Disordered postprandial metabolism of energy substrates is one of the main defining features of prediabetes and contributes to the development of several chronic diseases associated with obesity such as type 2 diabetes and cardiovascular diseases. Postprandial energy metabolism has been studied using classical isotopic tracer approaches that are limited by the poor access to splanchnic metabolism and the highly dynamic and complex exchanges of energy substrates involving multiple organs and systems. Advances in non-invasive molecular imaging modalities such as positron emission tomography (PET) and magnetic resonance imaging and spectroscopy (MRI/MRS) have recently allowed important advances in our understanding of postprandial energy metabolism in humans. The present review describes some of these recent advances, with particular focus on glucose and fatty acid metabolism in postprandial state, and discusses current gaps in knowledge and new perspectives of application of PET and MRI/MRS for the investigation and treatment of human metabolic diseases.
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