Prednisone treatment (40 mg/day) did not significantly alter cold-induced thermogenesis compared to placebo in healthy men (186 vs 153 kcal/24 h; p=0.38).
RCT (n=16)
Double-blinded
Cross-over
Does prednisone alter cold-induced thermogenesis in healthy men?
High-dose prednisone increases resting energy expenditure but does not affect cold-induced brown adipose tissue activity, suggesting its metabolic effects are independent of thermogenic adipocytes.
Absolute Event Rate: 186% vs 153%
p-value: p=0.38
BackgroundGlucocorticoids (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. MethodsWe performed a randomised, double-blinded cross-over trial in 16 healthy men (clinicaltrials. gov NCT03269747). 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. FindingsSixteen 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. InterpretationPrednisone 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. FundingGrants from Swiss National Science Foundation (PZ00P3₁67823), 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 2012A103 and 2015A228) to MR.
Maushart et al. (Mon,) conducted a rct in Healthy (n=16). Prednisone vs. Placebo was evaluated on Increase in resting energy expenditure in response to a mild-cold stimulus (cold-induced thermogenesis) (p=0.38). Prednisone treatment (40 mg/day) did not significantly alter cold-induced thermogenesis compared to placebo in healthy men (186 vs 153 kcal/24 h; p=0.38).