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Effect of high-dose glucocorticoid treatment on human brown adipose tissue activity: a randomised, double-blinded, placebo-controlled cross-over trial in healthy men.

Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland. Electronic address: claudia.maushart@usb.ch. Institute of Food, Nutrition, and Health, ETH Zurich, Schwerzenbach, Switzerland. Electronic address: wenfei-sun@stanford.edu. Department of Biology, Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland. Electronic address: othman@imsb.biol.ethz.ch. Institute of Food, Nutrition, and Health, ETH Zurich, Schwerzenbach, Switzerland; Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland. Electronic address: adhideb.ghosh@fgcz.ethz.ch. Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland. Electronic address: jaelrut.senn@usb.ch. Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland. Electronic address: jo.fischer92@gmail.com. Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. Electronic address: philipp.madoerin@usb.ch. Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland. Electronic address: rahel.loeliger@usb.ch. Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland. Electronic address: roebe@gmx.net. Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. Electronic address: martin.takes@usb.ch. Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. Electronic address: christoph.zech@usb.ch. Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. Electronic address: alin.chirindel@usb.ch. Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University Zurich (UZH), Zurich, Switzerland; Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany. Electronic address: felix.beuschlein@usz.ch. Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany. Electronic address: martin.reincke@med.uni-muenchen.de. Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. Electronic address: damian.wild@usb.ch. Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. Electronic address: oliver.bieri@usb.ch. Department of Biology, Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland. Electronic address: zamboni@imsb.biol.ethz.ch. Institute of Food, Nutrition, and Health, ETH Zurich, Schwerzenbach, Switzerland. Electronic address: christian-wolfrum@ethz.ch. Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland. Electronic address: matthias.betz@usb.ch.

EBioMedicine. 2023;:104771
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Abstract

BACKGROUND Glucocorticoids (GCs) are widely applied anti-inflammatory drugs that are associated with adverse metabolic effects including insulin resistance and weight gain. Previous research indicates that GCs may negatively impact brown adipose tissue (BAT) activity in rodents and humans. METHODS We performed a randomised, double-blinded cross-over trial in 16 healthy men (clinicaltrials.govNCT03269747). Participants received 40 mg of prednisone per day for one week or placebo. After a washout period of four weeks, participants crossed-over to the other treatment arm. Primary endpoint was the increase in resting energy expenditure (EE) in response to a mild-cold stimulus (cold-induced thermogenesis, CIT). Secondary outcomes comprised mean 18F-FDG uptake into supraclavicular BAT (SUVmean) as determined by FDG-PET/CT, volume of the BAT depot as well as fat content determined by MRI. The plasma metabolome and the transcriptome of supraclavicular BAT and of skeletal muscle biopsies after each treatment period were analysed. FINDINGS Sixteen participants were recruited to the trial and completed it successfully per protocol. After prednisone treatment resting EE was higher both during warm and cold conditions. However, CIT was similar, 153 kcal/24 h (95% CI 40-266 kcal/24 h) after placebo and 186 kcal/24 h (95% CI 94-277 kcal/24 h, p = 0.38) after prednisone. SUVmean of BAT after cold exposure was not significantly affected by prednisone (3.36 g/ml, 95% CI 2.69-4.02 g/ml, vs 3.07 g/ml, 95% CI 2.52-3.62 g/ml, p = 0.28). Results of plasma metabolomics and BAT transcriptomics corroborated these findings. RNA sequencing of muscle biopsies revealed higher expression of genes involved in calcium cycling. No serious adverse events were reported and adverse events were evenly distributed between the two treatments. INTERPRETATION Prednisone increased EE in healthy men possibly by altering skeletal muscle calcium cycling. Cold-induced BAT activity was not affected by GC treatment, which indicates that the unfavourable metabolic effects of GCs are independent from thermogenic adipocytes. FUNDING Grants from Swiss National Science Foundation (PZ00P3_167823), Bangerter-Rhyner Foundation and from Nora van der Meeuwen-Häfliger Foundation to MJB. A fellowship-grant from the Swiss National Science Foundation (SNF211053) to WS. Grants from German Research Foundation (project number: 314061271-TRR 205) and Else Kröner-Fresenius (grant support 2012_A103 and 2015_A228) to MR.

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Publication Type : Randomized Controlled Trial

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