Abstract
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with a poor survival rate and undefined molecular mechanisms. The identification of reliable biomarkers to help early diagnosis and predict disease progression is crucial for improving patient life. Although many biomarkers have been proposed, there is no consensus on reliable markers for IPF. Alterations in fatty acid (FA) metabolism have drawn increasing attention in the IPF pathogenesis. METHODS: This single-center, prospective, cross-sectional study enrolled 35 IPF patients and 24 control participants. Demographic, clinical, and pulmonary function data were collected. FA profiles were compared between the two groups, with statistical analyses including chi-square tests, ANOVA, Spearman's rank correlation, and ROC curve analysis. RESULTS: We found significant differences in serum FA levels between IPF patients and controls. Cis-Palmitoleic acid (26.4 mg/L vs 22.1 mg/L; p = 0.04), oleic acid (457.6 mg/L vs 376.4 mg/L, p = 0.04), and elaidic acid (33.7 mg/dL vs 28.2 mg/L, p = 0.02) were increased in IPF patients, while arachidonic acid (79.7 mg/dL vs 97.9 mg/L, p = 0.01) levels were significantly lower compared to the control group. Spearman's correlation analysis revealed positive correlations between these fatty acids. Notably, arachidonic acid levels showed a positive correlation with FEV1% (r = 0.348; p = 0.043) and FVC% (r = 0.431; p = 0.01), although ROC curve analysis indicated that this did not demonstrate strong diagnostic potential for IPF. CONCLUSION: In this study, we identified a dysregulation of cis-palmitoleic acid, oleic acid, elaidic acid, and arachidonic acid in IPF patients, indicating alterations in lipid metabolism and inflammatory pathways. Additionally, while arachidonic acid levels correlate with lung function, its diagnostic potential remains uncertain and warrants further evaluation in a larger patient population.