Air pollution, weight loss and metabolic benefits of bariatric surgery: a potential model for study of metabolic effects of environmental exposures

作者：Ghosh R; Gauderman W J; Minor H; Youn H A; Lurmann F; Cromar K R; Chatzi L; Belcher B; Fielding C R; McConnell R

来源：Pediatric Obesity, 2018, 13(5): 312-320.

DOI：10.1111/ijpo.12210

<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Emerging experimental evidence suggests that air pollution may contribute to development of obesity and diabetes, but studies of children are limited.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>We hypothesized that pollution effects would be magnified after bariatric surgery for treatment of obesity, reducing benefits of surgery.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In 75 obese adolescents, excess weight loss (EWL), high‐density lipoprotein (HDL) cholesterol, triglycerides, alkaline phosphatase (ALP) and hemoglobin A1c (HbA<jats:sub>1c</jats:sub>) were measured prospectively at baseline and following laparoscopic adjustable gastric banding (LAGB). Residential distances to major roads and the average two‐year follow‐up exposure to particulate matter &lt;2.5 μm (PM<jats:sub>2.5</jats:sub>), nitrogen dioxide (NO<jats:sub>2</jats:sub>) and ozone were estimated. Associations of exposure with change in outcome and with attained outcome two years post‐surgery were examined.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Major‐roadway proximity was associated with reduced EWL and less improvement in lipid profile and ALP after surgery. NO<jats:sub>2</jats:sub> was associated with less improvement in HbA<jats:sub>1c</jats:sub> and lower attained HDL levels and change in triglycerides over two years post‐surgery. PM<jats:sub>2.5</jats:sub> was associated with reduced EWL and reduced beneficial change or attained levels for all outcomes except HbA<jats:sub>1c</jats:sub>.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Near‐roadway, PM<jats:sub>2.5</jats:sub> and NO<jats:sub>2</jats:sub> exposures at levels common in developed countries were associated with reduced EWL and metabolic benefits of LAGB. This novel approach provides a model for investigating metabolic effects of other exposures.</jats:p></jats:sec>

• 出版日期2018-5