{"doi":"10.1210/clinem/dgz314","title":"Pheochromocytoma and Paraganglioma Patients With Poor Survival Often Show Brown Adipose Tissue Activation","abstract":"CONTEXT: Pheochromocytomas/paragangliomas (PPGLs) are neuroendocrine tumors that can secrete norepinephrine (NE). Brown adipose tissue (BAT) activation is mediated through the action of NE on β-adrenoceptors (β-ARs). In some malignancies, BAT activation is associated with higher cancer activity. OBJECTIVE: To study the relationship between BAT activation and PPGL clinical outcomes. DESIGN: A retrospective case-control study that included 342 patients with PPGLs who underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET/CT) imaging at the National Institutes of Health (NIH). We excluded all patients with parasympathetic tumors and those who underwent 18F-FDG PET/CT after PPGL resection. Scans of 205 patients were reviewed by 2 blinded nuclear medicine physicians; 16 patients had BAT activation on 18F-FDG PET/CT [7.80%; age 27.50 (15.00-45.50) years; 10 female/6 male; body mass index [BMI] 24.90 [19.60-25.35] kg/m2). From the remaining 189 patients, we selected 36 matched controls (age 34.4 [25.4-45.5] years; 21 female/15 male; BMI 25.0 [22.0-26.0] kg/m2). PRIMARY OUTCOME MEASURE: Overall survival. RESULTS: The presence of active BAT on 18F-FDG PET/CT was associated with decreased overall survival when compared with the control group (HRz 5.80; 95% CI, 1.05-32.05; P = 0.02). This association remained significant after adjusting for the SDHB mutation. Median plasma NE in the BAT group was higher than the control group [4.65 vs 0.55 times above the upper limit of normal; P < 0.01]. There was a significant association between higher plasma NE levels and mortality in PPGLs in both groups. CONCLUSIONS: Our findings suggest that the detection of BAT activity in PPGL patients is associated with higher mortality. We suggest that BAT activation could either be reflecting or contributing to a state of increased host stress that may predict poor outcome in metastatic PPGL.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2020,"id":98257,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":31,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9575,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":302290,"name":"Abhishek Jha","orcid":"0000-0001-9161-0450","position":1,"is_corresponding":false},{"id":374115,"name":"Ahmed Hamimi","orcid":"0000-0001-6688-1937","position":2,"is_corresponding":false},{"id":436145,"name":"Adel Mandl","orcid":"0000-0002-2852-7280","position":3,"is_corresponding":false},{"id":289376,"name":"Iris R. Hartley","orcid":"0000-0003-1029-3284","position":4,"is_corresponding":false},{"id":108961,"name":"Sriram Gubbi","orcid":"0000-0002-9263-1381","position":5,"is_corresponding":false},{"id":484972,"name":"Mayank Patel","orcid":"0000-0002-6609-5394","position":6,"is_corresponding":false},{"id":351470,"name":"Melissa Gonzales","orcid":"0000-0002-1883-1967","position":7,"is_corresponding":false},{"id":230214,"name":"David Taïeb","orcid":"0000-0002-0400-7600","position":8,"is_corresponding":false},{"id":484973,"name":"A. Cahid Civelek","orcid":"0000-0003-4637-6292","position":9,"is_corresponding":false},{"id":374116,"name":"Ahmed M. Gharib","orcid":"0000-0002-2476-481X","position":10,"is_corresponding":false},{"id":355656,"name":"Sungyoung Auh","orcid":"0000-0002-3901-0869","position":11,"is_corresponding":false},{"id":231159,"name":"Alana O’Mara","orcid":"0000-0002-7250-7586","position":12,"is_corresponding":false},{"id":70229,"name":"Karel Pacák","orcid":"0000-0002-3541-3767","position":13,"is_corresponding":false},{"id":60607,"name":"Aaron M. Cypess","orcid":"0000-0002-5570-9346","position":14,"is_corresponding":false},{"id":231164,"name":"Zahraa Abdul Sater","orcid":"0000-0003-3069-7788","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-18T22:36:34.157932Z","pmid":"31903484","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}