Brown Adipose Tissue, Adiposity, and Metabolic Profile in Preschool Children

J Clin Endocrinol Metab. 2021 Sep 27;106(10):2901-2914. doi: 10.1210/clinem/dgab447.


Context: An inverse relationship between brown adipose tissue (BAT) and obesity has previously been reported in older children and adults but is unknown in young children.

Objective: We investigated the influence of BAT in thermoneutral condition on adiposity and metabolic profile in Asian preschool children.

Design, setting, and participants: A total of 198 children aged 4.5 years from a prospective birth cohort study, Growing Up in Singapore Towards Healthy Outcomes (GUSTO) were successfully studied with water-fat magnetic resonance imaging of the supraclavicular and axillary fat depot (FDSA). Regions within FDSA with fat-signal-fraction between 20% and 80% were considered BAT, and percentage BAT (%BAT; 100*BAT volume/ FDSA volume) was calculated.

Main outcome measures: Abdominal adipose tissue compartment volumes, ectopic fat in the soleus muscle and liver, fatty liver index, metabolic syndrome scores, and markers of insulin sensitivity.

Results: A 1% unit increase in %BAT was associated with lower body mass index, difference (95% CI), -0.08 (-0.10, -0.06) kg/m2 and smaller abdominal adipose tissue compartment volumes. Ethnicity and sex modified these associations. In addition, each unit increase in %BAT was associated with lower ectopic fat at 4.5 years in the liver, -0.008% (-0.013%, -0.003%); soleus muscle, -0.003% (-0.006%, -0.001%) of water content and lower fatty liver index at 6 years.

Conclusions: Higher %BAT is associated with a more favorable metabolic profile. BAT may thus play a role in the pathophysiology of obesity and related metabolic disorders. The observed ethnic and sex differences imply that the protective effect of BAT may vary among different groups.

Keywords: adiposity; brown fat; metabolic profile; preschool children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Fat / metabolism
  • Adipose Tissue, Brown / metabolism*
  • Adiposity / physiology*
  • Asian People / statistics & numerical data
  • Body Mass Index
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Insulin Resistance
  • Liver / metabolism
  • Magnetic Resonance Imaging
  • Male
  • Metabolic Diseases / metabolism*
  • Metabolome / physiology*
  • Muscle, Skeletal / metabolism
  • Pediatric Obesity / metabolism*
  • Prospective Studies
  • Singapore