PET‐CT using 18F‐FDG is employed for detecting brown adipose tissue (BAT) in humans. Alternative methods are needed because of the radiation and cost of PET‐CT imaging. The aim was to evaluate the accuracy of infrared thermography (IRT) in detecting human BAT benchmarked to PET‐CT imaging. Seventeen individuals underwent a total of 29 PET‐CT scans, 12 of whom were studied twice, after 2 h of cold stimulation at 19°C, in parallel with measurement of skin temperatures overlying the supraclavicular (SCV) fossa and the lateral upper chest (control), before and after cold stimulation. Of the 29 scans, 20 were BAT positive after cold stimulation. The mean left SCV temperature tended to be higher in the BAT‐positive group before and during cooling. It was significantly higher (P =0.04) than the temperature of the control area, which fell significantly during cooling in the BAT‐positive (−1.2 ± 0.3°C, P =0.002) but not in the negative (−0.2 ± 0.4°C) group. The temperature difference (Δtemp) between left SCV and chest increased during cooling in the BAT‐positive (1.2 ± 0.2 to 2.0 ± 0.3°C, P <0.002) but not in the negative group (0.6 ± 0.1 to 0.7 ± 0.1°C). A Δtemp of 0.9°C conferred a positive predictive value of 85% for SCV BAT, superior to that of SCV temperature. The findings were similar on the right. In conclusion, the Δtemp is significantly and consistently greater in BAT‐positive subjects. The Δtemp quantified by IRT after 2‐h cooling shows promise as a noninvasive convenient technique for studying SCV BAT function.

AimsTo determine the frequencies of the variant alleles and the genotypes of CYP2C9 in a Korean population. MethodsThree hundred and fifty-eight healthy Korean subjects were studied. CYP2C9 alleles were detected by polymerase chain reaction-restriction fragment leng th polymorphism assays and direct sequencing assays. ResultsThe allele frequencies were 0.934 for CYP2C9 * 1 , 0.060 for CYP2C9 * 3 and 0.006 for CYP2C9 * 13 . The CYP2C9*2, * 4, * 5 and * 11 alleles were not detected. The frequencies of the CYP2C9 * 1/ * 1 , * 1/ * 3 and * 1/ * 13 genotypes were 0.869, 0.120 and 0.011, respectively. ConclusionThe frequency of the CYP2C9 * 3 allele in the Korean population studied was significantly higher than reported elsewhere, and a novel allele, CYP2C9 * 13 , was found at a frequency of 0.006 (95% confidence interval 0, 0.012). Only three genotypes of CYP2C9, CYP2C9

Prolonged exposure to 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.

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The activities of skeletal muscle 11beta-HSD1 and 11beta-HSD2 are altered in diabetes, which together may reduce intracellular cortisol generation, potentially conferring metabolic protection.

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ObjectiveTo evaluate pituitary function, sexual function and quality of life (QoL) in patients on oral or transdermal opioids.Design and methodsCross-sectional study comparing pituitary function, QoL and sexual function in people on long-term opioid therapy (n = 40) vs an age- and sex-matched control group (n = 25). Baseline pituitary function was assessed on blood samples collected prior to 0900 h. Further testing with corticotropin (250 µg IV) and metyrapone (30 mg/kg) stimulation tests was undertaken on participants with serum cortisol <250 nmol/L. Validated questionnaires completed to assess QoL, fatigue and sexual function.ResultsSecondary adrenal insufficiency (SAI) was identified on the basis of a failed stimulation test in 22.5% of opioid users vs no controls (P = 0.01). Opioid users with SAI had a higher median morphine-equivalent daily dose (MEDD),P = 0.037 – 50% with MEDD >200 mg and 0% with MEDD <60 mg had SAI. Among male participants, testosterone was inversely associated with BMI (P = 0.001) but not opioid use. A non-significant trend to low testosterone <8 nmol/L in male opioid users (11/24 opioid users vs 2/14 control,P = 0.08) suggests a small subgroup with opioid-induced androgen deficiency. Opioid users had greater fatigue, reduced quality of life in all subsections of the SF-36 and impaired sexual function in both males and females (all scoresP < 0.001 compared to controls).ConclusionLong-term opioid therapy was associated with dose-related SAI in over 20% of chronic pain patients and is associated with poor quality of life, fatigue and sexual dysfunction. Obesity confounds the interpretation of opioid-induced male androgen deficiency.

Thus, the capacity of adipose tissue to produce estrogen seems to increase significantly with age at the time of menopause and to be unaltered by exogenous estrogen therapy. This difference in extragonadal estrogen production with age may play a pivotal role in the increase in estrogen-dependent malignancies in the postmenopausal years.