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Bufano A, Iraci Sareri G, Ciuoli C, Cantara S, Marzocchi C, Benenati N, Batzibal MS, Bombardieri A, Caprio S, Sannino I, Voglino C, Tirone A, Vuolo G, Dalmiglio C, Castagna MG. Normalization of Spexin Levels in Patients with Obesity Submitted to Bariatric Surgery. Obes Surg 2024; 34:449-455. [PMID: 38072893 DOI: 10.1007/s11695-023-06972-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 01/26/2024]
Abstract
PURPOSE Spexin is expressed by white fat tissue and other endocrine organs. A negative correlation between spexin and gluco-lipidic metabolism, energy homeostasis, and food intake has been reported. The objectives of this study are (1) to compare spexin levels between patients with obesity (study group) and normal-weight subjects (control group); (2) to evaluate spexin levels after bariatric surgery; and (3) to identify a correlation between spexin and weight loss/metabolic profile of patients with obesity. MATERIALS AND METHODS We examined 53 patients with obesity (mean BMI 48.5 ± 9.4 kg/m2) who underwent bariatric surgery, compared to 55 normal-weight subjects. Serum spexin levels were assessed at baseline (study and control group) and at 3 and 6 months after surgery in patients with obesity. RESULTS Spexin at baseline was significantly lower in the study group (p < 0.0001). At 3 and 6 months after bariatric surgery, spexin significantly increased compared to pre-surgical levels (p < 0.001) reaching control group levels (p = 0.08) at 6 months. In patients with obesity, pre-surgical spexin was similar in patients with and without comorbidities. No correlation between spexin and C-reactive protein (p = 0.8) and HOMA index (p = 0.5) was found. A significant negative correlation between age and pre-surgical spexin was observed (p = 0.03). At multivariable analysis, no correlation between Δ spexin and pre-surgery BMI, HOMA index, age, and 6-month TWL% was found. CONCLUSION This study demonstrates that patients with obesity have significantly lower spexin levels than healthy subjects. After surgery, spexin levels of the study group become similar to those observed in the normal-weight group.
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Affiliation(s)
- Annalisa Bufano
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Gabriele Iraci Sareri
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Cristina Ciuoli
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Silvia Cantara
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Carlotta Marzocchi
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Nicoletta Benenati
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Maria Simon Batzibal
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Alessio Bombardieri
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Sonia Caprio
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Ida Sannino
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Costantino Voglino
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Andrea Tirone
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Giuseppe Vuolo
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Cristina Dalmiglio
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Maria Grazia Castagna
- Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Viale Bracci, 16, 53100, Siena, Italy.
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Pakyurek H, Aykota MR, Kilic-Erkek O, Ozban M, Senol H, Bor-Kucukatay M. Investigation of time-dependent alterations in adipokine levels and endoplasmic reticulum stress markers in obese patients with laparoscopic sleeve gastrectomy. Life Sci 2023; 330:121987. [PMID: 37541576 DOI: 10.1016/j.lfs.2023.121987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND AND AIMS We aimed to investigate the time-dependent alterations of serum, adipose tissue WISP1, Nrg4, asprosin, SPX adipokines and serum ER stress markers GRP78, XBP1, ATF6, CHOP in obese patients who underwent laparoscopic sleeve gastrectomy (LSG). MATERIALS AND METHODS Morbidly obese patients (n = 19) and normal-weight individuals (n = 19) were compared. Preoperative (control, obese) and postoperative 1st, 3rd and 6th month (obese) follow-up measurements were obtained. Levels of adipokines, ER stress markers were measured with commercial kits. RESULTS Body mass index (BMI), total fat, trunk fat mass, fat percentage of obese patients decreased after LSG. Postoperative serum glucose, insulin, HOMA-IR, triglyceride levels of obese patients decreased, HDL increased. In obese patients, preoperative LDL and total cholesterol, which were not different from control, were higher in the postoperative 6th month measurements. Omentum WISP1, subcutaneous adipose tissue WISP1 and SPX, and serum WISP1, asprosin, CHOP levels were higher, Nrg4 lower in obese patients. Serum Nrg4 was still lower in the postoperative 1st month measurements, while WISP1 was higher in the 3rd and asprosin in the 3rd, 6th months compared to control. 1st and 3rd month ATF6 and 3rd month CHOP concentrations were lower than preoperative values. Serum CHOP measured at the 6th month was significantly higher than control. Negative correlations were observed between serum Nrg4 and fat percentage, TG concentration. CHOP was negatively correlated with fat percentage. CONCLUSION The correlations between changes in serum Nrg4, CHOP and fat percentage highlight the roles of Nrg4 and CHOP in the fat loss following LSG.
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Affiliation(s)
- H Pakyurek
- Pamukkale University, Faculty of Medicine, Department of Physiology, Denizli, Turkey
| | - M R Aykota
- Pamukkale University, Faculty of Medicine, Department of General Surgery, Denizli, Turkey
| | - O Kilic-Erkek
- Pamukkale University, Faculty of Medicine, Department of Physiology, Denizli, Turkey
| | - M Ozban
- Pamukkale University, Faculty of Medicine, Department of General Surgery, Denizli, Turkey
| | - H Senol
- Pamukkale University, Faculty of Medicine, Department of Biostatistics, Denizli, Turkey
| | - M Bor-Kucukatay
- Pamukkale University, Faculty of Medicine, Department of Physiology, Denizli, Turkey.
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Circulating Spexin Is Associated with Body Mass Index and Fat Mass but Not with Physical Activity and Psychological Parameters in Women across a Broad Body Weight Spectrum. J Clin Med 2022; 11:jcm11175107. [PMID: 36079049 PMCID: PMC9457358 DOI: 10.3390/jcm11175107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/19/2022] [Accepted: 08/27/2022] [Indexed: 11/24/2022] Open
Abstract
Spexin (SPX) is a novel, widely expressed peptide, with anorexigenic effects demonstrated in animal models and negatively correlated with body mass index (BMI) in humans. It increases locomotor activity in rodents and is elevated in human plasma following exercise. Studies have also shown an effect of stress and anxiety on SPX’s expression in different brain structures in animals. The relationships between plasma SPX and physical activity, body composition, and patient-reported outcomes such as perceived stress, depressiveness, anxiety, and eating behaviors are unknown and were examined in this study over a wide BMI range. A total of 219 female (n = 68 with anorexia nervosa; n = 79 with obesity; n = 72 with normal weight) inpatients were enrolled. Perceived stress (PSQ 20), anxiety (GAD 7), depressiveness (PHQ 9), and eating disorder pathology (EDI 2), as well as BMI, bioimpedance analysis, and accelerometry, were measured cross-sectionally at the beginning of treatment and correlated with plasma SPX levels (measured by ELISA) obtained at the same time. Plasma SPX levels were negatively associated with BMI (r = −0.149, p = 0.027) and body fat mass (r = −0.149, p = 0.04), but did not correlate with perceived stress, anxiety, depressiveness, eating behavior, energy expenditure, and physical activity (p > 0.05). The results replicate the negative correlation of SPX with BMI and fat mass, but do not support the hypothesis that peripheral SPX plays a role in the regulation of stress, depressiveness, anxiety, eating behavior, or physical activity.
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Türkel İ, Memi G, Yazgan B. Impact of spexin on metabolic diseases and inflammation: An updated minireview. Exp Biol Med (Maywood) 2022; 247:567-573. [PMID: 35068225 PMCID: PMC9014522 DOI: 10.1177/15353702211072443] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
Spexin (SPX) is a 14 amino acid length peptide hormone which was discovered using bioinformatic tools. It is extensively expressed in central and peripheral tissues and secreted into circulation in response to metabolic stress. Recent studies revealed that SPX acts as a multifunctional peptide in various metabolic processes such as body weight, food intake, energy balance, glucose and lipid metabolism, lipid storage, salt-water balance, and arterial blood pressure. Endogenous SPX is sensitive to metabolic changes, and circulating levels of SPX have been shown to be reduced in chronic diseases such as obesity, diabetes, and insulin resistance. Moreover, in fish and rodent models, systemic SPX treatment has positive effects on metabolism including reduced food intake, fat mass, lipid accumulation, and inflammation, improved insulin sensitivity, energy expenditure, and organ functions which are underlying mechanisms in diseases. Taken together, these findings suggest that SPX is a potential drug target for the development of new pharmacological strategies to cure metabolic diseases. This review focuses on metabolo-protective properties of SPX and discusses novel insights into the biology and mechanism of SPX in the pathogenesis of diabetes, obesity, non-alcoholic fatty liver disease, metabolic syndrome, polycystic ovary syndrome, cardiovascular diseases, and kidney diseases, which are considerable global health problems.
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Affiliation(s)
- İbrahim Türkel
- Division of Exercise and Sport
Physiology, Faculty of Sport Sciences, Hacettepe University, Ankara 06800,
Turkey
| | - Gülsün Memi
- Department of Physiology, Faculty of
Medicine, Adıyaman University, Adıyaman 02040, Turkey
| | - Burak Yazgan
- Department of Medical Services and
Techniques, Sabuncuoğlu Serefeddin Health Services Vocational School, Amasya
University, Amasya 05100, Turkey
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Gu L, Yan S, Huang Y, Yang J, Peng Y, Wang Y. Serum spexin differed in newly diagnosed type 2 diabetes patients according to body mass index and increased with the improvement of metabolic status. Front Endocrinol (Lausanne) 2022; 13:1086497. [PMID: 36589830 PMCID: PMC9794602 DOI: 10.3389/fendo.2022.1086497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to explore serum spexin levels in newly diagnosed type 2 diabetes mellitus (T2DM) patients with different body mass indexes (BMIs) and to investigate the changes of spexin after improvement of metabolic indicators. METHODS A total of 323 newly diagnosed T2DM patients from national Metabolic Management Center (MMC) in Shanghai General Hospital were recruited. T2DM patients were categorized into three groups: diabetes with obesity group (DM-OB group, BMI≥28 kg/m2, n=89), diabetes with overweight group (DM-OV group, 24≤BMI<28 kg/m2, n=161), and diabetes with normal weight group (DM-NW group, 18≤BMI<24 kg/m2, n=73). In addition, 41 volunteers with normal glucose tolerance (NGT) were used as controls. Spexin and metabolic parameters were compared at baseline, and changes after MMC follow-up in 100 DM patients were investigated. RESULTS In the DM-OB group, the level of spexin was significantly lower than that in the DM-OV group and the DM-NW group (P < 0.01). Spexin was significantly negatively related to body mass index (BMI, β=-0.214, P<0.001), waist circumference (β=-0.249, P<0.001), visceral fat area (VFA, β=-0.214, P<0.001), and subcutaneous fat area (SFA, β=-0.265, P<0.001) after adjustment for age and sex. Among all the metabolic indicators, the decline in BMI in the DM-OB group was the most obvious among those in the three groups (-3.7 ± 0.8 kg/m2 vs. -0.9 ± 0.3 kg/m2 vs. 0.7 ± 0.6 kg/m2, P<0.01) after one year of MMC standardized management. The serum spexin level in the DM-OB group increased the most (1.00 ± 0.10 ng/mL vs. 0.49 ± 0.06 ng/mL in DM-OV group and 0.58 ± 0.09 ng/mL in DM-NW group, P < 0.001). CONCLUSIONS Serum spexin differed in newly diagnosed T2DM patients according to BMI and was lowest in the DM-OB group. With the improvement of metabolic indicators, especially the decline in BMI, serum spexin increased significantly after MMC management.
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Spexin: Its role, regulation, and therapeutic potential in the hypothalamus. Pharmacol Ther 2021; 233:108033. [PMID: 34763011 DOI: 10.1016/j.pharmthera.2021.108033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 12/14/2022]
Abstract
Spexin is the most recently discovered member of the galanin/kisspeptin/spexin family of peptides. This 14-amino acid peptide is highly conserved and is implicated in homeostatic functions including, but not limited to, metabolism, energy homeostasis, and reproduction. Spexin is expressed by neurons in the hypothalamus, which coordinate energy homeostasis and reproduction. Critically, levels of spexin appear to be altered in disorders related to energy homeostasis and reproduction, such as obesity, diabetes, and polycystic ovarian syndrome. In this review, we discuss the evidence for the involvement of spexin in the hypothalamic control of energy homeostasis and reproduction. The anorexigenic properties of spexin have been attributed to its effects on the energy-regulating neuropeptide Y/agouti-related peptide neurons and proopiomelanocortin neurons. While the role of spexin in reproduction remains unclear, there is evidence that gonadotropin-releasing hormone expressing neurons may produce and respond to spexin. Furthermore, we discuss the disorders and concomitant treatments, which have been reported to alter spexin expression, as well as the underlying signaling mechanisms that may be involved. Finally, we discuss the biochemical basis of spexin, its interaction with its cognate receptors, and how this information can be adapted to develop therapeutics for disorders related to the alteration of energy homeostasis and reproduction.
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