Diabetes, Obesity and Metabolism
Diabetes, Obesity and Metabolism
5 years ago

Glucocorticoids Suppress Brown Adipose Tissue Function In Humans: A Double-Blind Placebo-Controlled Study

Goce Dimeski, Jeyakantha Ratnasingam, W Phillip Law, Ken KY Ho, Moe Thuzar, Christina Jang
Aim To investigate the effect of glucocorticoids on BAT function in humans Materials & Methods In a randomised double-blind cross-over design, 13 healthy adults underwent 1 week of oral prednisolone (15mg/day) and placebo treatment with an intervening 2-week wash-out period. BAT function was assessed in response to cooling (190C) and to a standardised meal, by measuring fluoro-deoxyglucose (FDG) uptake using Positron Emission Tomography-Computed Tomography and skin temperatures overlying the supraclavicular (SCL) BAT depots using infrared thermography. Postprandial energy and substrate metabolism was assessed by indirect calorimetry. Results During cooling, prednisolone significantly reduced BAT FDG uptake (standardised uptake value, SUVmax, 6.1±2.2 vs 3.7±1.2; P<0.05) and SCL temperature (-0.45±0.1 vs -1.0±0.10C; P<0.01) compared to placebo. Postprandially, prednisolone significantly blunted the rise in SCL temperature (+0.2±0.1 vs -0.3±0.10C; P<0.05), enhanced energy production (+221±17 vs +283±27 kcal/day; P<0.01) and lipid synthesis (+16.3±3.2 vs +23.6±4.9 mg/min; P<0.05). The prednisolone-induced reduction in SCL temperature significantly correlated with the reduction in FDG uptake (r=0.65, P<0.05), while the increase in energy production significantly correlated with the increase in lipogenesis (r=0.6, P<0.05). Conclusion Prolonged glucocorticoid suppresses the function of human BAT. The enhancement of energy production and lipogenesis in the face of reduced dissipation of energy as heat suggests that glucocorticoids channel energy towards fat storage after nutrient intake. This is a novel mechanism of glucocorticoid-induced obesity.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/dom.13157

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