{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:10:38Z","timestamp":1788786638561,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Human data on obesity and type 2 diabetes mellitus (T2DM) remain limited and inconsistent, particularly with respect to adiposity-related phenotypes and renal involvement. We aimed to assess PNX-14 across body mass index (BMI) categories and to investigate its associations with BMI, insulin resistance indicators, and proteinuria in adults with T2DM. Materials and Methods: In this prospective cross-sectional study, participants were classified into four groups according to World Health Organization body mass index (BMI) thresholds: 18.5\u201324.9, 25.0\u201329.9, 30.0\u201334.9, and \u226535.0 kg\/m2. Serum PNX-14 was measured using a human ELISA kit. Group comparisons, trend analysis, false discovery rate-adjusted Spearman correlations, HC3-robust multivariable regression, and parsimonious structural equation modeling were performed. Results: PNX-14 differed significantly across BMI categories and increased monotonically with increasing BMI (p &lt; 0.001 for both the overall comparison and the trend). PNX-14 showed a positive correlation with BMI (\u03c1 = 0.491; qFDR &lt; 0.001), whereas no significant relationship was observed with insulin or HOMA-IR after FDR correction (qFDR = 0.795 for insulin and qFDR = 0.793 for HOMA-IR). In the model adjusted for age, sex, and BMI, higher PNX-14 was independently associated with lower proteinuria (\u03b2 = \u22120.326, 95% CI \u22120.584 to \u22120.067; p &lt; 0.05), whereas BMI was positively associated with proteinuria (\u03b2 = 0.407, 95% CI 0.132 to 0.682; p &lt; 0.01). Structural equation modeling supported positive BMI\u2192PNX-14 and BMI \u2192 proteinuria paths, a negative PNX-14\u2192proteinuria path, and a non-significant PNX-14\u2192HOMA-IR path. Conclusions: In adults with T2DM, PNX-14 appears to be more consistently related to adiposity than to glycemic or insulin resistance indicators. However, when evaluated together with proteinuria, it may offer a testable framework for phenotyping based on renal involvement within the obesity spectrum. Nevertheless, this approach needs to be validated in studies from different centers and with repeated measurements.<\/jats:p>","DOI":"10.3390\/medicina62040697","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:10:27Z","timestamp":1775448627000},"page":"697","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Phoenixin-14 with Body Mass Index Categories and Proteinuria in Adults with Type 2 Diabetes"],"prefix":"10.3390","volume":"62","author":[{"given":"Esra Suay","family":"Timurkaan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Fethi Sekin City Hospital, 23280 Elazig, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Ayy\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Fethi Sekin City Hospital, 23280 Elazig, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5573-2645","authenticated-orcid":false,"given":"Mehmet Bu\u011fra","family":"Bozan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Fethi Sekin City Hospital, 23280 Elazig, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6300-5130","authenticated-orcid":false,"given":"Muhammed Fuad","family":"Uslu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Fethi Sekin City Hospital, 23280 Elazig, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Timurkaan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Fethi Sekin City Hospital, 23280 Elazig, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1038\/s41574-019-0176-8","article-title":"Obesity: Global epidemiology and pathogenesis","volume":"15","year":"2019","journal-title":"Nat. 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