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Ruswandi YAR, Lesmana R, Rosdianto AM, Gunadi JW, Goenawan H, Zulhendri F. Understanding the Roles of Selenium on Thyroid Hormone-Induced Thermogenesis in Adipose Tissue. Biol Trace Elem Res 2024; 202:2419-2441. [PMID: 37758980 DOI: 10.1007/s12011-023-03854-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023]
Abstract
Brown adipose tissue (BAT) and white adipose tissue (WAT) are known to regulate lipid metabolism. A lower amount of BAT compared to WAT, along with adipose tissue dysfunction, can result in obesity. Studies have shown that selenium supplementation protects against adipocyte dysfunction, decreases WAT triglycerides, and increases BAT triiodothyronine (T3). In this review, we discuss the relationship between selenium and lipid metabolism regulation through selenoprotein deiodinases and the role of deiodinases and thyroid hormones in the induction of adipose tissue thermogenesis. Upon 22 studies included in our review, we found that studies investigating the relationship between selenium and deiodinases demonstrated that selenium supplementation affects the iodothyronine deiodinase 2 (DIO2) protein and the expression of its associated gene, DIO2, proportionally. However, its effect on DIO1 is inconsistent while its effect on DIO3 activity is not detected. Studies have shown that the activity of deiodinases especially DIO2 protein and DIO2 gene expression is increased along with other browning markers upon white adipose tissue browning induction. Studies showed that thermogenesis is stimulated by the thyroid hormone T3 as its activity is correlated to the expression of other thermogenesis markers. A proposed mechanism of thermogenesis induction in selenium supplementation is by autophagy control. However, more studies are needed to establish the role of T3 and autophagy in adipose tissue thermogenesis, especially, since some studies have shown that thermogenesis can function even when T3 activity is lacking and studies related to autophagy in adipose tissue thermogenesis have contradictory results.
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Affiliation(s)
- Yasmin Anissa R Ruswandi
- Graduate School of Master Program in Anti-Aging and Aesthetic Medicine, Faculty of Medicine, Universitas Padjadjaran, Kabupaten Sumedang, West Java, Indonesia
| | - Ronny Lesmana
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang, KM.21, Hegarmanah, Kec. Jatinangor, Kabupaten Sumedang, West Java, 45363, Indonesia.
| | - Aziiz Mardanarian Rosdianto
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang, KM.21, Hegarmanah, Kec. Jatinangor, Kabupaten Sumedang, West Java, 45363, Indonesia
- Veterinary Medicine Study Program, Faculty of Medicine, Universitas Padjadjaran, Kabupaten Sumedang, West Java, Indonesia
| | - Julia Windi Gunadi
- Department of Physiology, Faculty of Medicine, Maranatha Christian University, Bandung, West Java, Indonesia
| | - Hanna Goenawan
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang, KM.21, Hegarmanah, Kec. Jatinangor, Kabupaten Sumedang, West Java, 45363, Indonesia
| | - Felix Zulhendri
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Kabupaten Sumedang, West Java, Indonesia
- Kebun Efi, Kabanjahe, 22171, North Sumatra, Indonesia
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Seagroves A, Ross HM, Vidmar AP, Geffner ME, Kim WS, Hwang D, Borzutzky C, Fraga NR, Kim MS. Weight Loss During Topiramate Treatment in a Severely Obese Adolescent with Congenital Adrenal Hyperplasia and Migraine. J Clin Res Pediatr Endocrinol 2023; 15:81-85. [PMID: 34423627 PMCID: PMC9976166 DOI: 10.4274/jcrpe.galenos.2021.2020.0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Youth with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency exhibit an increased prevalence of obesity, early adiposity rebound, and increased abdominal adiposity compared to unaffected youth. Current obesity management in CAH largely focuses on lifestyle modifications. There is evidence that topiramate therapy is effective in reducing body mass index (BMI), as well as visceral adipose tissue (VAT), in unaffected adolescents with exogenous obesity. However, little is known about the efficacy of topiramate in patients with classical CAH. We report on a 17-year-old female with severe obesity and salt-wasting CAH due to 21-hydroxylase deficiency, who demonstrated reductions in BMI, as well as abdominal visceral and subcutaneous adipose tissue (SAT) while on topiramate therapy. The patient was diagnosed with classical CAH as a newborn with a 17-hydroxyprogesterone 11,000 ng/dL. She had a BMI over the 95th percentile at 3 years of age, followed by unremitting obesity. At 17 years old, she was started on topiramate to treat chronic migraines. Following three years of topiramate therapy, her BMI z-score decreased from +2.6 to +2.1. After four years of therapy, her waist circumference decreased from 110 to 101 cm, abdominal VAT decreased substantially by 34.2%, and abdominal SAT decreased by 25.6%. Topiramate therapy was associated with effective weight loss and reduced central adiposity in an adolescent with classical CAH and severe obesity, without any side effects. Further study is warranted regarding topiramate therapy in obese youth with classical CAH and increased central adiposity, who are at higher risk for significant morbidity.
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Affiliation(s)
- Amy Seagroves
- Children’s Hospital Los Angeles, Center for Endocrinology, Diabetes and Metabolism, California, USA
| | - Heather M. Ross
- Children’s Hospital Los Angeles, Center for Endocrinology, Diabetes and Metabolism, California, USA
| | - Alaina P. Vidmar
- Children’s Hospital Los Angeles, Center for Endocrinology, Diabetes and Metabolism, California, USA,University of Southern California, Keck School of Medicine, Department of Pediatrics, California, USA
| | - Mitchell E. Geffner
- Children’s Hospital Los Angeles, Center for Endocrinology, Diabetes and Metabolism, California, USA,University of Southern California, Keck School of Medicine, Department of Pediatrics, California, USA,The Saban Research Institute, California, USA
| | - William S. Kim
- Children’s Hospital Los Angeles, Center for Endocrinology, Diabetes and Metabolism, California, USA
| | - Darryl Hwang
- University of Southern California, Keck School of Medicine, Department of Pediatrics, California, USA
| | - Claudia Borzutzky
- University of Southern California, Keck School of Medicine, Department of Pediatrics, California, USA,Children’s Hospital Los Angeles, Clinic of Adolescent and Young Adult Medicine, California, USA
| | - Nicole R. Fraga
- Children’s Hospital Los Angeles, Center for Endocrinology, Diabetes and Metabolism, California, USA
| | - Mimi S. Kim
- Children’s Hospital Los Angeles, Center for Endocrinology, Diabetes and Metabolism, California, USA,University of Southern California, Keck School of Medicine, Department of Pediatrics, California, USA,The Saban Research Institute, California, USA,* Address for Correspondence: Children’s Hospital Los Angeles, Clinic of Pediatrics, California, USA Phone: +1 323-361-1358 E-mail:
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3
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Baranowska-Bik A, Bik W. The Association of Obesity with Autoimmune Thyroiditis and Thyroid Function-Possible Mechanisms of Bilateral Interaction. Int J Endocrinol 2020; 2020:8894792. [PMID: 33381173 PMCID: PMC7755496 DOI: 10.1155/2020/8894792] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/28/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022] Open
Abstract
A growing number of patients suffer from autoimmune diseases, including autoimmune thyroid disease. There has simultaneously been a significant increase in the prevalence of obesity worldwide. It is still an open question whether adiposity can directly influence activation of inflammatory processes affecting the thyroid in genetically predisposed individuals. Adipokines, biologically active substances derived from the adipocytes, belong to a heterogenic group of compounds involved in numerous physiological functions, including the maintenance of metabolism, hormonal balance, and immune response. Notably, the presence of obesity worsens the course of selected autoimmune diseases and impairs response to treatment. Moreover, the excess of body fat may result in the progression of autoimmune diseases. Nutritional status, body weight, and energy expenditure may influence thyroid hormone secretion. Interestingly, thyroid hormones might influence the activity of adipose tissue as metabolic alterations related to fat tissue are observed under pathological conditions in which there are deficits or overproduction of thyroid hormones. Functioning TSH receptors are expressed on adipocytes. Thermogenesis may presumably be stimulated by TSH binding to its receptor on brown adipocytes. There could be a bilateral interaction between the thyroid and adipose. Obesity may influence the onset and course of autoimmune disease.
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Affiliation(s)
- Agnieszka Baranowska-Bik
- Department of Endocrinology, Centre of Postgraduate Medical Education, Ceglowska 80, Warsaw 01-809, Poland
| | - Wojciech Bik
- Department of Neuroendocrinology, Centre of Postgraduate Medical Education, Marymoncka 99/103, Warsaw 01-813, Poland
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Jimenez‐Pavon D, Corral‐Perez J, Sánchez‐Infantes D, Villarroya F, Ruiz JR, Martinez‐Tellez B. Infrared Thermography for Estimating Supraclavicular Skin Temperature and BAT Activity in Humans: A Systematic Review. Obesity (Silver Spring) 2019; 27:1932-1949. [PMID: 31691547 PMCID: PMC6899990 DOI: 10.1002/oby.22635] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 07/25/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Brown adipose tissue (BAT) is a thermogenic tissue with potential as a therapeutic target in the treatment of obesity and related metabolic disorders. The most used technique for quantifying human BAT activity is the measurement of 18 F-fluorodeoxyglucose uptake via a positron emission tomography/computed tomography scan following exposure to cold. However, several studies have indicated the measurement of the supraclavicular skin temperature (SST) by infrared thermography (IRT) to be a less invasive alternative. This work reviews the state of the art of this latter method as a means of determining BAT activity in humans. METHODS The data sources for this review were PubMed, Web of Science, and EBSCOhost (SPORTdiscus), and eligible studies were those conducted in humans. RESULTS In most studies in which participants were first cooled, an increase in IRT-measured SST was noted. However, only 5 of 24 such studies also involved a nuclear technique that confirmed increased activity in BAT, and only 2 took into account the thickness of the fat layer when measuring SST by IRT. CONCLUSIONS More work is needed to understand the involvement of tissues other than BAT in determining IRT-measured SST; at present, IRT cannot determine whether any increase in SST is due to increased BAT activity.
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Affiliation(s)
- David Jimenez‐Pavon
- MOVE‐IT Research Group, Department of Physical Education, Faculty of Education SciencesUniversity of CádizCádizSpain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of CádizCádizSpain
| | - Juan Corral‐Perez
- MOVE‐IT Research Group, Department of Physical Education, Faculty of Education SciencesUniversity of CádizCádizSpain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of CádizCádizSpain
| | - David Sánchez‐Infantes
- Department of Endocrinology and NutritionGermans Trias i Pujol Research InstituteBadalonaBarcelonaSpain
- Biomedical Research Center (Fisiopatología de la Obesidad y Nutrición) (CIBEROBN), ISCIIIMadridSpain
| | - Francesc Villarroya
- Biomedical Research Center (Fisiopatología de la Obesidad y Nutrición) (CIBEROBN), ISCIIIMadridSpain
- Department of Biochemistry and Molecular BiomedicineInstitute of BiomedicineBarcelonaSpain
| | - Jonatan R. Ruiz
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Department of Physical Education and Sports, Faculty of Sport SciencesSport and Health University Research Institute (iMUDS), University of GranadaGranadaSpain
| | - Borja Martinez‐Tellez
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Department of Physical Education and Sports, Faculty of Sport SciencesSport and Health University Research Institute (iMUDS), University of GranadaGranadaSpain
- Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular MedicineLeiden University Medical CentreLeidenthe Netherlands
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5
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Law JM, Morris DE, Astle V, Finn E, Muros JJ, Robinson LJ, Randell T, Denvir L, Symonds ME, Budge H. Brown Adipose Tissue Response to Cold Stimulation Is Reduced in Girls With Autoimmune Hypothyroidism. J Endocr Soc 2019; 3:2411-2426. [PMID: 31777769 PMCID: PMC6872489 DOI: 10.1210/js.2019-00342] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 10/04/2019] [Indexed: 01/15/2023] Open
Abstract
Objective The interaction between thyroid status and brown adipose tissue (BAT) activation is complex. We assessed the effect of autoimmune hypothyroidism (ATD) in female children on BAT activation, measured using infrared thermography. Design Twenty-six female participants (14 with ATD and 12 healthy controls) between 5 and 17 years of age attended a single study session. Thermal images were taken of the supraclavicular region before, and after, the introduction of a cool stimulus. Results Participants with ATD had lower resting (hypothyroid, 34.9 ± 0.7°C; control, 35.4 ± 0.5°C; P = 0.03) and stimulated (hypothyroid, 35.0 ± 0.6°C; control, 35.5 ± 0.5°C; P = 0.04) supraclavicular temperatures compared with controls, but there was no difference between groups in the temperature increase with stimulation. BAT activation, calculated as the relative temperature change comparing the supraclavicular temperature to a sternal reference region, was reduced in participants with ATD (hypothyroid, 0.1 ± 0.1°C; control, 0.2 ± 0.2°C; P = 0.04). Children with ATD were frequently biochemically euthyroid due to replacement therapy, but, despite this, increased relative supraclavicular temperature was closely associated with increased TSH (r = 0.7, P = 0.01) concentrations. Conclusions Girls with ATD had an attenuated thermogenic response to cold stimulation compared with healthy controls, but, contrary to expectation, those with suboptimal biochemical control (with higher TSH) showed increased BAT activation. This suggests that the underlying disease process may have a negative effect on BAT response, but high levels of TSH can mitigate, and even stimulate, BAT activity. In summary, thyroid status is a complex determinant of BAT activity in girls with ATD.
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Affiliation(s)
- James M Law
- Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
| | - David E Morris
- Bioengineering Research Group, Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Valerie Astle
- Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
| | - Ellie Finn
- School of Medicine, Monash University, Melbourne, Victoria, Australia
| | - José Joaquín Muros
- Department of Food Science, School of Pharmacy, University of Granada, Granada, Spain
| | - Lindsay J Robinson
- Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
| | - Tabitha Randell
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Louise Denvir
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Michael E Symonds
- Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom.,Nottingham Digestive Disease Centre and Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
| | - Helen Budge
- Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
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Karampinos DC, Weidlich D, Wu M, Hu HH, Franz D. Techniques and Applications of Magnetic Resonance Imaging for Studying Brown Adipose Tissue Morphometry and Function. Handb Exp Pharmacol 2019; 251:299-324. [PMID: 30099625 DOI: 10.1007/164_2018_158] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The present review reports on the current knowledge and recent findings in magnetic resonance imaging (MRI) and spectroscopy (MRS) of brown adipose tissue (BAT). The work summarizes the features and mechanisms that allow MRI to differentiate BAT from white adipose tissue (WAT) by making use of their distinct morphological appearance and the functional characteristics of BAT. MR is a versatile imaging modality with multiple contrast mechanisms as potential candidates in the study of BAT, targeting properties of 1H, 13C, or 129Xe nuclei. Techniques for assessing BAT morphometry based on fat fraction and markers of BAT microstructure, including intermolecular quantum coherence and diffusion imaging, are first described. Techniques for assessing BAT function based on the measurement of BAT metabolic activity, perfusion, oxygenation, and temperature are then presented. The application of the above methods in studies of BAT in animals and humans is described, and future directions in MR study of BAT are finally discussed.
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Affiliation(s)
- Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Mingming Wu
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Houchun H Hu
- Department of Radiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Daniela Franz
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Larson CJ. Translational Pharmacology and Physiology of Brown Adipose Tissue in Human Disease and Treatment. Handb Exp Pharmacol 2019; 251:381-424. [PMID: 30689089 DOI: 10.1007/164_2018_184] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Human brown adipose tissue (BAT) is experimentally modeled to better understand the biology of this important metabolic tissue, and also to enable the potential discovery and development of novel therapeutics for obesity and sequelae resulting from the persistent positive energy balance. This chapter focuses on translation into humans of findings and hypotheses generated in nonhuman models of BAT pharmacology. Given the demonstrated challenges of sustainably reducing caloric intake in modern humans, potential solutions to obesity likely lie in increasing energy expenditure. The energy-transforming activities of a single cell in any given tissue can be conceptualized as a flow of chemical energy from energy-rich substrate molecules into energy-expending, endergonic biological work processes through oxidative degradation of organic molecules ingested as nutrients. Despite the relatively tight coupling between metabolic reactions and products, some expended energy is incidentally lost as heat, and in this manner a significant fraction of the energy originally captured from the environment nonproductively transforms into heat rather than into biological work. In human and other mammalian cells, some processes are even completely uncoupled, and therefore purely energy consuming. These molecular and cellular actions sum up at the physiological level to adaptive thermogenesis, the endogenous physiology in which energy is nonproductively released as heat through uncoupling of mitochondria in brown fat and potentially skeletal muscle. Adaptive thermogenesis in mammals occurs in three forms, mostly in skeletal muscle and brown fat: shivering thermogenesis in skeletal muscle, non-shivering thermogenesis in brown fat, and diet-induced thermogenesis in brown fat. At the cellular level, the greatest energy transformations in humans and other eukaryotes occur in the mitochondria, where creating energetic inefficiency by uncoupling the conversion of energy-rich substrate molecules into ATP usable by all three major forms of biological work occurs by two primary means. Basal uncoupling occurs as a passive, general, nonspecific leak down the proton concentration gradient across the membrane in all mitochondria in the human body, a gradient driving a key step in ATP synthesis. Inducible uncoupling, which is the active conduction of protons across gradients through processes catalyzed by proteins, occurs only in select cell types including BAT. Experiments in rodents revealed UCP1 as the primary mammalian molecule accounting for the regulated, inducible uncoupling of BAT, and responsive to both cold and pharmacological stimulation. Cold stimulation of BAT has convincingly translated into humans, and older clinical observations with nonselective 2,4-DNP validate that human BAT's participation in pharmacologically mediated, though nonselective, mitochondrial membrane decoupling can provide increased energy expenditure and corresponding body weight loss. In recent times, however, neither beta-adrenergic antagonism nor unselective sympathomimetic agonism by ephedrine and sibutramine provide convincing evidence that more BAT-selective mechanisms can impact energy balance and subsequently body weight. Although BAT activity correlates with leanness, hypothesis-driven selective β3-adrenergic agonism to activate BAT in humans has only provided robust proof of pharmacologic activation of β-adrenergic receptor signaling, limited proof of the mechanism of increased adaptive thermogenesis, and no convincing evidence that body weight loss through negative energy balance upon BAT activation can be accomplished outside of rodents. None of the five demonstrably β3 selective molecules with sufficient clinical experience to merit review provided significant weight loss in clinical trials (BRL 26830A, TAK 677, L-796568, CL 316,243, and BRL 35135). Broader conclusions regarding the human BAT therapeutic hypothesis are limited by the absence of data from most studies demonstrating specific activation of BAT thermogenesis in most studies. Additionally, more limited data sets with older or less selective β3 agonists also did not provide strong evidence of body weight effects. Encouragingly, β3-adrenergic agonists, catechins, capsinoids, and nutritional extracts, even without robust negative energy balance outcomes, all demonstrated increased total energy expenditure that in some cases could be associated with concomitant activation of BAT, though the absence of body weight loss indicates that in no cases did the magnitude of negative energy balance reach sufficient levels. Glucocorticoid receptor agonists, PPARg agonists, and thyroid hormone receptor agonists all possess defined molecular and cellular pharmacology that preclinical models predicted to be efficacious for negative energy balance and body weight loss, yet their effects on human BAT thermogenesis upon translation were inconsistent with predictions and disappointing. A few new mechanisms are nearing the stage of clinical trials and may yet provide a more quantitatively robust translation from preclinical to human experience with BAT. In conclusion, translation into humans has been demonstrated with BAT molecular pharmacology and cell biology, as well as with physiological response to cold. However, despite pharmacologically mediated, statistically significant elevation in total energy expenditure, translation into biologically meaningful negative energy balance was not achieved, as indicated by the absence of measurable loss of body weight over the duration of a clinical study.
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Affiliation(s)
- Christopher J Larson
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA.
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8
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Heinen CA, Zhang Z, Klieverik LP, de Wit TC, Poel E, Yaqub M, Boelen A, Kalsbeek A, Bisschop PH, van Trotsenburg ASP, Verberne HJ, Booij J, Fliers E. Effects of intravenous thyrotropin-releasing hormone on 18F-fluorodeoxyglucose uptake in human brown adipose tissue: a randomized controlled trial. Eur J Endocrinol 2018; 179:31-38. [PMID: 29724865 DOI: 10.1530/eje-17-0966] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/03/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Brown adipose tissue (BAT) activity in humans is stimulated by cold and by a limited number of pharmacological agents, including β3-adrenergic agonists and bile acids. Although thyrotropin-releasing hormone (TRH) is known to activate BAT in several mammals, this has not been reported in humans. DESIGN A randomized, placebo-controlled, double-blind, cross-over trial. METHODS We investigated the effects of intravenous bolus administration of 400 µg TRH or 2 mL saline on BAT activity in healthy, lean men. BAT activity was measured as standardized 18F-fluorodeoxyglucose (18F-FDG) uptake and glucose metabolic rate (MRglu) using dynamic PET/CT imaging. The first six individuals were studied at room temperature, while subsequently nine were exposed to mild cold (17°C ± 1°C) for 60 min before imaging. During the dynamic scan, blood was withdrawn for measurement of thyroid hormone and catecholamine concentrations. This trial is registered with The Netherlands National Trial Register (number NTR5512). RESULTS Sixteen participants were recruited. Six men studied at room temperature showed no visible BAT activity during either session. After exposure to mild cold, four of nine men (44.4%) showed clear increase of 18F-FDG uptake after TRH administration compared to placebo. Maximal standardized 18F-FDG uptake showed a trend toward increase after TRH compared to placebo (P = 0.066). MRglu showed a significant increase after TRH administration (P = 0.014). The increase in 18F-FDG uptake was not paralleled by changes in plasma thyroid hormone or catecholamine concentrations. CONCLUSION Systemic TRH administration can increase the activity of cold-stimulated BAT in adult men. These findings may assist developing pharmacological strategies for modulating BAT activity in the management of obesity.
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Affiliation(s)
- Charlotte A Heinen
- Departments of Endocrinology and Metabolism, Emma Children's Hospital
- Pediatric Endocrinology, Emma Children's Hospital
| | - Zhi Zhang
- Departments of Endocrinology and Metabolism, Emma Children's Hospital
| | - Lars P Klieverik
- Departments of Endocrinology and Metabolism, Emma Children's Hospital
| | - Tim C de Wit
- Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Edwin Poel
- Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Anita Boelen
- Departments of Endocrinology and Metabolism, Emma Children's Hospital
| | - Andries Kalsbeek
- Departments of Endocrinology and Metabolism, Emma Children's Hospital
- Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience (NIN), Amsterdam, The Netherlands
| | - Peter H Bisschop
- Departments of Endocrinology and Metabolism, Emma Children's Hospital
| | | | - Hein J Verberne
- Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Booij
- Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eric Fliers
- Departments of Endocrinology and Metabolism, Emma Children's Hospital
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Begaye B, Piaggi P, Thearle MS, Haskie K, Walter M, Schlögl M, Bonfiglio S, Krakoff J, Vinales KL. Norepinephrine and T4 Are Predictors of Fat Mass Gain in Humans With Cold-Induced Brown Adipose Tissue Activation. J Clin Endocrinol Metab 2018; 103:2689-2697. [PMID: 29788444 PMCID: PMC6276720 DOI: 10.1210/jc.2018-00387] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/11/2018] [Indexed: 12/24/2022]
Abstract
CONTEXT In healthy adults with detectable cold-induced brown adipose tissue activation (CIBA), the relationships between sympathetic nervous system (SNS) or thyroid activity during energy balance (EBL) with CIBA and body composition change are undetermined. OBJECTIVE To investigate the relationships between CIBA and thermoneutral catecholamines and thyroid hormones measured during EBL and to determine if CIBA, catecholamines, or thyroid hormones predict body composition changes. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS Twelve healthy volunteers (seven male and five female) with positive CIBA [>2 standardized uptake value (g/mL)] had 24-hour energy expenditure (24hEE) assessed during EBL via whole-room indirect calorimetry while residing on a clinical research unit. Positron emission tomography/computed tomography scans were performed after exposure to 16°C for 2 hours to quantify CIBA. MAIN OUTCOME MEASURES CIBA, 24hEE during EBL, and thermoneutrality with concomitant measurement of urinary catecholamines and plasma free T3 and free T4. Body composition at baseline and 6 months by dual-energy X-ray absorptiometry. RESULTS Lower urinary norepinephrine and free T4 were associated with higher CIBA (r = -0.65, P = 0.03; and r = -0.75, P < 0.01, respectively), but CIBA was not associated with 24hEE at thermoneutrality (P = 0.77). Lower CIBA (β = -3.5 kg/standardized uptake value; P < 0.01) predicted fat mass gain, whereas higher urinary norepinephrine and free T4 predicted future fat mass gain at 6 months (β = 3.0 kg per twofold difference in norepinephrine, P = 0.03; and β = 1.2 kg per 0.1-ng/dL difference in free T4, P = 0.03, respectively). CONCLUSION Lower SNS and free thyroid measurements at baseline indicate a greater capacity for CIBA, which may be predictive against fat mass gain.
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Affiliation(s)
- Brittany Begaye
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Marie S Thearle
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | | | - Mary Walter
- Clinical Core Laboratory, National Institute of Diabetes and Digestive and
Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Mathias Schlögl
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
- Department of Geriatrics and Aging Research, University Hospital Zurich,
Zurich, Switzerland
| | - Susan Bonfiglio
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Karyne L Vinales
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
- Correspondence and Reprint Requests: Karyne L. Vinales, MD,
Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research
Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th
Street, Phoenix, Arizona 85016. E-mail:
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10
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Recent advances in the detection of brown adipose tissue in adult humans: a review. Clin Sci (Lond) 2018; 132:1039-1054. [PMID: 29802209 DOI: 10.1042/cs20170276] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 02/07/2023]
Abstract
The activation of brown adipose tissue (BAT) is associated with reductions in circulating lipids and glucose in rodents and contributes to energy expenditure in humans indicating the potential therapeutic importance of targetting this tissue for the treatment of a variety of metabolic disorders. In order to evaluate the therapeutic potential of human BAT, a variety of methodologies for assessing the volume and metabolic activity of BAT are utilized. Cold exposure is often utilized to increase BAT activity but inconsistencies in the characteristics of the exposure protocols make it challenging to compare findings. The metabolic activity of BAT in response to cold exposure has most commonly been measured by static positron emission tomography of 18F-fluorodeoxyglucose in combination with computed tomography (18F-FDG PET-CT) imaging, but recent studies suggest that under some conditions this may not always reflect BAT thermogenic activity. Therefore, recent studies have used alternative positron emission tomography and computed tomography (PET-CT) imaging strategies and radiotracers that may offer important insights. In addition to PET-CT, there are numerous emerging techniques that may have utility for assessing BAT metabolic activity including magnetic resonance imaging (MRI), skin temperature measurements, near-infrared spectroscopy (NIRS) and contrast ultrasound (CU). In this review, we discuss and critically evaluate the various methodologies used to measure BAT metabolic activity in humans and provide a contemporary assessment of protocols which may be useful in interpreting research findings and guiding the development of future studies.
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11
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Do TSH, FT3, and FT4 Impact BAT Visualization of Clinical FDG-PET/CT Images? CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:4898365. [PMID: 29666563 PMCID: PMC5831944 DOI: 10.1155/2018/4898365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/29/2017] [Accepted: 01/04/2018] [Indexed: 01/14/2023]
Abstract
Objective We retrospectively analyzed activated BAT visualization on FDG-PET/CT in patients with various conditions and TH levels to clarify the relationships between visualization of BAT on FDG-PET/CT and the effect of TH. Methods Patients who underwent clinical FDG-PET/CT were reviewed and we categorized patients into 5 groups: (i) thyroid hormone withdrawal (THW) group; (ii) recombinant human thyrotropin (rhTSH) group; (iii) hypothyroidism group; (iv) hyperthyroidism group; and (v) BAT group. A total of sixty-two FDG-PET/CT imaging studies in fifty-nine patients were performed. To compare each group, gender; age; body weight; serum TSH, FT3, and FT4 levels; and outside temperature were evaluated. Results No significant visualization of BAT was noted in any of the images in the THW, rhTSH, hypothyroidism, and hyperthyroidism groups. All patients in the BAT group were in a euthyroid state. When the BAT-negative and BAT-positive patient groups were compared, it was noted that the minimum and maximum temperature on the day of the PET study and maximum temperature of the one day before the PET study were significantly lower in BAT-positive group than in all those of other groups. Conclusions Elevated TSH condition before RIT, hyperthyroidism, or hypothyroidism did not significantly impact BAT visualization of clinical FDG-PET/CT images.
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12
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Chondronikola M, Beeman SC, Wahl RL. Non-invasive methods for the assessment of brown adipose tissue in humans. J Physiol 2018; 596:363-378. [PMID: 29119565 PMCID: PMC5792561 DOI: 10.1113/jp274255] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/04/2017] [Indexed: 01/10/2023] Open
Abstract
Brown adipose tissue (BAT) is a recently rediscovered tissue in people that has shown promise as a potential therapeutic target against obesity and its metabolic abnormalities. Reliable non-invasive assessment of BAT volume and activity is critical to allow its importance in metabolic control to be evaluated. Positron emission tomography/computed tomography (PET/CT) in combination with 2-deoxy-2-[18 F]fluoroglucose administration is currently the most frequently used and most established method for the detection and quantification of activated BAT in humans. However, it involves radiation exposure and can detect activated (e.g. after cold exposure), but not quiescent, BAT. Several alternative methods that overcome some of these limitations have been developed including different PET approaches, single-photon emission imaging, CT, magnetic resonance based approaches, contrast-enhanced ultrasound, near infrared spectroscopy, and temperature assessment of fat depots containing brown adipocytes. The purpose of this review is to summarize and critically evaluate the currently available methods that non-invasively probe various aspects of BAT biology in order to assess BAT volume and/or metabolism. Although several of these methods show promise for the non-invasive assessment of BAT volume and function, further research is needed to optimize them to enable an accurate, reproducible and practical means for the assessment of human BAT content and its metabolic function.
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Affiliation(s)
- Maria Chondronikola
- Center for Human NutritionWashington University School of MedicineSt LouisMOUSA
- Harokopio University of AthensAthensGreece
| | - Scott C. Beeman
- Department of Radiology, Mallinckrodt Institute of RadiologyWashington University School of MedicineSt LouisMOUSA
| | - Richard L. Wahl
- Department of Radiology, Mallinckrodt Institute of RadiologyWashington University School of MedicineSt LouisMOUSA
- Department of Radiation Oncology, Mallinckrodt Institute of RadiologyWashington University School of MedicineSt LouisMOUSA
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13
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Law J, Chalmers J, Morris DE, Robinson L, Budge H, Symonds ME. The use of infrared thermography in the measurement and characterization of brown adipose tissue activation. Temperature (Austin) 2018; 5:147-161. [PMID: 30393752 DOI: 10.1080/23328940.2017.1397085] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/16/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022] Open
Abstract
Interest in brown adipose tissue has increased in recent years as a potential target for novel obesity, diabetes and metabolic disease treatments. One of the significant limitations to rapid progress has been the difficulty in measuring brown adipose tissue activity, especially in humans. Infrared thermography (IRT) is being increasingly recognized as a valid and complementary method to standard imaging modalities, such as positron emission tomography-computed tomography (PET/CT). In contrast to PET/CT, it is non-invasive, cheap and quick, allowing, for the first time, the possibility of large studies of brown adipose tissue (BAT) on healthy populations and children. Variations in study protocols and analysis methods currently limit direct comparison between studies but IRT following appropriate BAT stimulation consistently shows a change in supraclavicular skin temperature and a close association with results from BAT measurements from other methods.
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Affiliation(s)
- James Law
- Early Life Research Unit, Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jane Chalmers
- Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham
| | - David E Morris
- Department of Electrical & Electronic Engineering, Faculty of Engineering, University of Nottingham, United Kingdom
| | - Lindsay Robinson
- Early Life Research Unit, Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Helen Budge
- Early Life Research Unit, Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Michael E Symonds
- Early Life Research Unit, Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham
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14
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Abstract
Historically, brown adipose tissue has been elusive and not easy to detect, hence its relative obscurity in human physiology until its rediscovery in 2009. At that point, it was proven that the symmetrical artefacts frequently detected on positron emission tomography-computed tomography (PET-CT), which resolved if the environment was kept warm, were brown adipose tissue deposits. PET-CT has remained the stalwart of human brown adipose tissue research and is still considered the gold standard. However, PET-CT exposes the participant to ionising radiation, limiting studies to large, but retrospective, review of clinical imaging or a small-scale, but prospective, design. Within this context, alternative imaging modalities have been sought. Due to the heat-generating properties of brown adipose tissue, infrared thermography is a natural candidate for measuring its activity and the supraclavicular depot is relatively superficial, allowing detection of the heat signature. Infrared thermography is a non-invasive, non-contact technique for measuring temperature remotely. Recent developments in image analysis techniques have facilitated the use of infrared thermography to study brown adipose tissue activation in populations, and in ways, not previously feasible.
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15
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Zhang Z, Boelen A, Bisschop PH, Kalsbeek A, Fliers E. Hypothalamic effects of thyroid hormone. Mol Cell Endocrinol 2017; 458:143-148. [PMID: 28088468 DOI: 10.1016/j.mce.2017.01.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 11/30/2022]
Abstract
Thyroid hormone (TH) is a key driver of metabolism in mammals. Plasma concentrations of TH are kept within a narrow range by negative feedback regulation in the hypothalamus-pituitary-thyroid (HPT) axis. Plasma TH concentrations are an important determinant of metabolic processes in liver and brown adipose tissue (BAT). In addition to endocrine effects of TH derived from the circulation, recent studies have demonstrated additional neural routes for intrahypothalamic thyroid hormone to regulate metabolism in liver and BAT via the sympathetic and parasympathetic branch of the autonomic nervous system (ANS). This review provides an overview of studies reporting metabolic effects of selective administration of T3 within hypothalamic nuclei including the paraventricular nucleus (PVN), the ventromedial nucleus (VMH), the arcuate nucleus (Arc), and the anterior hypothalamic area (AHA). This overview of the literature suggests that intrahypothalamic T3 can have profound effects on hepatic glucose production and insulin sensitivity, energy expenditure in BAT, cardiovascular function and feeding behavior. As the experiments have been performed in experimental animals exclusively, and the timing and route of T3 administration may be an important determinant of effect size, the clinical relevance of these metabolic effects in the chronic setting remains to be established.
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Affiliation(s)
- Zhi Zhang
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Anita Boelen
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Peter H Bisschop
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Andries Kalsbeek
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands; Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, The Netherlands
| | - Eric Fliers
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands.
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16
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Loh RKC, Kingwell BA, Carey AL. Human brown adipose tissue as a target for obesity management; beyond cold-induced thermogenesis. Obes Rev 2017; 18:1227-1242. [PMID: 28707455 DOI: 10.1111/obr.12584] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 02/01/2023]
Abstract
Elevating energy expenditure via adaptive thermogenesis in brown adipose tissue (BAT) is a potential strategy to reverse obesity. Much early enthusiasm for this approach, based on rodent studies, was tempered by the belief that BAT was relatively inconsequential in healthy adult humans. Interest was reinvigorated a decade ago when a series of studies re-identified BAT, primarily in upper thoracic regions, in adults. Despite the ensuing explosion of pre-clinical investigations and identification of an extensive list of potential target molecules for BAT recruitment, our understanding of human BAT physiology remains limited, particularly regarding interventions which might hold therapeutic promise. Cold-induced BAT thermogenesis (CIT) has been well studied, although is not readily translatable as an anti-obesity approach, whereas little is known regarding the role of BAT in human diet-induced thermogenesis (DIT). Furthermore, human studies dedicated to translating known pharmacological mechanisms of adipose browning from animal models are sparse. Several lines of recent evidence suggest that molecular regulation and physiology of human BAT differ to that of laboratory rodents, which form the majority of our knowledge base. This review will summarize knowledge on CIT and expand upon the current understanding and evidence gaps related to human adaptive thermogenesis via mechanisms other than cold.
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Affiliation(s)
- R K C Loh
- Metabolic and Vascular Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - B A Kingwell
- Metabolic and Vascular Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - A L Carey
- Metabolic and Vascular Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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Gerngroß C, Schretter J, Klingenspor M, Schwaiger M, Fromme T. Active Brown Fat During 18F-FDG PET/CT Imaging Defines a Patient Group with Characteristic Traits and an Increased Probability of Brown Fat Redetection. J Nucl Med 2017; 58:1104-1110. [PMID: 28104743 DOI: 10.2967/jnumed.116.183988] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/07/2016] [Indexed: 12/24/2022] Open
Abstract
Brown adipose tissue (BAT) provides a means of nonshivering thermogenesis. In humans, active BAT can be visualized by 18F-FDG uptake as detected by PET combined with CT. The retrospective analysis of clinical scans is a valuable source to identify anthropometric parameters that influence BAT mass and activity and thus the potential efficacy of envisioned drugs targeting this tissue to treat metabolic disease. Methods: We analyzed 2,854 18F-FDG PET/CT scans from 1,644 patients and identified 98 scans from 81 patients with active BAT. We quantified the volume of active BAT depots (mean values in mL ± SD: total BAT, 162 ± 183 [n = 98]; cervical, 40 ± 37 [n = 53]; supraclavicular, 66 ± 68 [n = 71]; paravertebral, 51 ± 53 [n = 69]; mediastinal, 43 ± 40 [n = 51]; subphrenic, 21 ± 21 [n = 29]). Because only active BAT is detectable by 18F-FDG uptake, these numbers underestimate the total amount of BAT. Considering only 32 scans of the highest activity as categorized by a visual scoring strategy, we determined a mean total BAT volume of 308 ± 208 mL. In 30 BAT-positive patients with 3 or more repeated scans, we calculated a much higher mean probability to redetect active BAT (52% ± 25%) as compared with the overall prevalence of 4.9%. We calculated a BAT activity index (BFI) based on volume and intensity of individual BAT depots. Results: We detected higher total BFI in younger patients (P = 0.009), whereas sex, body mass index, height, mass, outdoor temperature, and blood parameters did not affect total or depot-specific BAT activity. Surprisingly, renal creatinine clearance as estimated from mass, age, and plasma creatinine was a significant predictor of BFI on the total (P = 0.005) as well as on the level of several individual depots. In summary, we detected a high amount of more than 300 mL of BAT tissue. Conclusion: BAT-positive patients represent a group with a higher than usual probability to activate BAT during a scan. Estimated renal creatinine clearance correlated with the extent of activated BAT in a given scan. These data imply an efficacy of drugs targeting BAT to treat metabolic disease that is at the same time higher and subject to a larger individual variation than previously assumed.
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Affiliation(s)
- Carlos Gerngroß
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Johanna Schretter
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Martin Klingenspor
- Molecular Nutritional Medicine, ZIEL-Institute for Food & Health, Technical University of Munich, Freising, Germany; and.,Molecular Nutritional Medicine, Else Kröner-Fresenius Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
| | - Markus Schwaiger
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Tobias Fromme
- Molecular Nutritional Medicine, ZIEL-Institute for Food & Health, Technical University of Munich, Freising, Germany; and.,Molecular Nutritional Medicine, Else Kröner-Fresenius Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
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18
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Gavrila A, Hasselgren PO, Glasgow A, Doyle AN, Lee AJ, Fox P, Gautam S, Hennessey JV, Kolodny GM, Cypess AM. Variable Cold-Induced Brown Adipose Tissue Response to Thyroid Hormone Status. Thyroid 2017; 27:1-10. [PMID: 27750020 PMCID: PMC5206686 DOI: 10.1089/thy.2015.0646] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND In addition to its role in adaptive thermogenesis, brown adipose tissue (BAT) may protect from weight gain, insulin resistance/diabetes, and metabolic syndrome. Prior studies have shown contradictory results regarding the influence of thyroid hormone (TH) levels on BAT volume and activity. The aim of this pilot study was to gain further insights regarding the effect of TH treatment on BAT function in adult humans by evaluating the BAT mass and activity prospectively in six patients, first in the hypothyroid and then in the thyrotoxic phase. METHODS The study subjects underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) scanning after cold exposure to measure BAT mass and activity while undergoing treatment for differentiated thyroid cancer, first while hypothyroid following TH withdrawal at the time of the radioactive iodine treatment and then three to six months after starting TH suppressive treatment when they were iatrogenically thyrotoxic. Thermogenic and metabolic parameters were measured in both phases. RESULTS All study subjects had detectable BAT under cold stimulation in both the hypothyroid and thyrotoxic state. The majority but not all (4/6) subjects showed an increase in detectable BAT volume and activity under cold stimulation between the hypothyroid and thyrotoxic phase (total BAT volume: 72.0 ± 21.0 vs. 87.7 ± 16.5 mL, p = 0.25; total BAT activity 158.1 ± 72.8 vs. 189.0 ± 55.5 SUV*g/mL, p = 0.34). Importantly, circulating triiodothyronine was a stronger predictor of energy expenditure changes compared with cold-induced BAT activity. CONCLUSIONS Iatrogenic hypothyroidism lasting two to four weeks does not prevent cold-induced BAT activation, while the use of TH to induce thyrotoxicosis does not consistently increase cold-induced BAT activity. It remains to be determined which physiological factors besides TH play a role in regulating BAT function.
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Affiliation(s)
- Alina Gavrila
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Per-Olof Hasselgren
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Allison Glasgow
- Harvard Catalyst Clinical Research Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ashley N. Doyle
- Harvard Catalyst Clinical Research Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alice J. Lee
- Harvard Catalyst Clinical Research Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Peter Fox
- Section of Integrative Physiology and Metabolism, Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Shiva Gautam
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - James V. Hennessey
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Gerald M. Kolodny
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Aaron M. Cypess
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Section of Integrative Physiology and Metabolism, Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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19
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Is It Possible to Detect Activated Brown Adipose Tissue in Humans Using Single-Time-Point Infrared Thermography under Thermoneutral Conditions? Impact of BMI and Subcutaneous Adipose Tissue Thickness. PLoS One 2016; 11:e0151152. [PMID: 26967519 PMCID: PMC4788460 DOI: 10.1371/journal.pone.0151152] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/23/2016] [Indexed: 01/10/2023] Open
Abstract
Purpose To evaluate the feasibility to detect activated brown adipose tissue (BAT) using single-time-point infrared thermography of the supraclavicular skin region under thermoneutral conditions. To this end, infrared thermography was compared with 18-F-FDG PET, the current reference standard for the detection of activated BAT. Methods 120 patients were enrolled in this study. After exclusion of 18 patients, 102 patients (44 female, 58 male, mean age 58±17 years) were included for final analysis. All patients underwent a clinically indicated 18F-FDG-PET/CT examination. Immediately prior to tracer injection skin temperatures of the supraclavicular, presternal and jugular regions were measured using spatially resolved infrared thermography at room temperature. The presence of activated BAT was determined in PET by typical FDG uptake within the supraclavicular adipose tissue compartments. Local thickness of supraclavicular subcutaneous adipose tissue (SCAT) was measured on CT. Measured skin temperatures were statistically correlated with the presence of activated BAT and anthropometric data. Results Activated BAT was detected in 9 of 102 patients (8.8%). Local skin temperature of the supraclavicular region was significantly higher in individuals with active BAT compared to individuals without active BAT. However, after statistical correction for the influence of BMI, no predictive value of activated BAT on skin temperature of the supraclavicular region could be observed. Supraclavicular skin temperature was significantly negatively correlated with supraclavicular SCAT thickness. Conclusion We conclude that supraclavicular SCAT thickness influences supraclavicular skin temperature and thus makes a specific detection of activated BAT using single-time-point thermography difficult. Further studies are necessary to evaluate the possibility of BAT detection using alternative thermographic methods, e.g. dynamic thermography or MR-based thermometry taking into account BMI as a confounding factor.
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Broeders EPM, Vijgen GHEJ, Havekes B, Bouvy ND, Mottaghy FM, Kars M, Schaper NC, Schrauwen P, Brans B, van Marken Lichtenbelt WD. Thyroid Hormone Activates Brown Adipose Tissue and Increases Non-Shivering Thermogenesis--A Cohort Study in a Group of Thyroid Carcinoma Patients. PLoS One 2016; 11:e0145049. [PMID: 26784028 PMCID: PMC4718641 DOI: 10.1371/journal.pone.0145049] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/26/2015] [Indexed: 11/19/2022] Open
Abstract
Background/Objectives Thyroid hormone receptors are present on brown adipose tissue (BAT), indicating a role for thyroid hormone in the regulation of BAT activation. The objective of this study was to examine the effect of thyroid hormone withdrawal followed by thyroid hormone in TSH-suppressive dosages, on energy expenditure and brown adipose tissue activity. Subjects/Methods This study was a longitudinal study in an academic center, with a follow-up period of 6 months. Ten patients with well-differentiated thyroid carcinoma eligible for surgical treatment and subsequent radioactive iodine ablation therapy were studied in a hypothyroid state after thyroidectomy and in a subclinical hyperthyroid state (TSH-suppression according to treatment protocol). Paired two-tailed t-tests and linear regression analyses were used. Results Basal metabolic rate (BMR) was significantly higher after treatment with synthetic thyroid hormone (levothyroxine) than in the hypothyroid state (BMR 3.8 ± 0.5 kJ/min versus 4.4 ± 0.6 kJ/min, P = 0.012), and non-shivering thermogenesis (NST) significantly increased from 15 ± 10% to 25 ± 6% (P = 0.009). Mean BAT activity was significantly higher in the subclinical hyperthyroid state than in the hypothyroid state (BAT standard uptake value (SUVMean) 4.0 ± 2.9 versus 2.4 ± 1.8, P = 0.039). Conclusions Our study shows that higher levels of thyroid hormone are associated with a higher level of cold-activated BAT. Trial Registration ClinicalTrials.gov NCT02499471
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Affiliation(s)
- Evie P. M. Broeders
- MUMC+, Department of Human Biology, Maastricht, the Netherlands
- MUMC+, Department of General Surgery, Maastricht, the Netherlands
| | - Guy H. E. J. Vijgen
- MUMC+, Department of Human Biology, Maastricht, the Netherlands
- St. Franciscus Gasthuis, Department of Surgery, Rotterdam, the Netherlands
- MUMC+, Department of General Surgery, Maastricht, the Netherlands
| | - Bas Havekes
- MUMC+, Department of Endocrinology, Maastricht, the Netherlands
| | - Nicole D. Bouvy
- MUMC+, Department of General Surgery, Maastricht, the Netherlands
| | - Felix M. Mottaghy
- MUMC+, Department of Nuclear Medicine, Maastricht, the Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen University, Aachen, Germany
| | - Marleen Kars
- MUMC+, Department of Endocrinology, Maastricht, the Netherlands
| | | | | | - Boudewijn Brans
- MUMC+, Department of Nuclear Medicine, Maastricht, the Netherlands
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Lapa C, Maya Y, Wagner M, Arias-Loza P, Werner RA, Herrmann K, Higuchi T. Activation of brown adipose tissue in hypothyroidism. Ann Med 2015; 47:538-45. [PMID: 26513396 DOI: 10.3109/07853890.2015.1085126] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Brown adipose tissue (BAT) attracts growing interest as a potential therapeutic target for obesity and diabetes. Hyperthyroidism is well-known to increase BAT activity, but the role of hypothyroidism is controversial. We aimed to investigate the association between different thyroid hormone (TH) states and BAT activity. METHODS FDG-PET studies were retrospectively evaluated in thyroid cancer patients after total thyroidectomy both at euthyroidism during TH replacement or at hypothyroidism after TH cessation. Serum TH levels were compared between patients with active BAT and control patients with non-active BAT matched for age, gender, and body mass index. Additionally, animal experiments with controls (n = 5) and hypothyroid rats (n = 5) were performed. RESULTS Out of 124 patients, 6 patients with active BAT were identified. These patients showed significantly higher thyroid-stimulating hormone (TSH) levels than matched controls (P < 0.05). In animal experiments, all hypothyroid animals showed BAT activation at room temperature (24 °C), whereas controls did not (P < 0.001). Increased BAT activity was also confirmed by increased expression of UCP-1 and D2. CONCLUSIONS Increased BAT metabolism appears to be related with hypothyroidism, which might be the result of a feedback mechanism to maintain body temperature in a state of reduced basal thermogenesis. Future research needs to explore the underlying mechanistic and biological implications.
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Affiliation(s)
- Constantin Lapa
- a Department of Nuclear Medicine , University Hospital Würzburg , Würzburg , Germany
| | - Yoshifumi Maya
- a Department of Nuclear Medicine , University Hospital Würzburg , Würzburg , Germany.,b Research Centre , Nihon Medi-Physics Co Ltd , Chiba , Japan
| | - Martin Wagner
- c Institute of Clinical Epidemiology and Biometry, University of Würzburg , Würzburg , Germany.,d Comprehensive Heart Failure Center , University Hospital Würzburg , Würzburg , Germany
| | - Paula Arias-Loza
- e Department of Internal Medicine I, Division of Cardiology , University Hospital Würzburg , Würzburg , Germany
| | - Rudolf A Werner
- a Department of Nuclear Medicine , University Hospital Würzburg , Würzburg , Germany
| | - Ken Herrmann
- a Department of Nuclear Medicine , University Hospital Würzburg , Würzburg , Germany.,f Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology , David Geffen School of Medicine at UCLA , USA
| | - Takahiro Higuchi
- a Department of Nuclear Medicine , University Hospital Würzburg , Würzburg , Germany.,d Comprehensive Heart Failure Center , University Hospital Würzburg , Würzburg , Germany
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Izzi-Engbeaya C, Salem V, Atkar RS, Dhillo WS. Insights into Brown Adipose Tissue Physiology as Revealed by Imaging Studies. Adipocyte 2015; 4:1-12. [PMID: 26167397 DOI: 10.4161/21623945.2014.965609] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 09/09/2014] [Accepted: 09/11/2014] [Indexed: 12/12/2022] Open
Abstract
There has been resurgence in interest in brown adipose tissue (BAT) following radiological and histological identification of metabolically active BAT in adult humans. Imaging enables BAT to be studied non-invasively and therefore imaging studies have contributed a significant amount to what is known about BAT function in humans. In this review the current knowledge (derived from imaging studies) about the prevalence, function, activity and regulation of BAT in humans (as well as relevant rodent studies), will be summarized.
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Key Words
- 11C-MHED, [11C]-meta-hydroxyephedrine
- 18F-FDG, [18F]-fluorodeoxyglucose
- 99mTc-sestamibi, technetium-99m sestamibi
- 99mTc-tetrofosmin, technetium-99m tetrofosmin
- ATP, adenosine triphosphate
- BAT, brown adipose tissue
- BMI, body mass index
- BOLD, blood oxygen level dependent
- CIT, cold-induced thermogenesis
- IQR, interquartile range
- MRI, magnetic resonance imaging
- NST, non-shivering thermogenesis
- PET-CT, positron emission tomography-computed tomography
- SPECT, single photon emission CT
- UCP-1, uncoupling protein 1
- WAT, white adipose tissue
- brown adipose tissue
- energy expenditure
- imaging
- metabolism
- thermogenesis
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Devlin MJ. The “Skinny” on brown fat, obesity, and bone. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 156 Suppl 59:98-115. [DOI: 10.1002/ajpa.22661] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Maureen J. Devlin
- Department of Anthropology; University of Michigan; Ann Arbor MI 48104
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