210827_batios_online_suppl_R1_clean.pdf (378.91 kB)
Download fileActive Brown Adipose Tissue is Associated With a Healthier Metabolic Phenotype in Obesity
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posted on 2021-10-18, 22:56 authored by Carsten T. Herz, Oana C. Kulterer, Marlene Prager, Christoph Schmöltzer, Felix B. Langer, Gerhard Prager, Rodrig Marculescu, Alexandra Kautzky-Willer, Marcus Hacker, Alexander R. Haug, Florian W. KieferObesity is associated with
increasing cardiometabolic morbidity and mortality worldwide. Not everyone with
obesity, however, develops metabolic complications. Brown adipose tissue (BAT)
has been suggested as a promoter of leanness and metabolic health. To date,
little is known about the prevalence and metabolic function of BAT in subjects
with severe obesity, a population at high cardiometabolic risk. In this
cross-sectional study, we included 40 individuals with WHO class II-III obesity
(BMI ≥ 35 kg/m2). Employing a 150-minute personalized cooling
protocol and 18F-fluorodeoxyglucose positron emission tomography/computed
tomography, cold-activated BAT was detectable in 14 (35%) of the participants. Cold-induced
thermogenesis was significantly higher in participants with detectable BAT
compared to those without. Notably, individuals with obesity and active BAT had
28.8% lower visceral fat mass despite slightly higher total fat mass compared
to those without detectable BAT 18F-FDG uptake. This was accompanied
by lower insulin resistance and systemic inflammation and improved NAFLD
parameters, all adjusted for age, sex, and percent body fat. Contrary to
previous assumptions, we show here that a significant fraction of individuals
with severe obesity has active BAT. We found that decreased BAT 18F-FDG
uptake was not associated with adiposity per se but with higher visceral fat
mass. In summary, active BAT is linked to a healthier metabolic phenotype in
obesity.