Blood-Brain Glucose Transfer in Alzheimer's disease: Effect of GLP-1 Analog Treatment

Sci Rep. 2017 Dec 13;7(1):17490. doi: 10.1038/s41598-017-17718-y.

Abstract

There are fewer than normal glucose transporters at the blood-brain barrier (BBB) in Alzheimer's disease (AD). When reduced expression of transporters aggravates the symptoms of AD, the transporters become a potential target of therapy. The incretin hormone GLP-1 prevents the decline of cerebral metabolic rate for glucose (CMRglc) in AD, and GLP-1 may serve to raise transporter numbers. We hypothesized that the GLP-1 analog liraglutide would prevent the decline of CMRglc in AD by raising blood-brain glucose transfer, depending on the duration of disease. We randomized 38 patients with AD to treatment with liraglutide (n = 18) or placebo (n = 20) for 6 months, and determined the blood-brain glucose transfer capacity (T max) in the two groups and a healthy age matched control group (n = 6). In both AD groups at baseline, T max estimates correlated inversely with the duration of AD, as did the estimates of CMRglc that in turn were positively correlated with cognition. The GLP-1 analog treatment, compared to placebo, highly significantly raised the T max estimates of cerebral cortex from 0.72 to 1.1 umol/g/min, equal to T max estimates in healthy volunteers. The result is consistent with the claim that GLP-1 analog treatment restores glucose transport at the BBB.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / metabolism
  • Blood-Brain Barrier / diagnostic imaging
  • Blood-Brain Barrier / drug effects*
  • Blood-Brain Barrier / metabolism
  • Cognition / drug effects
  • Cognition / physiology
  • Double-Blind Method
  • Fluorodeoxyglucose F18
  • Glucagon-Like Peptide 1 / analogs & derivatives
  • Glucose / metabolism*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Liraglutide / therapeutic use*
  • Middle Aged
  • Positron-Emission Tomography
  • Treatment Outcome

Substances

  • Hypoglycemic Agents
  • Fluorodeoxyglucose F18
  • Liraglutide
  • Glucagon-Like Peptide 1
  • Glucose