title: Chronic adrenergic stimulation induces brown adipose tissue differentiation in visceral adipose tissue.
abstract: BACKGROUND
  Recruitment of brown adipose tissue is a promising strategy to treat obesity and Type 2 diabetes, but the physiological effects of a large amount of metabolically active brown adipose tissue in humans are unknown.
  
  
  METHODS
  In the present paper, we report a case of massive brown adipose tissue infiltration of the visceral adipose tissue depot in a person with Type 2 diabetes with a catecholamine-secreting paraganglioma. The patient was evaluated with [18F]-fludeoxyglucose positron emission tomography/computed tomography on three occasions: pre-therapy, during α-blockade and postoperatively. During surgery, biopsies of visceral and subcutaneous adipose tissue were obtained and evaluated for brown adipose tissue. At diagnosis, brown adipose tissue glucose uptake, assessed by [18F]-fludeoxyglucose-positron emission tomography, was massively increased. [18F]-fludeoxyglucose uptake was confined to known locations for brown adipose tissue, with additional uptake in the visceral adipose tissue. As a result of increased thermogenesis, resting energy expenditure was doubled. After surgical removal of the tumour, antidiabetic medicine was no longer needed, despite an 8.2-kg weight gain.
  
  
  CONCLUSIONS
  These results show that human visceral adipose tissue holds an unprecedented potential for brown adipogenic differentiation; however, a detrimental effect on glucose metabolism persisted despite massive brown adipose tissue activity, with a doubling of resting energy expenditure.
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; The Danish Diabetes Academy, Aarhus, Denmark.
authors.forename: E
authors.initials: E
authors.lastname: Søndergaard
authors.forename: L C
authors.initials: LC
authors.lastname: Gormsen
authors.forename: M H
authors.initials: MH
authors.lastname: Christensen
authors.forename: S B
authors.initials: SB
authors.lastname: Pedersen
authors.forename: P
authors.initials: P
authors.lastname: Christiansen
authors.forename: S
authors.initials: S
authors.lastname: Nielsen
authors.forename: P L
authors.initials: PL
authors.lastname: Poulsen
authors.forename: N
authors.initials: N
authors.lastname: Jessen
mesh_terms: D002001:Adipose Tissue, Brown / Q000000981:diagnostic imaging / Q000378:metabolism*; D050154:Adiposity; D001481:Basal Metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood / Q000378:metabolism*; D010235:Paraganglioma / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D011877:Radionuclide Imaging; D015854:Up-Regulation
chemical_list: D009638:Norepinephrine