SAT-709 Identifying Pharmacologic Regulators Of Brown Adipose Tissue In Humans

Abstract Disclosure: T. Lam: None. N. Gomez-Banoy: None. P. Cohen: None. Adipose tissue is a major regulator of energy homeostasis and a key player in the pathogenesis of obesity-associated cardiometabolic diseases. There are two types of adipose tissue: white adipose tissue, which stores energy in the form of triglycerides in the subcutaneous and visceral compartments, and brown adipose tissue (BAT), which utilizes energy to produce heat via non-shivering thermogenesis. Our previous study found that humans with detectable BAT by fluorodeoxyglucose-positron emission tomography (FDG-PET) scans have decreased prevalence of type 2 diabetes, HTN, and CAD (1). Despite the growing evidence that BAT protects against metabolic diseases, our knowledge of pharmacologic agents that could activate this tissue in humans is limited. To identify candidate medications that increase BAT, we retrospectively studied 1096 patients from Memorial Sloan Kettering Cancer Center (MSK) who had longitudinal evidence of BAT activation, as determined by the absence of BAT in an initial FDG-PET scan followed by having detectable BAT in their subsequent scan (BAT positive group). A propensity score-matched cohort of patients (n=2180) who had two consecutive FDG-PET scans without detectable BAT was created as a control (BAT negative group). We proceeded to extract data on home medications 1 month prior to both scans per group to analyze changes in medication usage in BAT positive versus BAT negative patients. Our analysis was restricted to 125 medications identified in our previous study. The number of patients who started each medication between their two scans was obtained and compared between the two groups via odds ratios. Statistical analysis was performed using Chi-square tests. Our results show that the incidence of starting nine medications (inhaled fluticasone, hydrochlorothiazide, vitamin D3, vitamin D2, exemestane, aspirin, amlodipine, letrozole, pantoprazole) was higher in the BAT positive group compared to the BAT negative group (OR >1, p<0.05), indicating that usage of these medications was associated with BAT activation. On the other hand, the incidence of starting escitalopram was significantly lower in the BAT positive group versus BAT negative group, as shown previously by others (2). In summary, our unique longitudinal analyses on medication usage have unraveled candidate medications that can potentially be repurposed to activate BAT in humans. References: (1) Becher T, Palanisamy S, Kramer DJ, Eljalby M, Marx SJ, Wibmer AG, et al. Brown adipose tissue is associated with cardiometabolic health. Nat Med. 2021;27(1):58-65. (2) Suchacki KJ, Ramage LE, Kwok TC, Kelman A, McNeill BT, Rodney S, Keegan M, Gray C, MacNaught G, Patel D, Fletcher AM, Simpson JP, Carter RN, Semple RK, Homer NZM, Morton NM, van Beek EJR, Wakelin SJ, Stimson RH. The serotonin transporter sustains human brown adipose tissue thermogenesis. Nat Metab. 2023 Aug;5(8):1319-1336. Presentation: Saturday, July 12, 2025