Serum spexin levels as a biomarker for hyperemesis gravidarum: a case-control study

The aim of this study was to evaluate the concentration of serum spexin (SPX) in pregnant women with hyperemesis gravidarum (HG) and to investigate its potential as a biomarker for disease severity.

A case-control study was conducted involving 44 pregnant women diagnosed with HG and 44 healthy controls matched for age, BMI and gestational age. The SPX concentration in serum was measured using an enzyme-linked immunosorbent assay (ELISA). Clinical and biochemical parameters, including ketonuria, thyroid hormones, liver enzymes, renal function tests and inflammatory markers, were also analysed.

Serum SPX concentrations were significantly higher in the HG group compared to controls (1501 ± 635.2 pg/ml vs. 1186 ± 533.6 pg/ml, p = 0.014). HG patients had elevated white blood cell, neutrophil, ALT, AST, free T3 and free T4 levels, while TSH, creatinine and blood urea nitrogen (BUN) were significantly lower compared to controls (p < 0.05 for all comparisons). No significant correlation between SPX levels and gestational age was found. However, SPX levels negatively correlated with TSH (r = -0.275, p = 0.013) and BUN (r = -0.234, p = 0.028), and positively correlated with free T4 (r = 0.237, p = 0.033). ROC analysis identified a SPX cutoff level of > 1541 pg/ml to predict HG with a sensitivity of 57 % and a specificity of 73 % (AUC = 0.648, p = 0.013).

Although serum SPX levels were significantly elevated in HG patients, its moderate diagnostic performance and cross-sectional design limit its clinical applicability as a stand-alone biomarker. These findings should be considered preliminary and require validation by larger prospective studies.