Blood biomarkers forecast long-term blood pressure improvement after adolescent bariatric surgery

A groundbreaking study published in Hypertension, the journal of the American Heart Association, has identified a set of blood-based biomarkers that can predict improvements in blood pressure five years after adolescents underwent metabolic bariatric surgery. This is the first study to demonstrate that measures of a patient's unique biological profile taken before weight loss surgery can outperform traditional demographic and clinical risk factors in forecasting long-term blood pressure outcomes.

"This is the first time blood-based biomarkers have been identified that predict which adolescents are most likely to experience improvements in blood pressure after bariatric surgery," said Thomas H. Inge, MD, PhD, Surgeon-in-Chief at Ann & Robert H. Lurie Children's Hospital of Chicago and Professor of Surgery at Northwestern University Feinberg School of Medicine, co-author and principal investigator of the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study, which includes 108 teens who participated in this research.

Compared to standard blood biomarkers, the "omics" approach used in this study, which involves analysis of thousands of the individual's small molecules and proteins, could allow a more precise way to predict who will respond well to weight loss surgery. This method allows clinicians to consider other therapies in adolescents who are unlikely to benefit from surgery.

"High blood pressure in adolescence can set the stage for lifelong heart disease, yet we still know little about why some young people respond better to treatment than others," said the study's senior author, Vaia Lida Chatzi, MD, PhD, Professor of Population and Public Health Sciences and Pediatrics and Director of the Center for Translational Exposomics Research (CTER) at the Keck School of Medicine of USC.

Using AI, researchers found 10 molecules in the pre-surgery blood samples that were associated with blood pressure outcomes five years later. This omics data was a better predictor of blood pressure improvements than traditional risk factors, such as sex, race, socioeconomic status and pre-surgery body mass index (BMI) and blood pressure.

Six of the 10 molecules were also linked to blood pressure in another group of 79 participants, aged 17-24 with above average BMI, who had not undergone surgery. This finding suggests that the blood-based biomarkers may be broadly applicable.

These data highlight the importance of trans-disciplinary collaboration. Without the multi-year partnership between the Teen-LABS study group and USC Center for Translational Research on Environmental Health, none of this work would have been possible."

Justin Ryder, PhD, co-author, Vice Chair of Research for the Department of Surgery at Lurie Children's and Associate Professor of Surgery and Pediatrics at Northwestern University Feinberg School of Medicine

Next, the team will examine whether omics can forecast other intended benefits of bariatric surgery, such as improvements in diabetes and kidney function.

This work was supported by the National Institute of Environmental Health Sciences [R01ES030364]; the American Heart Association Predoctoral Fellowship [24PRE1187910]; and the National Institutes of Health [U01HG013288, R01ES030691, R01ES03069, R01ES029944 and P30ES007048]. The Teen-LABS consortium is supported by cooperative agreements with the National Institute of Diabetes and Digestive and Kidney Diseases through grants for a clinical coordinating center [UM1DK072493] and the data coordinating center [UM1DK095710].