Background

Lipophilic persistent organic pollutants (POPs) are stored in adipose tissues and released in case of weight loss.

Objectives

To analyze the kinetics and characteristics of this release during drastic weight loss after bariatric surgery and compare the results in case of women of childbearing age (WCBA) with critical blood concentration thresholds.

Methods

100 morbidly obese patients (73 women including 53 of childbearing age and 27 men) were screened before and 3, 6 and 12 months after bariatric surgery for serum concentrations of 67 congeners or metabolites of banned or not yet banned organohalogenated persistent pollutants, including highly lipophilic polychlorobiphenyls (PCBs), organochlorine pesticides (OCPs), brominated flame retardants (BFRs), and less lipophilic perfluorinated alkylated substances (PFASs).

Results

Circulating levels of all chemicals, except PFASs, increased progressively after surgery, reaching after one year an increase between 30 and 139% compared to initial pre-surgical levels; median levels increased for PCB153 from 36.8 to 86.4 ng/g lw (+130%), for dichlorodiphenyldichloroethylene (p,p’-DDE) from 59.8 to 136.1 ng/g lw (+120%), and for hexachlorobenzene (HCB) from 9.8 to 20.3 ng/g lw (+110%). Weight loss averaging 30% of initial body weight at 12 months in both sexes (mean: 40.0 kg for men, 36.1 kg for women), was the main parameter related to the concentration increases (3.1 to 3.6% per kilogram weight loss). They were not dependent on initial BMI, presence of metabolic syndrome or type of surgical procedure but influenced by gender and biochemical properties such as degree of chlorination for PCBs and/or lipophilicity since PFASs did not increase at all. ∑PCB₆ in blood after one year exceeded the critical concentration threshold for 24.5% women of childbearing age (13/53) versus 3.6% (2/53) before surgery.

Discussion

Massive weight loss within the first year following bariatric surgery is associated with a sustained increase of circulating lipophilic POPs. Short- and long-term consequences should be considered, mostly for childbearing age obese women, because of potential health risks for the future fetus and breastfeeding infant.

中文翻译：

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减肥手术后减肥引起的持久性有机污染物的持续血流释放：对育龄妇女的影响

背景

亲脂性持久性有机污染物（POPs）存储在脂肪组织中，并在体重减轻的情况下释放。

目标

为了分析减肥手术后体重急剧下降过程中释放的动力学和特征，并将育龄妇女（WCBA）的结果与临界血药浓度阈值进行比较。

方法

在减肥手术之前和之后，3、6和12个月筛查了100名病态肥胖患者（73名女性，其中育龄的53岁，男性27名），以筛查67种同类或禁忌或尚未禁忌的有机卤代持久性污染物（包括高度亲脂性）的代谢产物的血清浓度多氯联苯（PCB），有机氯农药（OCP），溴化阻燃剂（BFR）和较少亲脂的全氟烷基化物质（PFAS）。

结果

除PFAS外，所有化学物质的循环水平在手术后逐渐增加，一年后与最初的手术前水平相比增加了30％至139％；PCB153的中位数水平从36.8增至86.4 ng / g lw（+ 130％），二氯二苯基二氯乙烯（p，p'-DDE）从59.8增至136.1 ng / g lw（+ 120％），六氯苯（HCB）则从9.8至20.3 ng / g lw（+ 110％）。男女平均在12个月时平均体重下降30％（平均：男性40.0千克，女性36.1千克），是体重增加的主要参数（每千克体重减轻3.1％至3.6％）。他们不依赖最初的BMI，代谢综合征的存在或外科手术类型，但受性别和生化特性（如多氯联苯的氯化程度和/或亲脂性）的影响，因为PFAS根本没有增加。∑PCB一年后血液中的₆超过了24.5％育龄妇女的临界浓度阈值（13/53），而手术前为3.6％（2/53）。

讨论

减肥手术后第一年内大量体重减轻与循环亲脂性POP持续增加有关。应考虑短期和长期后果，主要是对育龄肥胖的妇女，因为这对未来的胎儿和母乳喂养婴儿具有潜在的健康风险。