A recent study from the University of Southern California (USC) finds that exposure to per- and polyfluoroalkyl substances (PFAS), commonly referred to as “forever chemicals,” may limit improvements in blood sugar levels following bariatric surgery in adolescents. The research shows that teenagers who had higher levels of these substances in their blood prior to undergoing the surgery exhibited significantly smaller enhancements in their metabolic health over a five-year period.
The findings, published in the journal Environmental Endocrinology, highlight the importance of monitoring PFAS exposure as a potential factor influencing the success of bariatric procedures. Blood sugar levels, specifically fasting glucose and hemoglobin A1c (HbA1c), are key indicators of surgical success. The study suggests that, for some patients, these metabolic benefits may diminish within a decade.
Impact of PFAS on Metabolic Health
Researchers measured blood levels of eight types of PFAS in 186 adolescents aged 19 or younger who participated in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS). The study tracked these individuals’ metabolic health at intervals of six months, one year, three years, and five years following their operations.
Results indicated that while most participants experienced significant improvements in metabolic health post-surgery, those with elevated PFAS levels showed a troubling trend. Specifically, their HbA1c levels increased by an average of 0.27 percentage points three years after surgery. In medical terms, an HbA1c level under 5.7% is considered normal, making this increase noteworthy.
A particular substance, perfluorohexanesulfonic acid (PFHxS), was identified as having a significant negative effect. Teens with higher exposure to PFHxS experienced annual increases in HbA1c of 0.15 percentage points, which could potentially lead to prediabetes or type 2 diabetes within a few years. Similarly, PFHxS exposure correlated with a rise in fasting glucose levels, suggesting that the initial improvements in blood sugar could be reversed over time.
Future Directions and Implications
The study’s lead researcher, Brittney Baumert, PhD, MPH, emphasized the need for collaboration between environmental epidemiologists and physicians to improve patient outcomes. “Targeted precision medicine based on our growing knowledge of PFAS and environmental health may help ensure patients have the greatest success with this weight loss intervention,” Baumert stated.
The research team is pursuing further investigations to explore the biological mechanisms behind these observations. They aim to determine how PFAS exposure can affect metabolism and recovery post-surgery. Researchers highlighted the necessity of integrating environmental factors into treatment protocols, suggesting that screening for PFAS levels before surgery could identify patients who may require additional interventions to maintain healthy blood sugar levels.
“Our findings show that metabolic recovery is influenced not only by clinical treatment but also by environmental factors,” said Vaia Lida Chatzi, MD, PhD, director of the ShARP Center at USC. The ShARP Center aims to identify barriers to metabolic health during critical developmental periods, particularly in adolescents.
The study’s implications extend beyond bariatric surgery, suggesting that PFAS may interfere with the body’s ability to manage glucose levels more broadly. As the body of evidence linking PFAS to metabolic health continues to grow, researchers advocate for further studies to clarify these relationships and improve public health outcomes.
In conclusion, this research underscores the complexity of metabolic health and the need to consider environmental exposures when evaluating patient outcomes in bariatric surgery. The potential for PFAS to hinder recovery highlights an area of critical concern that warrants further study and action.
