Roux-en-Y gastric bypass surgery in youth with severe obesity: 1-year longitudinal changes in spexin

Seema Kumar, MD Jobayer Hossain, Thomas Inge, P. Babu Balagopal*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: Spexin is a novel peptide predominantly produced in human white adipose tissue and has recently been implicated as a potential signal in the regulation of body weight, energy homeostasis, and satiety. The effect of bariatric surgery on spexin is unknown. Objectives: To study the effect of Roux-en-Y gastric bypass (RYGB) surgery on endogenous spexin concentration and various risk factors of type 2 diabetes and cardiovascular disease in youth with severe obesity. Setting: University hospital, United States Methods: Spexin, body mass index (BMI), insulin, glucose, total and high molecular weight adiponectin, leptin, and high sensitivity C- reactive protein were measured longitudinally (baseline, 6 mo, and 12 mo) after RYGB surgery in girls with severe obesity (n = 12; age = 16.7 ± 1.5 years; BMI = 51.6 ± 2.9 kg/m2). Results: Serum spexin concentration increased (P =.01) at 6 months after surgery and stabilized afterward. Spexin level correlated negatively with homeostatic model assessment insulin resistance, HOMA-IR (Spearman correlation r = −.796, P <.001) and positively with high molecular weight adiponectin (Spearman correlation r =.691, P =.011). The change in spexin concentration, from baseline to 6 months after surgery, was inversely correlated with the corresponding change in BMI (Spearman correlation r = −.573, P =.051). Furthermore, the 6-month changes in spexin and HOMA-IR were inversely correlated (slope [standard error, SE] = −.0084 (.0019), P =.001)], even after adjusting for the change in BMI. Conclusions: The enhancement of circulating spexin concentration in response to RYGB and correlations with beneficial postoperative changes in various adipokines in youth are novel findings that require further validation.

Original languageEnglish (US)
Pages (from-to)1537-1543
Number of pages7
JournalSurgery for Obesity and Related Diseases
Issue number10
StatePublished - Oct 2018
Externally publishedYes


  • Roux-en-Y gastric bypass
  • Severe obesity
  • Spexin

ASJC Scopus subject areas

  • Surgery


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