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BAT

Lack of BAT could explain susceptibility to MetS

Findings suggest that making more BAT or increasing its activity could have great therapeutic potential in south Asians

Lower amounts of brown adipose tissue (BAT) could help explain why south Asians have an exceptionally high susceptibility to developing metabolic problems such as obesity and type 2 diabetes, according to a study published in The Lancet Diabetes & Endocrinology journal.

"Our findings suggest that making more BAT or increasing its activity could have great therapeutic potential in south Asians, helping them increase the clearance of glucose and fatty acids and converting surplus white fat into heat, potentially lessening the risk of diabetes,” said lead authors, Mariëtte Boon and Patrick Rensen from Leiden University Medical Center in the Netherlands.

BAT has shown beneficial effects on glucose tolerance, lipid metabolism, and body weight in pre-clinical studies, and unlike white fat cells, brown fat cells in BAT can convert some of this energy (lipids and glucose) into large amounts of heat when the body is exposed to cold, thus burning the energy surplus rather than storing it.

"It has recently been shown that BAT can be recruited in humans following ten days of cold intervention. Future studies should be directed towards the efficacy of this strategy, as well as other options, such as medication, to increase BAT activity. These strategies might finally be used to improve the metabolic phenotype in south Asians,” the authors add.

Estimates suggest that fully activated BAT contributes up to 20% of total energy expenditure. Previous studies have shown that BAT activity is reduced in obese adults.

In this study, researchers from the Netherlands compared resting energy expenditure and BAT volume and activity in 12 healthy lean south Asian men (aged about 25 years) and 12 matched white Caucasian men after exposure to cold using 18F-fluorodeoxyglucose positron emission tomography and computed tomography (18F-FDG-PET-CT) scans. The effect of cold exposure on non-shivering thermogenesis and plasma lipid levels was also measured.

The outcomes revealed that thermoneutral resting energy expenditure was 1297 kcal per day (SD 123) in south Asian participants compared with 1689 kcal per day (193) in white Caucasian participants (difference −32%, p=0·0008). On cold exposure, shiver temperature of south Asians was 2·0°C higher than Caucasians (p=0·0067) and non-shivering thermogenesis was increased by 20% in white Caucasians (p<0·0001) but was not increased in south Asians.

Although the maximum and mean standardised uptake values of 18F-FDG in BAT did not differ between groups, total BAT volume was lower in south Asians (188mL) than it was in Caucasians (287 mL; difference −34%, p=0·04). Overall, BAT volume correlated positively with basal resting energy expenditure in all assessable individuals (β=0·44, p=0·04).

“Lower resting energy expenditure, non-shivering thermogenesis, and BAT volumes in south Asian populations might underlie their high susceptibility to metabolic disturbances, such as obesity and type 2 diabetes,” the authors conclude. “Development of strategies to increase BAT volume and activity might help prevent and treat such disorders, particularly in south Asian individuals.”

The study was funded by the Dutch Heart Foundation and the Dutch Diabetes Research Foundation.

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