Circulating Spexin levels in pregnant women with and without gestational diabetes


  • Coskun Simsir Department of Obstetrics and Gynecology, Liv Hospital Ankara, Ankara, Turkey
  • Muberra Namli Kalem Department of Obstetrics and Gynecology, Bahcesehir University, Istanbul, Turkey
  • Ziya Kalem Department of Obstetrics and Gynecology, Istinye University Liv Hospital Bahcesehir, Istanbul, Turkey
  • Turgut Var Department of Obstetrics and Gynecology, Liv Hospital Ankara, Ankara, Turkey
  • Batuhan Bakirarar Department of Biostatistics, Ankara University, Ankara, Turkey
  • Bugra Coskun Department of Obstetrics and Gynecology, Liv Hospital Ankara, Ankara, Turkey
  • Bora Coskun Department of Obstetrics and Gynecology, Liv Hospital Ankara, Ankara, Turkey



Blood glucose, Gestational diabetes, HbA1c, Lipid profiles, OGTT, Spexin


Background: Several previous studies suggest that SPX plays a role in appetite control and body weight and blood glucose regulation. The aim of this study to determine SPX levels in healthy pregnancies and in gestational diabetes (GDM) and to investigate the association of SPX levels with weight gain and lipid and glucose metabolism in subjects with and without GDM.

Methods: A total of 44 women with GDM and 44 women without GDM were randomly enrolled who applied for GDM screening during the 24-28th week of pregnancy. Demographics, blood glucose and lipid profiles and Spexin levels were compared between groups.

Results: The mean age, BMI, and weight gain during pregnancy were higher in the GDM group. The LDL cholesterol, Hba1c, SPX and glucose levels in response to OGTT were higher in the GDM group. The SPX levels were correlated with Hba1c and blood glucose levels after OGTT, and were not correlated with the age, BMI, weight gain during pregnancy, lipid parameters, and fasting blood glucose levels in the whole study population.

Conclusions: SPX levels were higher in the GDM group compared with non-GDM group and SPX levels were correlated with HbA1c levels and post-OGTT glucose levels but not with fasting glucose levels.


Mirabeau O, Perlas E, Severini C, Audero E, Gascuel O, Possenti R, et al. Identification of novel peptide hormones in the human proteome by hidden Markov model screening. Genome Res. 2007;17(3):320-7.

Walewski JL, Ge F, Lobdell IV H, Levin N, Schwartz GJ, Vasselli JR, et al. Spexin is a novel human peptide that reduces adipocyte uptake of long chain fatty acids and causes weight loss in rodents with diet‐induced obesity. Obesity. 2014;22(7):1643-52.

Porzionato A, Rucinski M, Macchi V, Stecco C, Sarasin G, Sfriso MM, et al. Spexin is expressed in the carotid body and is upregulated by postnatal hyperoxia exposure. In: Arterial Chemoreception. Springer. 2012:207-213.

Rucinski M, Porzionato A, Ziolkowska A, Szyszka M, Macchi V, De Caro R, et al. Expression of the spexin gene in the rat adrenal gland and evidences suggesting that spexin inhibits adrenocortical cell proliferation. Peptides. 2010;31(4):676-82.

Wong MK, Sze KH, Chen T, Cho CK, Law HC, Chu IK, et al. Goldfish spexin: solution structure and novel function as a satiety factor in feeding control. Am J Physiol-Endocrinol Metabol. 2013;305(3):E348-E366.

Liu Y, Li S, Qi X, Zhou W, Liu X, Lin H, et al. A novel neuropeptide in suppressing luteinizing hormone release in goldfish, Carassius auratus. Mol Cellular Endocrinol. 2013;374(1-2):65-72.

Wu H, Lin F, Chen H, Liu J, Gao Y, Zhang X, et al. Ya-fish (Schizothorax prenanti) spexin: identification, tissue distribution and mRNA expression responses to periprandial and fasting. Fish Physiol Biochem. 2016;42(1):39-49.

Ma A, He M, Bai J, Wong MK, Ko WK, Wong AO. Dual role of insulin in spexin regulation: functional link between food intake and spexin expression in a fish model. Endocrinol. 2017;158(3):560-77.

Zheng B, Li S, Liu Y, Li Y, Chen H, Tang H, et al. Spexin suppress food intake in zebrafish: evidence from gene knockout study. Scient Repo. 2017;7(1):14643.

Ma A, Bai J, He M, Wong AO. Spexin as a neuroendocrine signal with emerging functions. General Comp Endocrinol. 2018;265:90-6.

Cinti S. Anatomy and physiology of the nutritional system. Mol Aspects Med Else. 2019:83-100.

Dash S, Xiao C, Morgantini C, Lewis GF. New insights into the regulation of chylomicron production. Ann Rev Nutr. 2015;35:265-94.

Lin CY, Huang T, Zhao L, Zhong LL, Lam WC, Fan BM, et al. Circulating spexin levels negatively correlate with age, BMI, fasting glucose, and triglycerides in healthy adult women. J Endo Society. 2018;2(5):409-19.

Al-Daghri NM, Alenad A, Al-Hazmi H, Amer OE, Hussain SD, Alokail MS. Spexin levels are associated with metabolic syndrome components. Dis Mark. 2018.

Hodges SK, Teague AM, Dasari PS, Short KR. Effect of obesity and type 2 diabetes, and glucose ingestion on circulating spexin concentration in adolescents. Pediater Diabet. 2018;19(2):212-6.

Kumar S, Hossain J, Nader N, Aguirre R, Sriram S, Balagopal PB. Decreased circulating levels of spexin in obese children. J Clin Endocrinol Metabol. 2016;101(7):2931-6.

Gu L, Ma Y, G20u M, Zhang Y, Yan S, Li N, et al. Spexin peptide is expressed in human endocrine and epithelial tissues and reduced after glucose load in type 2 diabetes. Peptides. 2015;71:232-9.

Al-Daghri NM, Al-Hazmi HA, Al-Ajlan A, Masoud MS, Al-Amro A, Al-Ghamdi A, et al. Associations of spexin and cardiometabolic parameters among women with and without gestational diabetes mellitus. Saudi J Biol Sci. 2018;25(4):710-4.

International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82.

Agarwal M, Dhatt G, Othman Y. Gestational diabetes: differences between the current international diagnostic criteria and implications of switching to IADPSG. J Diab Compli. 2015;29(4):544-9.

Kołodziejski P, Pruszyńska-Oszmałek E, Korek E, Sassek M, Szczepankiewicz D, Kaczmarek P. Serum levels of spexin and kisspeptin negatively correlate with obesity and insulin resistance in women. Physiol Res. 2018;67(1):45-56.

Jasmine FG, Walewski J, Anglade D, Berk P. Regulation of hepatocellular fatty acid uptake in mouse models of fatty liver disease with and without functional leptin signaling: roles of NfKB and SREBP-1C and the effects of spexin. In: Seminars in liver disease, Thieme Med Pub. 2016:360-372.

Berk PD, Verna EC. Nonalcoholic fatty liver disease: lipids and insulin resistance. Clinics Liver Dis. 2016;20(2):245-62.

Saglam B, Uysal S, Sozdinler S, Dogan OE, Onvural B. Diagnostic value of glycemic markers HbA1c, 1, 5-anhydroglucitol and glycated albumin in evaluating gestational diabetes mellitus. Ther Adv Endocrinol Metabol. 2017;8(12):161-7.






Original Research Articles