Transfer of liraglutide from blood to cerebrospinal fluid is minimal in patients with type 2 diabetes

• Published in: International Journal of Obesity 2015-11, Vol.39 (11), p.1651-1654
• Main Authors: Christensen, M, Sparre-Ulrich, A H, Hartmann, B, Grevstad, U, Rosenkilde, M M, Holst, J J, Vilsbøll, T, Knop, F K
• Format: Article
• Language: English
• Subjects: 631/378; 631/92/436/108; 692/163; 692/308; 692/699/2743/137/773; 692/700/565/1436; Aged; Anti-Obesity Agents - pharmacology; Antibodies; Antidiabetics; Biochemistry; Biomarkers - blood; Blood; Blood-Brain Barrier - drug effects; Body weight; Body Weight - drug effects; Body weight loss; Care and treatment; Cerebrospinal fluid; Complications and side effects; Correlation; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diagnostic tests; Epidemiology; Female; Glucagon-Like Peptide 1 - analogs & derivatives; Glucagon-Like Peptide 1 - therapeutic use; Health aspects; Health Promotion and Disease Prevention; Hospitals; Humans; Hypothalamus; Internal Medicine; Levels; Liraglutide - pharmacology; Low concentrations; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; N-Terminus; Obesity; Patients; Plasma; Public Health; Radioimmunoassay; short-communication; Treatment Outcome; Type 2 diabetes; Weight control; Weight loss; Weight loss measurement
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2015.136

Treatment with liraglutide leads to weight loss. We investigated whether blood-to-cerebrospinal fluid (CSF) transfer of liraglutide occurs, and if so, whether it associates with clinical weight loss following liraglutide treatment in humans. We performed lumbar puncture and blood sampling in eight patients with type 2 diabetes (mean (range)): age 63 (54–79) years; actual body weight: 90 (75–118) kg treated with 1.8 mg liraglutide for 14 (5–22) months and with a treatment-induced weight loss of 8.4 (7–11) kg. We measured liraglutide in plasma and CSF with a radioimmunoassay specific for the N-terminus of the GLP-1 moiety of liraglutide. Mean plasma liraglutide was 31 (range: 21–63) nmol l −1 . The mean CSF-liraglutide concentration was 6.5 (range: 0.9–13.9) pmol l −1 . Ratio of CSF: plasma-liraglutide concentrations was 0.02 (range: 0.07–0.002)% and plasma liraglutide did not correlate with CSF-liraglutide levels ( P =0.67). Body weight loss tended to correlate with plasma-liraglutide levels ( P =0.06), but not with CSF-liraglutide levels ( P =0.69). In conclusion, we measured very low concentrations of liraglutide in CSF, and the levels of CSF liraglutide did not correlate with the actual clinical weight loss in these patients. The amount of liraglutide in plasma tended to correlate with the clinical weight loss.