Air pollution, weight loss and metabolic benefits of bariatric surgery: a potential model for study of metabolic effects of environmental exposures.
BACKGROUND
Emerging experimental evidence suggests that air pollution may contribute to development of obesity and diabetes, but studies of children are limited.


OBJECTIVES
We hypothesized that pollution effects would be magnified after bariatric surgery for treatment of obesity, reducing benefits of surgery.


METHODS
In 75 obese adolescents, excess weight loss (EWL), high-density lipoprotein (HDL) cholesterol, triglycerides, alkaline phosphatase (ALP) and hemoglobin A1c (HbA1c ) 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 <2.5 μm (PM2.5 ), nitrogen dioxide (NO2 ) and ozone were estimated. Associations of exposure with change in outcome and with attained outcome two years post-surgery were examined.


RESULTS
Major-roadway proximity was associated with reduced EWL and less improvement in lipid profile and ALP after surgery. NO2 was associated with less improvement in HbA1c and lower attained HDL levels and change in triglycerides over two years post-surgery. PM2.5 was associated with reduced EWL and reduced beneficial change or attained levels for all outcomes except HbA1c .


CONCLUSIONS
Near-roadway, PM2.5 and NO2 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.
['Ghosh|R|R|0000-0002-3630-6912', 'Gauderman|W J|WJ|', 'Minor|H|H|', 'Youn|H A|HA|', 'Lurmann|F|F|', 'Cromar|K R|KR|', 'Chatzi|L|L|', 'Belcher|B|B|', 'Fielding|C R|CR|', 'McConnell|R|R|']
D000293:Adolescent D000397:Air Pollution D000469:Alkaline Phosphatase D050110:Bariatric Surgery D002648:Child D004781:Environmental Exposure D005260:Female D006442:Glycated Hemoglobin A D006801:Humans D008055:Lipids D008297:Male D009585:Nitrogen Dioxide D010126:Ozone D063766:Pediatric Obesity D011446:Prospective Studies D016896:Treatment Outcome D015431:Weight Loss
Air pollution bariatric surgery obesity lipids metabolic syndrome