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Liraglutide reduces short-term central nervous system responses to food images
Compared with treatment with insulin, short-term treatment with liraglutide reduces central nervous system activation in response to viewing food and images of high-calorie food during fasted and post-meal states, according to recent findings.
In the randomized crossover study, Jennifer S. ten Kulve, MD, of VU University Medical Center in Amsterdam, and colleagues evaluated 20 patients (mean age, 59.3 years) with overweight or obesity and type 2 diabetes to determine whether glucagon-like peptide-1 receptor agonists associated with reduced appetite and body weight might be mediated by the central nervous system (CNS). All patients were treated with metformin.
The study included two randomized treatment intervals of 12 weeks with a 12-week washout period in between. Patients received an evening injection of liraglutide during one treatment period. Dosing initiated at 0.6 mg once daily, with weekly increasing increments of 0.6 mg reaching a final dose of 1.8 mg daily by the end of the second week. The other period consisted of treatment with insulin glargine, initiated at 10 IU once daily, and patients were directed to increase daily dose based on fasting levels of self-monitored blood glucose.
A total of six functional MRI tests were conducted, one at baseline for each treatment period, one after 10 days of each treatment and once after 12 weeks. During each functional MRI, patients viewed 10-minute presentations of pictures of high-calorie food items, low-calorie food items and non-food items. The researchers evaluated the effects of the treatments on CNS responses to viewing the pictures in the fasted condition and 30 minutes after meal consumption.
After 12 weeks, liraglutide yielded a greater reduction in HbA1c compared with insulin glargine (P < .001). During liraglutide treatment, body weight was reduced more compared with insulin glargline (P < .001).
At 10 days, patients treated with liraglutide showed a greater reduction in insula and putamen responses to food pictures (P .02). Moreover, liraglutide added to postprandial satiation on putamen and amygdala responses (P .05). There were no disparities observed in CNS activation responses between liraglutide and insulin glargine after 12 weeks.
According to the researchers, these findings suggest that GLP-1 receptor agonists may induce weight loss, but may not necessarily maintain this weight loss.
“This might indicate that central [GLP-1 receptor agonist] effects contribute to the induction phase of weight loss,” the researchers wrote. “The absence of an effect at 12 weeks might explain why weight loss does not proceed after the initial period of treatment with liraglutide.” – by Jennifer Byrne
Disclosure: ten Kulve reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.