van den Broek NM, Ciapaite J, Nicolay K, Prompers JJ. Comparison of in vivo postexercise phosphocreatine recovery and resting ATP synthesis flux for the assessment of skeletal muscle mitochondrial function. Am J Physiol Cell Physiol 299: C1136 -C1143, 2010. First published July 28, 2010; doi:10.1152/ajpcell.00200.2010.-31 P magnetic resonance spectroscopy (MRS) has been used to assess skeletal muscle mitochondrial function in vivo by measuring 1) phosphocreatine (PCr) recovery after exercise or 2) resting ATP synthesis flux with saturation transfer (ST). In this study, we compared both parameters in a rat model of mitochondrial dysfunction with the aim of establishing the most appropriate method for the assessment of in vivo muscle mitochondrial function. Mitochondrial dysfunction was induced in adult Wistar rats by daily subcutaneous injections with the complex I inhibitor diphenyleneiodonium (DPI) for 2 wk. In vivo 31 P MRS measurements were supplemented by in vitro measurements of oxygen consumption in isolated mitochondria. Two weeks of DPI treatment induced mitochondrial dysfunction, as evidenced by a 20% lower maximal ADP-stimulated oxygen consumption rate in isolated mitochondria from DPI-treated rats oxidizing pyruvate plus malate. This was paralleled by a 46% decrease in in vivo oxidative capacity, determined from postexercise PCr recovery. Interestingly, no significant difference in resting, ST-based ATP synthesis flux was observed between DPI-treated rats and controls. These results show that PCr recovery after exercise has a more direct relationship with skeletal muscle mitochondrial function than the ATP synthesis flux measured with 31 P ST MRS in the resting state. 31 P magnetic resonance spectroscopy; saturation transfer; high-resolution respirometry; complex I inhibition; diphenyleneiodonium MITOCHONDRIA play a pivotal role in many cellular processes, the most important function being the production of energy in the form of ATP through a process termed oxidative phosphorylation. In the last decade, mitochondria gained interest in the field of insulin resistance (IR) and type 2 diabetes (T2D) (21,34,43, 49,53,55). Based on the in vivo observation that ATP synthesis flux in resting skeletal muscle is lower in insulinresistant subjects and offspring of T2D patients compared with healthy controls (38, 39), it has been hypothesized that skeletal muscle mitochondrial dysfunction is a predisposing factor for IR and/or T2D. The proposed mechanism links muscle mitochondrial dysfunction to impaired fatty acid metabolism, which subsequently leads to the accumulation of intramyocellular lipids and lipid intermediates (e.g., diacylglycerol and ceramides) that interfere with the insulin signaling cascade (68).The role of skeletal muscle mitochondrial dysfunction in the development of IR and/or T2D has been investigated using a variety of techniques (12, 16 -18, 24, 31-33, 37-40, 45, 48, 52). In vitro methodologies, like the determination of gene expression levels, enzyme activities, mitochondrial content, mor...