The aim of the study is to investigate whether treatment with glucocorticoids leads to a change in heat production of the human body at mild cold conditions.
Brown adipose tissue (BAT) is a thermogenic tissue that can convert chemical energy directly into heat due to the expression of uncoupling protein 1 (UCP1) protein. Data from preclinical studies shows that glucocorticoids (GCs) inhibit the function of BAT. In clinical practice GCs are often administered due tue their antiinflammatory properties making the investigation of short term (e.g. one week) and long therm (several months) effects practically relevant. This study's objective is to evaluate the effect of glucocorticoid treatment on cold induced thermogenesis (CIT) in humans.
Study Type
OBSERVATIONAL
Enrollment
7
Resting energy expenditure
Temperature: supraclavicular, infraclavicular, abdominal, mid-thigh, non-dominant lower arm, middle finger tip, left lower leg, left dorsal foot, ear thermometer
Body composition
University Hospital Basel, Department of Endocrinology
Basel, Canton of Basel-City, Switzerland
Cold-induced thermogenesis (CIT) under glucocorticoids
Comparison of CIT change off-glucocorticoids with warm ischemia time (WIT) on-glucocorticoids by using indirect calorimetry. Comparing two Groups (Observation group A and B) we will address the CIT change from glucocorticoid start to 4-8 weeks into treatment (group A) and the CIT change from glucocorticoid therapy to weaning off upon more than 3 months after glucocorticoid withdrawal (group B)
Time frame: Change from glucocortoid start to +4 to 8 weeks into treatment/ +3 months after weaning off GCs (resp.)
Resting metabolic rate (RMR)
Comparison of RMR of patients starting GCs or patients stopping GCs, measured by indirect calorimetry
Time frame: Baseline and +4 to 8 weeks into treatment/ +3 months after weaning off GCs (resp.)
Body composition
Comparison of body composition concerning muscle mass and fat mass, determined by DXA
Time frame: Baseline and +4 to 8 weeks into treatment/ +3 months after weaning off GCs (resp.)
Cold stimulated glucose uptake into supraclavicular BAT
Determination of 'standardized uptake value' (SUV) mean in two volumes of interest on the supraclavicular adipose tissue, after PET-CT
Time frame: Baseline and +4 to 8 weeks into treatment/ +3 months after weaning off GCs (resp.)
SUV max in supraclavicular adipose tissue depot
Determination of SUV max in the supraclavicular adipose tissue, after positron emission tomography (PET)-CT
Time frame: Baseline and +4 to 8 weeks into treatment/ +3 months after weaning off GCs (resp.)
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thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), HbA1c, Fibroblast growth factor 21 (FGF21)
Dynamic PET scanning of the neck-region
Prior to fluorodeoxyglucose (FDG)-PET in order to avoid hyperglycemia
Ultrasound guided biopsy of the supraclavicular adipose tissue