{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T04:56:20Z","timestamp":1770958580155,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Aims<\/jats:title>\n                <jats:p>Proneurotensin (Pro-NT) is a strong predictor of cardiometabolic disease including type 2 diabetes and obesity, however, the effect of lifestyle change on Pro-NT has not been investigated in this context. Middle Eastern (ME) immigrants represent the largest and fastest growing minority population in Europe and are a high-risk population for obesity and type 2 diabetes. In this randomised controlled lifestyle intervention (RCT) addressing ME immigrants to Sweden where weight-loss was previously studied as the main outcome, as a secondary analysis we aimed to study change in Pro-NT during follow-up and if baseline Pro-NT predicted weight loss.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Immigrants from the Middle East at high risk for type 2 diabetes were invited to participate in this RCT adapted lifestyle intervention of four months\u2019 duration. The intervention group (N\u2009=\u200948) received a culturally adapted lifestyle intervention comprising seven group sessions and a cooking class addressing healthier diet and increased physical activity. The control group (N\u2009=\u200944) received treatment as usual with information to improve lifestyle habits on their own. Data assessed using mixed effects regression.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Outcomes<\/jats:title>\n                <jats:p>Primary outcome; change in Pro-NT. Secondary outcome; change in BMI in relation to baseline plasma concentration of Pro-NT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During the four months follow up, weight was significantly reduced in the intervention (-2.5\u00a0kg) compared to the control group (0.8\u00a0kg) (\u03b2 -0.12, 95% CI -0.24 to -0.01, <jats:italic>P<\/jats:italic>\u2009=\u20090.028). Pro-NT increased to a significantly greater extent in the intervention compared to the control group during follow up (28.2 vs. 3.5 pmol\/L) (\u03b2 11.4; 4.8 to 18.02, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Change over time in BMI was associated with baseline Pro-NT (\u03b2 0.02; 0.01 to 0.04, <jats:italic>P<\/jats:italic>\u2009=\u20090.041).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In consistence with data from surgical weight loss, this RCT paradoxically shows increased levels of Pro-NT during a multifactorial lifestyle intervention resulting in weight loss. Long term studies of Pro-NT following weight loss are needed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>This study is a secondary analysis of the RCT trial registered at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">www.clinicaltrials.gov<\/jats:ext-link>. Registration number: NCT01420198. Date of registration 19\/08\/2011. The performance and results of this trial conform to the CONSORT 2010 guidelines.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-022-01183-4","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T08:04:07Z","timestamp":1667203447000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The effect of a randomised controlled lifestyle intervention on weight loss and plasma proneurotensin"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7101-1290","authenticated-orcid":false,"given":"Louise","family":"Bennet","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayesha","family":"Fawad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Struck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara L\u00f6nn","family":"Larsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Bergmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olle","family":"Melander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"1183_CR1","unstructured":"IDF Diabetes Atlas. <https:\/\/diabetesatlas.org\/upload\/resources\/material\/20200302_133351_IDFATLAS9e-final-web.pdf (2019)."},{"key":"1183_CR2","doi-asserted-by":"publisher","first-page":"166","DOI":"10.2337\/diabetes.54.1.166","volume":"54","author":"V Lyssenko","year":"2005","unstructured":"Lyssenko V, et al. Predictors of and longitudinal changes in insulin sensitivity and secretion preceding onset of type 2 diabetes. Diabetes. 2005;54:166\u201374.","journal-title":"Diabetes"},{"key":"1183_CR3","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1186\/s12889-016-3892-1","volume":"16","author":"L Bennet","year":"2016","unstructured":"Bennet L, Stenkula K, Cushman SW, Brismar K. BMI and waist circumference cut-offs for corresponding levels of insulin sensitivity in a Middle Eastern immigrant versus a native Swedish population - the MEDIM population based study. BMC Public Health. 2016;16:1242. https:\/\/doi.org\/10.1186\/s12889-016-3892-1.","journal-title":"BMC Public Health"},{"key":"1183_CR4","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1038\/nature17662","volume":"533","author":"J Li","year":"2016","unstructured":"Li J, et al. An obligatory role for neurotensin in high-fat-diet-induced obesity. Nature. 2016;533:411\u20135. https:\/\/doi.org\/10.1038\/nature17662.","journal-title":"Nature"},{"key":"1183_CR5","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.neulet.2009.10.064","volume":"468","author":"ER Kim","year":"2010","unstructured":"Kim ER, Mizuno TM. Role of neurotensin receptor 1 in the regulation of food intake by neuromedins and neuromedin-related peptides. Neurosci Lett. 2010;468:64\u20137. https:\/\/doi.org\/10.1016\/j.neulet.2009.10.064.","journal-title":"Neurosci Lett"},{"key":"1183_CR6","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1038\/oby.2008.652","volume":"17","author":"JH Cooke","year":"2009","unstructured":"Cooke JH, et al. Peripheral and central administration of xenin and neurotensin suppress food intake in rodents. Obes (Silver Spring). 2009;17:1135\u201343. https:\/\/doi.org\/10.1038\/oby.2008.652.","journal-title":"Obes (Silver Spring)"},{"key":"1183_CR7","doi-asserted-by":"publisher","first-page":"6854","DOI":"10.1016\/S0021-9258(19)43429-7","volume":"248","author":"R Carraway","year":"1973","unstructured":"Carraway R, Leeman SE. The isolation of a new hypotensive peptide, neurotensin, from bovine hypothalami. J Biol Chem. 1973;248:6854\u201361.","journal-title":"J Biol Chem"},{"key":"1183_CR8","doi-asserted-by":"publisher","first-page":"7053","DOI":"10.1016\/S0021-9258(17)32939-3","volume":"251","author":"P Kitabgi","year":"1976","unstructured":"Kitabgi P, Carraway R, Leeman SE. Isolation of a tridecapeptide from bovine intestinal tissue and its partial characterization as neurotensin. J Biol Chem. 1976;251:7053\u20138.","journal-title":"J Biol Chem"},{"key":"1183_CR9","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1016\/j.peptides.2006.01.021","volume":"27","author":"A Ernst","year":"2006","unstructured":"Ernst A, Hellmich S, Bergmann A. Proneurotensin 1-117, a stable neurotensin precursor fragment identified in human circulation. Peptides. 2006;27:1787\u201393. https:\/\/doi.org\/10.1016\/j.peptides.2006.01.021.","journal-title":"Peptides"},{"key":"1183_CR10","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1001\/jama.2012.12998","volume":"308","author":"O Melander","year":"2012","unstructured":"Melander O, et al. Plasma proneurotensin and incidence of diabetes, cardiovascular disease, breast cancer, and mortality. JAMA. 2012;308:1469\u201375. https:\/\/doi.org\/10.1001\/jama.2012.12998.","journal-title":"JAMA"},{"key":"1183_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.metabol.2016.10.001","volume":"66","author":"F Siddiqui","year":"2017","unstructured":"Siddiqui F, Kurbasic A, Lindblad U, Nilsson PM, Bennet L. Effects of a culturally adapted lifestyle intervention on cardio-metabolic outcomes: a randomized controlled trial in Iraqi immigrants to Sweden at high risk for Type 2 diabetes. Metab Clin Exp. 2017;66:1\u201313. https:\/\/doi.org\/10.1016\/j.metabol.2016.10.001.","journal-title":"Metab Clin Exp"},{"key":"1183_CR12","doi-asserted-by":"publisher","first-page":"c332","DOI":"10.1136\/bmj.c332","volume":"340","author":"KF Schulz","year":"2010","unstructured":"Schulz KF, Altman DG, Moher D, Group, C. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332. https:\/\/doi.org\/10.1136\/bmj.c332.","journal-title":"BMJ"},{"key":"1183_CR13","doi-asserted-by":"publisher","first-page":"2827","DOI":"10.1017\/s136898001700146x","volume":"20","author":"F Siddiqui","year":"2017","unstructured":"Siddiqui F, et al. Changes in dietary intake following a culturally adapted lifestyle intervention among Iraqi immigrants to Sweden at high risk of type 2 diabetes: a randomised trial. Public Health Nutr. 2017;20:2827\u201338. https:\/\/doi.org\/10.1017\/s136898001700146x.","journal-title":"Public Health Nutr"},{"key":"1183_CR14","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/1745-6215-14-279","volume":"14","author":"S Saha","year":"2013","unstructured":"Saha S, et al. A culturally adapted lifestyle intervention addressing a Middle Eastern immigrant population at risk of diabetes, the MEDIM (impact of Migration and Ethnicity on Diabetes In Malmo): study protocol for a randomized controlled trial. Trials. 2013;14:279. https:\/\/doi.org\/10.1186\/1745-6215-14-279.","journal-title":"Trials"},{"key":"1183_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2014.01.002","author":"L Bennet","year":"2014","unstructured":"Bennet L, Groop L, Lindblad U, Agardh CD, Franks PW. Ethnicity is an independent risk indicator when estimating diabetes risk with FINDRISC scores: A cross sectional study comparing immigrants from the Middle East and native Swedes. Prim Care Diabetes. 2014. https:\/\/doi.org\/10.1016\/j.pcd.2014.01.002.","journal-title":"Prim Care Diabetes"},{"key":"1183_CR16","doi-asserted-by":"publisher","first-page":"3482","DOI":"10.1210\/en.2016-1329","volume":"157","author":"C Ratner","year":"2016","unstructured":"Ratner C, et al. Effects of Peripheral Neurotensin on Appetite Regulation and Its Role in Gastric Bypass Surgery. Endocrinology. 2016;157:3482\u201392. https:\/\/doi.org\/10.1210\/en.2016-1329.","journal-title":"Endocrinology"},{"key":"1183_CR17","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-018-0084-3","author":"C von Loeffelholz","year":"2018","unstructured":"von Loeffelholz C, et al. The anorexigenic peptide neurotensin relates to insulin sensitivity in obese patients after BPD or RYGB metabolic surgery. Int J Obes (Lond). 2018. https:\/\/doi.org\/10.1038\/s41366-018-0084-3.","journal-title":"Int J Obes (Lond)"},{"key":"1183_CR18","doi-asserted-by":"publisher","unstructured":"Ramirez-Virella J, Leinninger GM. The Role of Central Neurotensin in Regulating Feeding and Body Weight. Endocrinology 162, https:\/\/doi.org\/10.1210\/endocr\/bqab038 (2021).","DOI":"10.1210\/endocr\/bqab038"},{"key":"1183_CR19","doi-asserted-by":"crossref","unstructured":"Fawad A, Struck J, Bergmann A, Melander O, Bennet L. The association between plasma proneurotensin and glucose regulation is modified by country of birth. Under review Scientific Reports. (2019).","DOI":"10.1038\/s41598-019-50040-3"},{"key":"1183_CR20","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/bf01308198","volume":"30","author":"YC Lee","year":"1985","unstructured":"Lee YC, et al. Quantitation and characterization of human plasma neurotensin-like immunoreactivity in response to a meal. Dig Dis Sci. 1985;30:129\u201333. https:\/\/doi.org\/10.1007\/bf01308198.","journal-title":"Dig Dis Sci"},{"key":"1183_CR21","doi-asserted-by":"publisher","first-page":"3544","DOI":"10.1210\/jc.2006-0256","volume":"91","author":"M Christ-Crain","year":"2006","unstructured":"Christ-Crain M, et al. Effect of gastric bypass and gastric banding on proneurotensin levels in morbidly obese patients. J Clin Endocrinol Metab. 2006;91:3544\u20137. https:\/\/doi.org\/10.1210\/jc.2006-0256.","journal-title":"J Clin Endocrinol Metab"},{"key":"1183_CR22","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s13679-015-0155-x","volume":"4","author":"J Grams","year":"2015","unstructured":"Grams J, Garvey WT. Weight Loss and the Prevention and Treatment of Type 2 Diabetes Using Lifestyle Therapy, Pharmacotherapy, and Bariatric Surgery: Mechanisms of Action. Curr Obes Rep. 2015;4:287\u2013302. https:\/\/doi.org\/10.1007\/s13679-015-0155-x.","journal-title":"Curr Obes Rep"},{"key":"1183_CR23","unstructured":"(Statistics Sweden)."},{"key":"1183_CR24","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/0196-9781(86)90054-9","volume":"7","author":"J Holst Pedersen","year":"1986","unstructured":"Holst Pedersen J, Fahrenkrug J. Neurotensin-like immunoreactivities in human plasma: feeding responses and metabolism. Peptides. 1986;7:15\u201320. https:\/\/doi.org\/10.1016\/0196-9781(86)90054-9.","journal-title":"Peptides"},{"key":"1183_CR25","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.2337\/db18-1009","volume":"68","author":"C Ratner","year":"2019","unstructured":"Ratner C, et al. Long-Acting Neurotensin Synergizes With Liraglutide to Reverse Obesity Through a Melanocortin-Dependent Pathway. Diabetes. 2019;68:1329\u201340. https:\/\/doi.org\/10.2337\/db18-1009.","journal-title":"Diabetes"},{"key":"1183_CR26","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1056\/NEJMoa1700459","volume":"377","author":"TD Adams","year":"2017","unstructured":"Adams TD, et al. Weight and Metabolic Outcomes 12 Years after Gastric Bypass. N Engl J Med. 2017;377:1143\u201355. https:\/\/doi.org\/10.1056\/NEJMoa1700459.","journal-title":"N Engl J Med"},{"key":"1183_CR27","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1007\/s11695-017-2981-2","volume":"28","author":"M Gaeta","year":"2018","unstructured":"Gaeta M, et al. Bariatric Surgery to Reduce Mortality in US Adults. A Public Health Perspective from the Analysis of the American National Health and Nutrition Examination Survey Linked to the US Mortality Register. Obes Surg. 2018;28:900\u20136. https:\/\/doi.org\/10.1007\/s11695-017-2981-2.","journal-title":"Obes Surg"},{"key":"1183_CR28","doi-asserted-by":"publisher","unstructured":"Benotti PN, et al. Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long-Term Risks of Congestive Heart Failure. J Am Heart Assoc 6, https:\/\/doi.org\/10.1161\/JAHA.116.005126 (2017).","DOI":"10.1161\/JAHA.116.005126"},{"key":"1183_CR29","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.diabres.2010.11.032","volume":"91","author":"LA Jaber","year":"2011","unstructured":"Jaber LA, et al. Feasibility of group lifestyle intervention for diabetes prevention in Arab Americans. Diabetes Res Clin Pract. 2011;91:307\u201315. https:\/\/doi.org\/10.1016\/j.diabres.2010.11.032.","journal-title":"Diabetes Res Clin Pract"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-022-01183-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-022-01183-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-022-01183-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T20:04:32Z","timestamp":1667246672000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-022-01183-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,31]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1183"],"URL":"https:\/\/doi.org\/10.1186\/s12902-022-01183-4","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,31]]},"assertion":[{"value":"30 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Lund University Ethics Review Board (approval 2009\/36; 2010\/561 and 2011\/88). All methods are carried out in accordance with the relevant guidelines and regulations. All participants received written as well as oral consent in their spoken language. All participants signed an informed consent form prior to participation in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JS is employed by Sphingotec GmbH, a company that has patent rights regarding Pro-NT assay and commercializing it. AB is CEO of Sphingotec GmbH and holds shares in this company. JS and AB provided the pro-NT kits, conducted and quality controlled the pro-NT measurements. The specific roles of these authors [JS and AB] are articulated in the \u2018author contributions\u2019 section above. The other authors declare they have no disclosures. The commercial affiliation does not alter us adherence to the policies of BMC Endocrine disorders on sharing data and materials.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"264"}}