Identification and Importance of Brown Adipose Tissue in Adult Humans

By A. Cypess, S. Lehman, Gethin Williams, Ilan Tal, D. Rodman, A. Goldfine, F. Kuo, E. Palmer, Y. Tseng, A. Doria and 2 more. New England Journal of Medicine, 2009

4,298 citations recorded by the source corpus.

BACKGROUND Obesity results from an imbalance between energy intake and expenditure. In rodents and newborn humans, brown adipose tissue helps regulate energy expenditure by thermogenesis mediated by the expression of uncoupling protein 1 (UCP1), but brown adipose tissue has been considered to have no physiologic relevance in adult humans. METHODS We analyzed 3640 consecutive 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomographic and computed tomographic (PET–CT) scans performed for various diagnostic reasons in 1972 patients for the presence of substantial depots of putative brown adipose tissue. Such depots were defined as collections of tissue that were more than 4 mm in diameter, had the density of adipose tissue according to CT, and had maximal standardized uptake values of 18F-FDG of at least 2.0 g per milliliter, indicating high metabolic activity. Clinical indexes were recorded and compared with those of date-matched controls. Immunostaining for UCP1 was performed on biopsy specimens from the neck and supraclavicular regions in patients undergoing surgery. RESULTS Substantial depots of brown adipose tissue were identified by PET–CT in a region extending from the anterior neck to the thorax. Tissue from this region had UCP1-immunopositive, multilocular adipocytes indicating brown adipose tissue. Positive scans were seen in 76 of 1013 women (7.5%) and 30 of 959 men (3.1%), corresponding to a female:male ratio greater than 2:1 (P<0.001). Women also had a greater mass of brown adipose tissue and higher 18F-FDG uptake activity. The probability of the detection of brown adipose tissue was inversely correlated with years of age (P<0.001), outdoor temperature at the time of the scan (P= 0.02), beta-blocker use (P<0.001), and among older patients, body-mass index (P = 0.007). CONCLUSIONS Defined regions of functionally active brown adipose tissue are present in adult humans, are more frequent in women than in men, and may be quantified noninvasively with the use of 18F-FDG PET–CT. Most important, the amount of brown adipose tissue is inversely correlated with body-mass index, especially in older people, suggesting a potential role of brown adipose tissue in adult human metabolism.

Subfields: Cardiology and Cardiovascular Medicine, Epidemiology, Physiology

View Paper: https://www.semanticscholar.org/paper/d21f888bf58263722e0bbc69f3287b86f6b50e9f

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Citations in the corpus

Brown and beige fat in humans: thermogenic adipocytes that control energy and glucose homeostasis. (2015, neutral): “Understanding BAT-mediated interor-gan communication would further uncover new roles for BAT in energy and glucose homeostasis.”
Brown adipose tissue regulates glucose homeostasis and insulin sensitivity. (2013, positive): “Discussion The advances in brown adipose cell biology during the last decade have increased our understanding of the cellular origin (27–29), function (8, 13, 29), and adult human tissue distribution (2, 3, 7, 9) of BAT.”
Brown adipose tissue activity controls triglyceride clearance (2011, background): “and has recently been shown to be present in human”
Beige Adipocytes are a Distinct Type of Thermogenic Fat Cell in Mouse and Human (2012, background): “Recent data indicate that adult humans contain significant deposits of UCP1-positive brown fat that can be detected by positron emission tomography (PET)-scanning methods, particularly in the supraclavicular and neck region (Cypess et al., 2009; Mirbolooki et al., 2011; Orava et al., 2011; van Marke”
Cold acclimation recruits human brown fat and increases nonshivering thermogenesis. (2013, neutral): “There has been revitalized interest in BAT after the discovery of functional BAT in human adults in 2009 (1, 2, 13), not in the least because BAT activation may be able to counteract obesity and type 2 diabetes (27, 29).”
The emergence of cold-induced brown adipocytes in mouse white fat depots is determined predominantly by white to brown adipocyte transdifferentiation. (2010, background): “Therefore, the phenomenon of appearance of brown adipocytes in WAT after cold exposure and acclimatization warrants further research, also taking into account recent evidence for functional brown adipocytes in adult humans (27, 56, 67, 68, 70).”
Adipose Tissue Remodeling: Its Role in Energy Metabolism and Metabolic Disorders (2016, background): “However, recent positron emission tomography/computed tomography studies have shown that BAT is viable and functional in human adults (12, 13).”
Obesity, Oxidative Stress, Adipose Tissue Dysfunction, and the Associated Health Risks: Causes and Therapeutic Strategies (2015, background): “The occurrence of BAT in adult humans varies from 2% to 100%.(401,402) Possible BAT-oriented therapeutic treatments to combat obesity, aimed at increasing energy expenditure, might work in one of two ways: first, by stimulating the activity of already existing BAT and, second, by upregulating the oc”
The nature of nutrition: a unifying framework (2011, background): “Having been digested and absorbed across the gut, further rebalancing of nutrient supply can be achieved by differentially voiding excess nutrients and conserving nutrients that are in limited supply (Zanotto et al. 1997; Stock 1999; Silva 2006; Cypess et al. 2009).”
The sexual dimorphism of obesity (2015, positive): “3), which have recently been demonstrated to facilitate browning of white adipose tissues by up regulation of UCP-1 and by activating mitochondrial biogenesis and uncoupling in white adipose tissues (Bordicchia et al., 2012; Collins, 2014).”
Thyroid hormone regulation of metabolism. (2014, background): “Recent studies utilizing PET and CT imaging have shown a significant amount of BAT, especially in the subscapular and chest region (50, 257).”