Weight-loss with activation of brown fat: Suspect pheochromocytoma

Geslot, Aurore; Bennet, A.; Hitzel, Anne; Thoulouzan, M.; Mouly, C.; Savagner, Frédérique; Ranty, Marie–Laure; Caron, Philippe; Vezzosi, Delphine

doi:10.1016/j.ando.2019.06.004

Cited by 4 publications

(6 citation statements)

References 29 publications

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“…This has a regulatory function by increasing the number of brown fat cells, lipolysis, glucose transport, and uncoupling protein-1 (UCP-1) expression, resulting in heat production [ 1 , 10 ]. Persistently elevated catecholamines lead to upregulation of UCP-1, triggering BAT hyperplasia and hypertrophy and inducing transdifferentiation of white adipocytes to brown adipocyte-like cells, generating a pseudotumoral appearance, especially in locations close to the pheochromocytoma [ 11 ]. Here lies the importance of knowing this potential pitfall interpretation as metastasis or hematological malignancies in morphological and metabolic studies like CT, MRI, or PET-CT [ 1 , 5 , 6 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Pheochromocytoma With Brown Adipose Tissue Stimulation: A Case Report

Muñoz-Caicedo,

García-Gómez,

Arroyave-Peña

et al. 2024

Cureus

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Brown adipose tissue represents about 1% of the adult body mass and decreases with age. Under variable circumstances, this amount changes, for example, with age or environmental conditions. Pathological states with hypersecretion of catecholamines can induce hypertrophy and hyperplasia in mature brown adipocytes. Consequently, this response can have imaging representation as pseudonodules, a pitfall in imaging interpretation, and may be confused with neoplastic involvement. A case of pheochromocytoma with brown fat stimulation and catecholamine cardiomyopathy is presented.

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Section: Discussionmentioning

confidence: 99%

Pheochromocytoma With Brown Adipose Tissue Stimulation: A Case Report

Muñoz-Caicedo,

García-Gómez,

Arroyave-Peña

et al. 2024

Cureus

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“…Furthermore, repeated intermittent cold exposure for ~7–10 days increased BAT mass and glucose uptake (using 18 F-FDG-PET/CT), BAT oxidative metabolism, NST and wider cold-induced thermogenesis (CIT) ( 38 , 52 ). Rare diseases also highlight the plasticity of BAT, as previously mentioned BAT activation is under sympathetic control and patients with catecholamine-secreting tumours (called phaeochromocytomas) often have substantial BAT mass and function which regress upon surgical removal of the tumour ( 53 , 54 ). Importantly, BAT function can be increased in obese subjects both with and without T2DM (the target patient group) by weight loss, which increased 18 F-FDG uptake by BAT, BAT volume and non-shivering thermogenesis in some subjects ( 50 , 55 , 56 ).…”

Section: The Importance Of Brown Adipose Tissue In Adult Humansmentioning

confidence: 98%

“…Therefore, the ideal drug would expand BAT mass in addition to activating BAT. As BAT expansion and activation are both under sympathetic regulation ( 53 , 88 ), the majority of research in this area has focused on the effect of sympathetic agonists.…”

Section: Approaches To Activating Batmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Human brown adipose tissue as a therapeutic target: warming up or cooling down?

McNeill

Suchacki

Stimson

2021

European Journal of Endocrinology

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Excessive accumulation of white adipose tissue leads to obesity and its associated metabolic health consequences such as type 2 diabetes and cardiovascular disease. Several approaches to treat or prevent obesity including public health interventions, surgical weight loss, and pharmacological approaches to reduce caloric intake have failed to substantially modify the increasing prevalence of obesity. The (re-)discovery of active brown adipose tissue (BAT) in adult humans approximately 15 years ago led to a resurgence in research into whether BAT activation could be a novel therapy for the treatment of obesity. Upon cold stimulus, BAT is activated and generates heat to maintain body temperature, thus increasing energy expenditure. Activation of BAT may provide a unique opportunity to increase energy expenditure without the need for exercise. However, much of the underlying mechanisms surrounding BAT activation are still being elucidated and the effectiveness of BAT as a therapeutic target has not been realised. Research is ongoing to determine how best to expand BAT mass and activate existing BAT; approaches include cold exposure, pharmacological stimulation using sympathomimetics, browning agents that induce formation of thermogenic beige adipocytes in white adipose depots, and the identification of factors secreted by BAT with therapeutic potential. In this review, we discuss the caloric capacity and other metabolic benefits from BAT activation in humans and the role of metabolic tissues such as skeletal muscle in increasing energy expenditure. We discuss the potential of current approaches and the challenges of BAT activation as a novel strategy to treat obesity and metabolic disorders.

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“…In individual case reports, patient weight loss was significant (>10 kg), mostly in elderly women. [7,[13][14][15][16] Among 79 patients with PCC, four cases (5.1%) demonstrated a preoperative weight loss of > 10%. [17] Other studies reported weight loss rates of 10.5% to 6% (including children) but did not provide specific descriptions of the extent of weight loss.…”

Section: Abnormal Energy Metabolism In Patients With Ppglmentioning

confidence: 99%

“…Additionally, weight loss, a typical manifestation of energy expenditure exceeding intake, is also common among patients with PPGL and is sometimes a primary reason for their medical visits. [7] Discrepancies in energy intake, whether deficient or excessive, can aggravate these imbalances, leading to altered body composition and negative effects on disease prognosis.…”

Section: Introductionmentioning

confidence: 99%

Main mechanisms and clinical implications of alterations in energy expenditure state among patients with pheochromocytoma and paraganglioma: A review

Yang,

Zhou,

Zhao

et al. 2024

Medicine

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Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors with diverse clinical presentations. Alterations in energy expenditure state are commonly observed in patients with PPGL. However, the reported prevalence of hypermetabolism varies significantly and the underlying mechanisms and implications of this presentation have not been well elucidated. This review discusses and analyzes the factors that contribute to energy consumption. Elevated catecholamine levels in patients can significantly affect substance and energy metabolism. Additionally, changes in the activation of brown adipose tissue (BAT), inflammation, and the inherent energy demands of the tumor can contribute to increased resting energy expenditure (REE) and other energy metabolism indicators. The PPGL biomarker, chromogranin A (CgA), and its fragments also influence energy metabolism. Chronic hypermetabolic states may be detrimental to these patients, with surgical tumor removal remaining the primary therapeutic intervention. The high energy expenditure of PPGL has not received the attention it deserves, and an accurate assessment of energy metabolism is the cornerstone for an adequate understanding and treatment of the disease.

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Weight-loss with activation of brown fat: Suspect pheochromocytoma

Cited by 4 publications

References 29 publications

Pheochromocytoma With Brown Adipose Tissue Stimulation: A Case Report

Pheochromocytoma With Brown Adipose Tissue Stimulation: A Case Report

MECHANISMS IN ENDOCRINOLOGY: Human brown adipose tissue as a therapeutic target: warming up or cooling down?

Main mechanisms and clinical implications of alterations in energy expenditure state among patients with pheochromocytoma and paraganglioma: A review

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