Faienza Maria Felicia, Chiarito Mariangela, Aureli Alessia, Buganza Raffaele, Corica Domenico, Delvecchio Maurizio, De Sanctis Luisa, Fintini Danilo, Grugni Graziano, Licenziati Maria Rosaria, Madeo Simona, Mozzillo Enza, Rutigliano Irene, Valerio Giuliana
Pediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "A. Moro", Bari, Italy.
Endocrinology and Diabetology Unit, Pediatric University Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
J Endocrinol Invest. 2025 Apr;48(4):979-986. doi: 10.1007/s40618-024-02511-2. Epub 2024 Dec 5.
Individuals with Prader-Willi syndrome (PWS) exhibit hyperphagic behavior, the severity of which varies throughout life. The mechanisms underlying this behavior are still unknown. Asprosin is a new discovered adipokine involved in the regulation of food intake, glucose homeostasis and energy balance. In this study we assessed asprosin serum levels in a cohort of children, adolescents and adults with PWS with the aim to correlate them with hyperphagic behavior, body mass index (BMI) and metabolic parameters, and to evaluate age-related changes.
This cross-sectional study included 87 children and adolescents and 31 adults with PWS. Auxological data, fasting levels of glucose, insulin, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG) and asprosin were collected, and the homeostasis model assessment for insulin resistance (HOMA-IR) was determined. The 11-item Italian version of the Hyperphagia Questionnaire (HQ) was administered to the parents/caregivers of the patients to assess hyperphagia.
Patients were analysed according to age (children < 10 years, adolescents between 10 and 17.9 years, adults ≥ 18 years) or BMI categories [normal weight (NW), overweight (OW), and obesity (OB)]. No significant correlations were found between asprosin levels and cardiometabolic risk factors in the whole cohort. Higher values of asprosin were found in adults compared with adolescents, as well as in the OB group compared to the NW group (p = 0.014). Hyperphagia total score and hyperphagic subdimensions were significantly lower in children compared to adults (p < 0.05). Similarly, hyperphagia total score and hyperphagic subdimensions were significantly lower in the NW group compared to the OB group. Asprosin levels were significantly higher in patients with deletion versus patients with uniparental disomy (p = 0.037). By logistic regression analysis, HQ total score and hyperphagic subdimensions were significantly associated with BMI-SDS independently of age, sex, and asprosin levels.
In conclusion, our data demonstrated higher asprosin levels in PWS individuals with OB compared to NW, while differences by age and sex were inconsistent. The lower levels of hyperphagia, BMI-SDS, and metabolic variables in children with PWS compared to adults underline that prevention of obesity should start very early in life and should be maintained over time.
普拉德-威利综合征（PWS）患者表现出贪食行为，其严重程度在一生中有所不同。这种行为背后的机制仍然未知。阿朴脂蛋白是一种新发现的脂肪因子，参与食物摄入、葡萄糖稳态和能量平衡的调节。在本研究中，我们评估了一组患有PWS的儿童、青少年和成人的血清阿朴脂蛋白水平，旨在将其与贪食行为、体重指数（BMI）和代谢参数相关联，并评估与年龄相关的变化。
这项横断面研究纳入了87名儿童和青少年以及31名患有PWS的成人。收集了人体测量数据、空腹血糖、胰岛素、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）和阿朴脂蛋白水平，并测定了胰岛素抵抗的稳态模型评估（HOMA-IR）。向患者的父母/照顾者发放了11项意大利版的贪食问卷（HQ），以评估贪食情况。
根据年龄（儿童<10岁、青少年10至17.9岁、成人≥18岁）或BMI类别[正常体重（NW）、超重（OW）和肥胖（OB）]对患者进行分析。在整个队列中，未发现阿朴脂蛋白水平与心血管代谢危险因素之间存在显著相关性。与青少年相比，成人的阿朴脂蛋白值更高，与NW组相比，OB组的阿朴脂蛋白值也更高（p = 0.014）。与成人相比，儿童的贪食总分和贪食子维度显著更低（p < 0.05）。同样，与OB组相比，NW组的贪食总分和贪食子维度显著更低。与单亲二体患者相比，缺失患者的阿朴脂蛋白水平显著更高（p = 0.037）。通过逻辑回归分析，HQ总分和贪食子维度与BMI-SDS显著相关，且独立于年龄、性别和阿朴脂蛋白水平。
总之，我们的数据表明，与NW相比，患有OB的PWS个体的阿朴脂蛋白水平更高，而年龄和性别的差异并不一致。与成人相比，PWS儿童的贪食、BMI-SDS和代谢变量水平较低，这强调肥胖预防应在生命早期就开始，并应长期维持。
