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Large Study Links Brown Fat With Lower Rates of Cardiometabolic Disease
People who have brown fat detected on imaging seem to be at reduced risk of cardiac and metabolic conditions, ranging from type 2 diabetes to hypertension and coronary artery disease, with a notably strong effect in people with obesity, according to a new study in more than 52,000 individuals who had PET/CT scans as part of cancer evaluation.
Although studied for decades in newborns and animals, only in the past decade have scientists appreciated that some adults have brown fat, typically around the neck and shoulders.
The new study, by far the largest of its kind in humans, appears to confirm the health benefits of brown fat suggested by previous studies, say Tobias Becher, MD, and colleagues from Rockefeller University, New York City, in their article published online January 4 in Nature Medicine.
“Our study indicates an important contribution of brown adipose tissue to cardiometabolic health and suggests…[it] has therapeutic potential in humans,” they state.
Brown Fat Detected in 10% of Participants
Contrary to white fat, which stores energy, brown fat is thermogenic, activated by cold conditions, and instead burns energy. And although animal studies have shown a link between brown fat and improvements in glucose and lipid homeostasis, the effects of brown fat in humans are not well understood.
Becher and colleagues explain that large-scale studies of brown fat have been practically impossible because the tissue only shows up on medical imaging and it would be unethical to expose people to radiation just to study brown fat.
Does Brown Fat Mitigate Some Harms of Obesity?
Among those with brown fat, the rate of type 2 diabetes was 4.6% compared with 9.5% in those with no detected brown fat (P < .0001), and in a multivariate analysis, the odds ratio (OR) for type 2 diabetes in the presence of brown fat was 0.44.
The occurrence of coronary artery disease was significantly lower in those with brown fat (OR, 0.68; P = .0002), as was cerebrovascular disease (OR, 0.77; P = .0317), congestive heart failure (OR, 0.62; P = .0043), and hypertension (OR, 0.85; P = .0014).
Brown fat was also associated with notable improvements in glucose, triglycerides, and HDL-C levels (all P < .0001), while no differences were seen in measures of LDL-Cs or total cholesterol.
Leukocyte and platelet counts were significantly decreased in individuals with brown fat (both P < .0001).
The findings “suggest potential roles for brown adipose beyond regulation of lipid and glucose metabolism,” the authors write.
Most notably, the effects were more pronounced in people with obesity. For example, the prevalence of type 2 diabetes in those with obesity and brown fat was less than half the rate in those with obesity without brown fat (7.5% vs 20.3%; P < .0001).
This could indicate that brown adipose tissue “might play a role in mitigating the deleterious effects of obesity,” the researchers state.
Nature Med. Published January 4, 2021. Abstract
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