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Brown adipose tissue volume in healthy lean south Asian adults compared with white Caucasians: A prospective, case-controlled observational study

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Author: Bakker, L.E.H. · Boon, M.R. · Linden, R.A.D. van der · Arias-Bouda, L.P. · Klinken, J.B. van · Smit, F. · Verberne, H.J. · Jukema, J.W. · Tamsma, J.T. · Havekes, L.M. · Marken Lichtenbelt, W.D. van · Jazet, I.M. · Rensen, P.C.N.
Source:The Lancet Diabetes and Endocrinology, 3, 2, 210-217
Identifier: 507097
doi: doi:10.1016/S2213-8587(13)70156-6
Keywords: Biology · Fatty acid · Fluorodeoxyglucose f 18 · Glucose · Adult · Analytical parameters · Brown adipose tissue · Case control study · Caucasian · Computer assisted tomography · Controlled study · Energy metabolism · Ethnic difference · Ethnic group · Ethnicity · Human · Human tissue · Incidence · Non insulin dependent diabetes mellitus · Observational study · Outcome assessment · Prospective study · South Asian · Tissue volume · Biomedical Innovation · Healthy Living · Life · MHR - Metabolic Health Research · ELSS - Earth, Life and Social Sciences


Background: Individuals of south Asian origin have a very high risk of developing type 2 diabetes compared with white Caucasians. We aimed to assess volume and activity of brown adipose tissue (BAT), which is thought to have a role in energy metabolism by combusting fatty acids and glucose to produce heat and might contribute to the difference in incidence of type 2 diabetes between ethnic groups. Methods: We enrolled Dutch nationals with south Asian ancestry and matched Caucasian participants at The Rijnland Hospital (Leiderdorp, Netherlands). Eligible participants were healthy lean men aged 18-28 years, and we matched groups for BMI. We measured BAT volume and activity with cold-induced 18F-fluorodeoxyglucose (18F-FDG) PET CT scans, and assessed resting energy expenditure, non-shivering thermogenesis, and serum parameters. This study is registered with the Netherlands Trial Register, number 2473. Findings: Between March 1, 2013, and June 1, 2013, we enrolled 12 participants in each group; one Caucasian participant developed hyperventilation after 18F-FDG administration, and was excluded from all cold-induced and BAT measurements. Compared with Caucasian participants, south Asian participants did not differ in age (mean 23·6 years [SD 2·8] for south Asians vs 24·6 years [2·8] for Caucasians) or BMI (21·5 kg/m2 [2·0] vs 22·0 kg/m2 [1·6]), but were shorter (1·74 m [0·06] vs 1·85 m [0·04]) and lighter (65·0 kg [8·5] vs 75·1 kg [7·2]). 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 (188 mL [SD 81]) than it was in Caucasians (287 mL [169]; 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). Interpretation: 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. Development of strategies to increase BAT volume and activity might help prevent and treat such disorders, particularly in south Asian individuals. © 2014 Elsevier Ltd. Chemicals/CAS: fluorodeoxyglucose f 18, 63503-12-8; glucose, 50-99-7, 84778-64-3