Analysis of serum by high-field proton nuclear magnetic resonance

Improvements in nuclear magnetic resonance (NMR) technology are generating an expanding variety of medical applications. In this investigation I have used high-field proton NMR to identify and quantity endogenous and ingested substances in human serum. After addition of a small amount of 2H2O and a reference compound to a 0.4-mL specimen, spectra were recorded for 3 min in Fourier-transform mode, with use of presaturation to suppress the extremely intense H2O peak. Compounds detected at clinically significant concentrations include glucose, alcohols, acetone, organic acids, and salicylate. Less than 1 mmol/L of some of these substances could be detected. For serum containing 20--500 mg of added methanol per liter, peak area was a linear function of concentration (r = 0.998). High-field proton NMR, despite the drawback of expensive, sophisticated instrumentation, offers some unique advantages for clinical chemistry: it permits rapid, specific, nondestructive measurement of several compounds simultaneously, including some that may be inconvenient to measure by conventional means.