CONTEXT: Brown adipose tissue (BAT) found by positron emission/computed tomography (PET-CT) using flouro-deoxyglucose (FDG) is inducible by cold exposure in men. Factors leading to increased BAT are of great interest for its potential role in the treatment of diabetes and obesity. OBJECTIVE: We tested whether thyroid hormone (TH) levels are related to the volume and activity of BAT in a patient with a mutation in the insulin receptor gene. DESIGN/SETTING/INTERVENTION: Our work was based on the case report of a patient in an observational study at the National Institutes of Health. PATIENT: The patient discontinued insulin and oral antidiabetics after thyroidectomy and suppressive-dose levothyroxine therapy for thyroid cancer. PET-CT uptake in BAT was confirmed by histology and molecular analysis. OUTCOMES: PET-CT studies were performed, and we measured hemoglobin A1c and resting energy expenditure before and after levothyroxine discontinuation for thyroid cancer testing. Molecular studies of BAT and white adipose samples are presented. RESULT: Supraclavicular and periumbilical sc adipose tissue demonstrated molecular features of BAT including uncoupling protein-1, type 2 deiodinase, and PR domain containing 16 by quantitative PCR. Activity of type 2 deiodinase activity was increased. The discontinuation of levothyroxine resulted in decreased FDG uptake and diminished volume of BAT depots accompanied by worsening of diabetic control. CONCLUSIONS: This case demonstrates the TH effect on BAT activity and volume in this patient and an association between BAT activity and glucose levels in this patient. Because the contribution of TH on skeletal muscle energy expenditure and fuel metabolism was not assessed, an association between BAT activity and glucose homeostasis can only be suggested.
CONTEXT: Brown adipose tissue (BAT) found by positron emission/computed tomography (PET-CT) using flouro-deoxyglucose (FDG) is inducible by cold exposure in men. Factors leading to increased BAT are of great interest for its potential role in the treatment of diabetes and obesity. OBJECTIVE: We tested whether thyroid hormone (TH) levels are related to the volume and activity of BAT in a patient with a mutation in the insulin receptor gene. DESIGN/SETTING/INTERVENTION: Our work was based on the case report of a patient in an observational study at the National Institutes of Health. PATIENT: The patient discontinued insulin and oral antidiabetics after thyroidectomy and suppressive-dose levothyroxine therapy for thyroid cancer. PET-CT uptake in BAT was confirmed by histology and molecular analysis. OUTCOMES: PET-CT studies were performed, and we measured hemoglobin A1c and resting energy expenditure before and after levothyroxine discontinuation for thyroid cancer testing. Molecular studies of BAT and white adipose samples are presented. RESULT: Supraclavicular and periumbilical sc adipose tissue demonstrated molecular features of BAT including uncoupling protein-1, type 2 deiodinase, and PR domain containing 16 by quantitative PCR. Activity of type 2 deiodinase activity was increased. The discontinuation of levothyroxine resulted in decreased FDG uptake and diminished volume of BAT depots accompanied by worsening of diabetic control. CONCLUSIONS: This case demonstrates the TH effect on BAT activity and volume in this patient and an association between BAT activity and glucose levels in this patient. Because the contribution of TH on skeletal muscle energy expenditure and fuel metabolism was not assessed, an association between BAT activity and glucose homeostasis can only be suggested.
Authors: W Edward Visser; Karen A Heemstra; Sigrid M A Swagemakers; Zeliha Ozgür; Eleonora P Corssmit; Jacobus Burggraaf; Wilfred F J van Ijcken; Peter J van der Spek; Johannes W A Smit; Theo J Visser Journal: J Clin Endocrinol Metab Date: 2009-06-30 Impact factor: 5.958
Authors: Andrew L Carey; Renata Pajtak; Melissa F Formosa; Bruce Van Every; David A Bertovic; Mitchell J Anderson; Nina Eikelis; Gavin W Lambert; Victor Kalff; Stephen J Duffy; Martin H Cherk; Bronwyn A Kingwell Journal: Diabetologia Date: 2015-03-01 Impact factor: 10.122
Authors: Antonio C Bianco; Alexandra Dumitrescu; Balázs Gereben; Miriam O Ribeiro; Tatiana L Fonseca; Gustavo W Fernandes; Barbara M L C Bocco Journal: Endocr Rev Date: 2019-08-01 Impact factor: 19.871
Authors: Miles E Matsen; Joshua P Thaler; Brent E Wisse; Stephan J Guyenet; Thomas H Meek; Kayoko Ogimoto; Alex Cubelo; Jonathan D Fischer; Karl J Kaiyala; Michael W Schwartz; Gregory J Morton Journal: Am J Physiol Endocrinol Metab Date: 2013-02-05 Impact factor: 4.310
Authors: Alina Gavrila; Per-Olof Hasselgren; Allison Glasgow; Ashley N Doyle; Alice J Lee; Peter Fox; Shiva Gautam; James V Hennessey; Gerald M Kolodny; Aaron M Cypess Journal: Thyroid Date: 2016-11-29 Impact factor: 6.568
Authors: Miguel López; Luis Varela; María J Vázquez; Sergio Rodríguez-Cuenca; Carmen R González; Vidya R Velagapudi; Donald A Morgan; Erik Schoenmakers; Khristofor Agassandian; Ricardo Lage; Pablo Blanco Martínez de Morentin; Sulay Tovar; Rubén Nogueiras; David Carling; Christopher Lelliott; Rosalía Gallego; Matej Oresic; Krishna Chatterjee; Asish K Saha; Kamal Rahmouni; Carlos Diéguez; Antonio Vidal-Puig Journal: Nat Med Date: 2010-08-29 Impact factor: 53.440