{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:54:59Z","timestamp":1790740499189,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,5,20]],"date-time":"2017-05-20T00:00:00Z","timestamp":1495238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["HEALTH\u2010F2\u20102009\u2010241762"],"award-info":[{"award-number":["HEALTH\u2010F2\u20102009\u2010241762"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002428","name":"Austrian Science Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002428","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001821","name":"Vienna Science and Technology Fund","doi-asserted-by":"publisher","award":["LS12\u2010008"],"award-info":[{"award-number":["LS12\u2010008"]}],"id":[{"id":"10.13039\/501100001821","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Abstract<\/jats:title>Background & Aims<\/jats:title>With the rising prevalence of non\u2010alcoholic fatty liver disease (NAFLD<\/jats:styled-content>) and steatohepatitis (NASH<\/jats:styled-content>) non\u2010invasive tools obtaining pathomechanistic insights to improve risk stratification are urgently needed. We therefore explored high\u2010 and ultra\u2010high\u2010field magnetic resonance spectroscopy (MRS<\/jats:styled-content>) to obtain novel mechanistic and diagnostic insights into alterations of hepatic lipid, cell membrane and energy metabolism across the spectrum of NAFLD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>MRS<\/jats:styled-content> and liver biopsy were performed in 30 NAFLD<\/jats:styled-content> patients with NAFL<\/jats:styled-content> (n=8) or NASH<\/jats:styled-content> (n=22). Hepatic lipid content and composition were measured using 3\u2010Tesla proton (1<\/jats:sup>H)\u2010MRS<\/jats:styled-content>. 7\u2010Tesla phosphorus (31<\/jats:sup>P)\u2010MRS<\/jats:styled-content> was applied to determine phosphomonoester (PME<\/jats:styled-content>) including phosphoethanolamine (PE<\/jats:styled-content>), phosphodiester (PDE<\/jats:styled-content>) including glycerophosphocholine (GPC<\/jats:styled-content>), phosphocreatine (PC<\/jats:styled-content>r), nicotinamide adenine dinucleotide phosphate (NADPH<\/jats:styled-content>), inorganic phosphate (Pi), \u03b3\u2010ATP<\/jats:styled-content> and total phosphorus (TP<\/jats:styled-content>). Saturation transfer technique was used to quantify hepatic ATP<\/jats:styled-content> flux.<\/jats:p><\/jats:sec>Results<\/jats:title>Hepatic steatosis in 1<\/jats:sup>H\u2010MRS<\/jats:styled-content> highly correlated with histology (P<\/jats:italic><.001) showing higher values in NASH<\/jats:styled-content> than NAFL<\/jats:styled-content> (P<\/jats:italic><.001) without differences in saturated or unsaturated fatty acid indices. PE<\/jats:styled-content>\/TP<\/jats:styled-content> ratio increased with advanced fibrosis (F3\/4) (P<\/jats:italic>=.002) whereas GPC<\/jats:styled-content>\/PME<\/jats:styled-content>+PDE<\/jats:styled-content> decreased (P<\/jats:italic>=.05) compared to no\/mild fibrosis (F0\u20102). \u03b3\u2010ATP<\/jats:styled-content>\/TP<\/jats:styled-content> was lower in advanced fibrosis (P<\/jats:italic>=.049), while PC<\/jats:styled-content>r\/TP<\/jats:styled-content> increased (P<\/jats:italic>=.01). NADPH<\/jats:styled-content>\/TP<\/jats:styled-content> increased with higher grades of ballooning (P<\/jats:italic>=.02). Pi\u2010to\u2010ATP<\/jats:styled-content> exchange rate constant (P<\/jats:italic>=.003) and ATP<\/jats:styled-content> flux (P<\/jats:italic>=.001) were lower in NASH<\/jats:styled-content> than NAFL<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Ultra\u2010high\u2010field MRS<\/jats:styled-content>, especially saturation transfer technique uncovers changes in energy metabolism including dynamic ATP<\/jats:styled-content> flux in inflammation and fibrosis in NASH<\/jats:styled-content>. Non\u2010invasive profiling by MRS<\/jats:styled-content> appears feasible and may assist further mechanistic and therapeutic studies in NAFLD<\/jats:styled-content>\/NASH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13451","type":"journal-article","created":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T11:12:53Z","timestamp":1493032373000},"page":"1544-1553","source":"Crossref","is-referenced-by-count":43,"title":["Ultra\u2010high\u2010field magnetic resonance spectroscopy in non\u2010alcoholic fatty liver disease: Novel mechanistic and diagnostic insights of energy metabolism in non\u2010alcoholic steatohepatitis and advanced fibrosis"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4929-691X","authenticated-orcid":false,"given":"Stefan","family":"Traussnigg","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of Vienna Vienna 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