INS and acromegaly: Using 31P/1H-magnetic resonance spectroscopy (MRS) to evaluate hepatic mitochondrial function (31P-MRS) and lipid content (1H-MRS) in individuals with acromegaly and matched controls, Fellinger and colleagues suggest that this “disconnect” between insulin resistance and hepatic lipid content may be secondary to increased hepatic mitochondrial activity in those with acromegaly, who demonstrated 50% higher ATP synthesis rate compared with controls [70].