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Metabolism of cyclic GMP in non-alcoholic fatty liver disease in morbid obesity

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BMC Pharmacology201111 (Suppl 1) :P73

  • Published:


  • Metabolic Syndrome
  • Renin
  • Aldosterone
  • Morbid Obesity
  • Fatty Liver Disease


To study cGMP metabolism in Nonalcoholic Fatty Liver Disease (NAFLD) in patients with Morbid Obesity (MO).


Patients: MO group: 48 patients (40 women and 8 men) diagnosed of MO with an age of 46.9± 7.9. Control group: 19 subjects without overweight and with normal analytical data and normal ultrasound scan of the liver. The following parameters were measured:

A.- Clinical data: Age, sex, weight, height, abdominal and hip perimeters, Body Mass Index (BMI), clinical history and pharmacological treatment, Metabolic Syndrome, morfometry and haematic chemistry, Insulin Resistance (HOMA) and viral markers.

B - Immunomodulators: (Leptin, Adiponectin, CK18Asp396 (CK18), Interleukin-6 (IL-6), aldosterone and rennin).

C - Histological analysis was performed after obtaining hepatic tissue during surgery for MO. The NAFLD Score was calculated: Steatosis Degree, Fibrosis, Inflammation, hepatocyte lesions and other injuries).


The livers of patients can be divided in 4 groups according to the histological analysis: Normal Liver (2.1 %), Steatosis (60.4 %), Steatohepatitis (35.4 %), Cirrhosis (2.1 %). We find higher values of cGMP in plasma from patients with NAFLD than in the control group (F =2.35; p <0.0001) and in patients with Steatohepatitis (NASH) than in the Steatosis group (F=4.02; p=0.025). Analyzing according to the NAFLD Score, only the fibrosis (F=3.4; p=0.02) shows differences, with no variations according to grade of Steatosis (p=0.05), neither lobular inflammation (p=0.1) nor hepatocellular ballooning (p=0.6).

According to the clinical and analytical data studied, the cGMP level in plasma was higher according to the waist to hip ratio (p<0.05), Metabolic Syndrome (p<0.05): There are no significant differences according to HOMA and BMI. We have not found significant correlations between cGMP and leptin, adiponectin, IL-6, CK-18 or renin, whereas there was a correlation (Pearson=0.43; p=0.14) with aldosterone.


There is an alteration in cGMP metabolism in NAFLD in patients with morbid obesity. This alteration is associated mainly with development of hepatic fibrosis without alterations related with Steatosis, inflammation or hepatocyte lesions. The alteration in cGMP is independent of the immunomodulators (leptin, adiponectin, CK-18, IL-6, aldosterone and renin) studied.

Authors’ Affiliations

Fundacion Investigacion Hospital Clinico de Valencia. INCLIVA, Spain
Servicios de Hepatologia, Centro de Investigacion Principe Felipe, Valencia, Spain
Laboratory of Neurobiology, Centro de Investigacion Principe Felipe, Valencia, Spain
Endocrinología, Hospital Clinico Universitario, Valencia, Spain
Cirugía, Hospital Clinico Universitario, Valencia, Spain
Anatomia Patologica, Hospital Clinico Universitario, Valencia, Spain


© Urios et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.