title: Inverse association between brown adipose tissue activation and white adipose tissue accumulation in successfully treated pediatric malignancy.
abstract: BACKGROUND
  Although the accumulation of white adipose tissue (WAT) is a risk factor for disease, brown adipose tissue (BAT) has been suggested to have a protective role against obesity.
  
  
  OBJECTIVE
  We studied whether changes in BAT were related to changes in the amounts of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in children treated for malignancy.
  
  
  METHODS
  We examined the effect of BAT activity on weight, SAT, and VAT in 32 pediatric patients with cancer whose positron emission tomography-computed tomography (PET-CT) scans at diagnosis showed no BAT activity. Changes in weight, SAT, and VAT from diagnosis to remission for children with metabolically active BAT at disease-free follow-up (BAT+) were compared with those in children without visualized BAT when free of disease (BAT-).
  
  
  RESULTS
  Follow-up PET-CT studies (4.7 ± 2.4 mo later) after successful treatment of the cancer showed BAT+ in 19 patients but no active BAT (BAT-) in 13 patients. BAT+ patients, in comparison with BAT- patients, gained significantly less weight (3.3 ± 6.6% compared with 11.0 ± 11.6%; P = 0.02) and had significantly less SAT (18.2 ± 26.5% compared with 67.4 ± 71.7%; P = 0.01) and VAT (22.6 ± 33.5% compared with 131.6 ± 171.8%; P = 0.01) during treatment. Multiple regression analysis indicated that the inverse relations between BAT activation and measures of weight, SAT, and VAT persisted even after age, glucocorticoid treatment, and the season when the PET-CT scans were obtained were accounted for.
  
  
  CONCLUSIONS
  The activation of BAT in pediatric patients undergoing treatment of malignancy is associated with significantly less adipose accumulation. This trial was registered at clinicaltrials.gov as NCT01517581.
authors.affiliation: Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Chalfant
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Smith
authors.forename: Houchun H
authors.initials: HH
authors.lastname: Hu
authors.forename: Fred J
authors.initials: FJ
authors.lastname: Dorey
authors.forename: Fariba
authors.initials: F
authors.lastname: Goodarzian
authors.forename: Cecilia H
authors.initials: CH
authors.lastname: Fu
authors.forename: Vicente
authors.initials: V
authors.lastname: Gilsanz
mesh_terms: D000009:Abdominal Muscles; D002001:Adipose Tissue, Brown / Q000378:metabolism*; D050154:Adiposity; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D064847:Multimodal Imaging / Q000379:methods; D009369:Neoplasms / Q000628:therapy*; D049268:Positron-Emission Tomography; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000378:metabolism*; D014057:Tomography, X-Ray Computed
chemical_list: D005938:Glucocorticoids