Jansen Aina, Lyche Jan L, Polder Anuschka, Aaseth Jan, Skaug Marit Aralt
a Center for Morbid Obesity , Department of Surgery, Innlandet Hospital Trust , Gjøvik , Norway.
b Department of Food Safety and Infection Biology , Norwegian University of Life Sciences (NMBU) , Campus Adamstuen, Oslo , Norway.
J Toxicol Environ Health B Crit Rev. 2017;20(1):22-37. doi: 10.1080/10937404.2016.1246391. Epub 2017 Jan 4.
Lipophilic persistent organic pollutants (POP) are stored in adipose tissue. Following rapid weight loss such as when induced by bariatric surgery, an increased release of potential harmful lipophilic compounds into the blood circulation may occur. Weight reduction is recommended for overweight and obese individuals in order to decrease risk of weight-related health problems. However, in cases of significant weight reduction POP become mobilized chemicals and consequently may adversely affect health, including endocrine disruption. The objective of the present investigation was to estimate quantitatively the level of mobilization of POP following weight loss over time. According to literature search criteria, 17 studies were identified with 2061 participants. Data from 5 of the studies with 270 participants were used to assess the change in blood levels of POP in percent per kilogram weight loss. Weight loss in the included studies varied from 4.4 to 64.8 kg. In all studies, the majority of POP concentrations in blood were found to rise following weight reduction. Blood concentrations following weight reduction were elevated by 2-4% per kilogram weight loss for most POP examined. The increased POP levels were still elevated 12 mo after intervention. Most research in this field, including animal studies, is carried out on a single compound or group of selected compounds, not taking the "cocktail effect" into consideration. This does not reflect the true range of POP to which humans are actually exposed. Few chronic investigations have been published and, in particular, few studies were available that compared the increase in POP concentrations with clinical consequences as individuals lost weight. These limitations call for caution in interpreting results. The benefits of losing weight still far outweigh the potential adverse health risks. However, further studies are recommended to determine the clinical significance of increased blood levels of POPs following rapid and excessive weight loss, particularly for women attending weight reduction treatment before pregnancy.
亲脂性持久性有机污染物（POP）储存于脂肪组织中。在快速减重时，如通过减肥手术诱导的那样，可能会有更多潜在有害的亲脂性化合物释放到血液循环中。建议超重和肥胖个体减重，以降低与体重相关的健康问题风险。然而，在显著减重的情况下，POP会成为可移动的化学物质，从而可能对健康产生不利影响，包括内分泌干扰。本研究的目的是定量评估减重后随时间推移POP的移动水平。根据文献检索标准，确定了17项研究，共2061名参与者。来自其中5项研究的270名参与者的数据用于评估每千克体重减轻时POP血液水平的变化百分比。纳入研究中的体重减轻范围为4.4至64.8千克。在所有研究中，发现大多数POP的血液浓度在减重后上升。对于大多数检测的POP，每千克体重减轻时血液浓度升高2 - 4%。干预后12个月，POP水平仍居高不下。该领域的大多数研究，包括动物研究，都是针对单一化合物或选定的一组化合物进行的，没有考虑“鸡尾酒效应”。这并未反映出人类实际接触的POP的真实范围。已发表的慢性研究很少，特别是很少有研究比较了POP浓度的增加与个体减重时的临床后果。这些局限性要求在解释结果时谨慎。减重的益处仍然远大于潜在的健康风险。然而，建议进一步研究以确定快速和过度减重后血液中POP水平升高的临床意义，并在怀孕前接受减重治疗的女性中进行，尤其如此。
