Cold‐Activated Brown Adipose Tissue is Associated with Less Cardiometabolic Dysfunction in Young Adults with Obesity

OBJECTIVE: To test the hypothesis that young adults with obesity and cold-activated brown adipose tissue (BAT) are less likely to have metabolic dysfunction (dyslipidemia, insulin resistance, hypertension) than those without cold-activated BAT. Previous studies have noted a potentially protective effect of BAT and higher adiponectin/leptin ratios, but they acknowledged that the clinical implications of these findings remain uncertain. METHODS: We enrolled 21 females and 23 males with obesity (BMI ≥ 30kg/m(2)) who underwent a 2-hour cooling protocol before FDG-PET/CT scan, to determine the prevalence, volume and FDG uptake of cold-activated BAT. RESULTS: Cold-activated BAT was identified in 43% of participants (11F, 8M); females had greater FDG uptake. Those with cold-activated BAT had lesser degree of metabolic dysfunction. Cold-activated BAT volume correlated with triglycerides (inversely) and adiponectin (concordantly). Body mass adjusted cold-activated BAT activity correlated with HDL cholesterol (concordantly). Males with cold-activated BAT had lower leptin and higher adiponectin/leptin ratios. CONCLUSIONS: We report a high prevalence of cold-activated BAT in our study participants. We suggest that BAT could be important in decreasing metabolic dysfunction among young adults with obesity, making it a potential target for treating metabolically unhealthy obesity. CLINICAL TRIAL REGISTRATION: Trial registry name is STAGES Trial: Study of Adiposity, Growth and Endocrine Stages (STAGES). The clinical trial registration number is NCT01460784. https://clinicaltrials.gov/ct2/show/NCT01460784?term=obesity&cond=brown&draw=8&rank=54