Key result
Brown adipose tissue presence is linked to ~58% lower odds of type 2 diabetes.
Why the study?
The complete spectrum of health conditions associated with brown adipose tissue (BAT) and high-throughput methods to quantify BAT activity in humans were lacking.
Does the presence and higher metabolic activity of brown adipose tissue (BAT) associate with a reduced prevalence of cardiometabolic and psychiatric diseases?
Observational (n=101,243)
No
Does the presence and higher metabolic activity of brown adipose tissue (BAT) associate with a reduced prevalence of cardiometabolic and psychiatric diseases?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“This indicates that repurposing a widely used drug, with a well-known safety profile, may be a clinically viable method of stimulating brown fat, which has been linked to improved cardiovascular health and, identified for the first time in this study, psychiatric health.”
“The unique reverse translational approach of this study, enabled by large clinical datasets and next-generation analytical tools, provides a much-needed clinical rationale for exploring brown adipose tissue as a therapeutic target in humans across a spectrum of diseases.”
“The fact that its different effects are mediated by different molecular pathways is advantageous, since it means we could potentially isolate them in future therapies. That way you would be able to stimulate brown fat in people with normal blood pressure.”
AI-enabled quantification of brown adipose tissue (BAT) activity from PET-CT scans reveals that higher BAT activity is robustly associated with healthier metabolic profiles and significantly lower rates of cardiometabolic and psychiatric diseases.
Adipose tissue has a central role in systemic energy balance and the pathogenesis of obesity and its sequelae1,2. In contrast to white adipose tissue, brown adipose tissue (BAT) uses energy to produce heat3. Detectable BAT in humans is associated with decreased prevalence of cardiometabolic diseases4. However, the complete spectrum of health conditions associated with BAT remains unknown, and high-throughput methods to quantify BAT activity in humans are lacking5,6. Here we leveraged big data and artificial intelligence to systematically define the clinical impact of BAT in a cohort of 101,243 patients from a large cancer centre. Our unbiased analyses revealed that, across all diagnoses, cardiovascular and psychiatric diseases were less prevalent in people with BAT. Using a machine learning approach, we semi-automatically quantified BAT activity in approximately 8,700 patients and demonstrated that higher BAT activity, especially in the axillary depot, is associated with lower odds of cardiometabolic diseases and healthier white fat distribution. People with BAT also exhibited more favourable glycaemic parameters, lipid profiles, inflammatory markers and echocardiographic indices. Analysis of medication usage demonstrated that angiotensin receptor blocker use was positively associated with BAT presence. As proof of concept, we showed that the angiotensin receptor blocker losartan increased brown adipocyte activity and whole-body energy expenditure. Altogether, our studies harnessing artificial intelligence and big data identify new clinical phenotypes linked to BAT and serve as a platform for drug repurposing to activate this tissue in humans. Artificial intelligence-enabled quantification and analyses of brown adipose tissue (BAT) activity uncover links between BAT and a healthier metabolic profile along with lower rates of psychiatric disease, and can identify pharmacologic agents that could be repurposed to activate this tissue in humans.
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Gómez-Banoy et al. (2026) conducted an observational in Patients undergoing 18F-FDG-PET-CT scans (n=101,243). Presence of brown adipose tissue (BAT) vs. Absence of detectable brown adipose tissue (BAT-) was evaluated on Prevalence of Type 2 Diabetes (OR 0.42, 95% CI 0.35-0.50, p=<0.001). The presence of brown adipose tissue was associated with a significantly lower prevalence of type 2 diabetes (OR 0.42) and chronic ischemic heart disease (OR 0.53) compared to patients without BAT.
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