Liver and Plasma concentrations of Per- and Polyfluoroalkyl Substances in Adolescents from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study

Background and aim Exposure to per- and poly-fluoroalkyl substances (PFAS) is ubiquitous due to their persistence in the environment and in humans. Extreme weight loss has been shown to influence concentrations of circulating persistent organic pollutants (POPs). Using data from the multi-center perspective Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort, we compared concentrations of liver and plasma-PFAS and investigated changes in plasma-PFAS in adolescents after bariatric surgery. Methods Adolescents (Mean age = 17.1 years, SD = 1.5 years) undergoing bariatric surgery were enrolled in the Teen-LABS study. Plasma-PFAS were measured at the time of surgery and then 6-, 12-, and 36 months post-surgery. PFAS was measured in liver tissue from biopsies collected at the time of bariatric surgery. Concentrations of liver and plasma-PFAS were compared using Spearman’s rank correlation coefficients. Linear mixed effect models were used to evaluate longitudinal changes in plasma-PFAS after the time of bariatric surgery. Results This study included 186 adolescents at baseline with severe obesity who underwent bariatric surgery between 2007 and 2012. Baseline plasma and liver-PFAS concentrations were found to be strongly positively correlated (ρ = 0.76-0.91). Models of longitudinal changes in plasma-PFAS after bariatric surgery revealed an increase in plasma-PFAS concentrations from the time of surgery to 6 months (p<0.05 for all plasma-PFAS except PFHxS) and a decline in PFAS concentrations from 6 months to 36 months (p<0.05 for all plasma-PFAS). Conclusions Bariatric surgery in adolescents was associated with an initial increase in circulating PFAS at 6 months following surgery, followed by continuing decline in concentration to 36 months following bariatric surgery. High correlations between liver and plasma-PFAS concentrations suggest that measurements in plasma are a good proxy for PFAS accumulation in the liver and potential liver-specific PFAS effects. Keywords: PFAS, children, environmental health, weight loss