Mineralocorticoid antagonism enhances brown adipose tissue function in humans: A randomized placebo‐controlled cross‐over study

Abstract

MC antagonism enhanced human BAT function in response to cooling and to a meal during which lipid synthesis was suppressed. As postprandial EPR comprises energy dissipated as heat and energy required to store nutrients, the reduction in lipid synthesis during MC antagonism is a probable consequence of concurrent stimulation of BAT thermogenesis. The shift in energy usage from storage to heat dissipation indicates that MC antagonists may have therapeutic benefit for obesity.

Infrared Thermography for Estimating Supraclavicular Skin Temperature and BAT Activity in Humans: A Systematic Review

“…Thuzar et al correlated the changes in SST by IRT following an intervention with the changes in 18 F‐FDG uptake by BAT but reported no actual data regarding this finding. In another study by the same group , it was reported that SST measured by IRT after cold exposure positively correlated (r = 0.62; P = 0.03) with the BAT maximal standardized uptake of 18 F‐FDG as measured by PET/CT. In another study comparing SST measured by IRT with 18 F‐FDG‐PET/CT, Law et al reported that SST relative to the sternal temperature correlated positively with BAT 18 F‐FDG uptake in eight lean adults.…”

“…Sarasniemi et al compared IRT‐measured SST with the temperature of the supraclavicular depot as measured by MRS and observed a positive and significant correlation in lean adults but a negative correlation in adults with obesity. Moreover, Thuzar et al performed two independent studies in which they compared IRT‐measured SST against BAT 18 F‐FDG uptake as measured by a PET/CT scan on the same day, reporting a positive and significant association between them. In contrast, Law et al made the same kind of measurements on separate days and using different cold exposure times.…”

Comment on “mineralocorticoid antagonism enhances brown adipose tissue function in humans: A randomized placebo‐controlled cross‐over study”

“…Importantly, administration of MRAs to high‐fat‐diet‐fed mice was able to enhance classical (interscapular) BAT activity and, in parallel, to induce browning of white adipose tissue (WAT), a process consisting in the appearance of brown‐like adipocytes, termed “beige” or “brite”, in WAT depots . Data by Thuzar et al confirm similar effects in humans treated with MRAs, showing activation of BAT in cervical, supraclavicular, axillary and paravertebral fat depots.…”

“…The recent article by Thuzar et al has shown for the first time that treatment of adult humans with the mineralocorticoid receptor (MR) antagonist spironolactone (spiro) is capable of increasing brown adipose tissue (BAT) activity and thermogenesis, suggesting that MR antagonists (MRAs) may lead to beneficial metabolic effects and represent a valid approach to fight obesity and obesity‐associated diseases (metabolic syndrome). Clinical trials conducted over the last 20 years have shown the efficacy of these compounds in reducing cardiovascular mortality in patients with heart failure (HF) .…”

“…Thuzar et al showed that administration of spiro to healthy adults for 2 weeks increased BAT activity (evaluated using postitron‐emission tomography [PET]‐computed tomography [CT]) in response to cold stimulus. Interestingly, spiro was able to fire BAT activity also in PET‐negative participants, thus displaying a high effectiveness in inducing the thermogenic gene programme.…”