: association with insulin resistance, type 2 diabetes, and cancer. Clin
Chem. 2009;55(3):425-438. doi:10.1373/clinchem.2008.115352
6) De Silva GS, Desai K, Darwech M, et al. Circulating serum fatty acid synthase is elevated in patients with diabetes and carotid artery stenosis and is
LDL-associated. Atherosclerosis. 2019;287:38-45. doi:10.1016/j.atherosclerosis.2019.05.016