Normalization of Spexin Levels in Patients with Obesity Submitted to Bariatric Surgery

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/m 2 ) 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. Graphical Abstract