{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:16:06Z","timestamp":1763388966964},"reference-count":6,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,18]],"date-time":"2016-01-18T00:00:00Z","timestamp":1453075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Liver disease in diabetes is common and is frequently the result of hepatic steatosis. Diabetic hepatosclerosis is a relatively recent description of sinusoidal fibrosis, without steatosis, observed in liver biopsies of people with diabetes presenting with cholestasis. Its association with other microvascular complications suggests it is a form of hepatic diabetic microangiopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>We report the case of a 50\u2010year\u2010old woman with longstanding Type\u00a01 diabetes, complicated by nephropathy resulting in cadaveric renal transplant, retinopathy, gastroparesis and neuropathy with slowly healing ulceration to her right foot. She was noted to have deranged liver function tests: alanine aminotransferase, 162\u00a0<jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\/l; bilirubin, 44\u00a0<jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\/l; alkaline phosphatase, 5279\u00a0<jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\/l (isoenzymes; bone 1029\u00a0<jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\/l, liver 4250\u00a0<jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\/l); \u03b3\u2013glutamyl transferase, 662\u00a0<jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content>\/l. A non\u2010invasive liver screen did not reveal the cause of the cholestasis. A liver biopsy demonstrated sinusoidal fibrosis without evidence of steatosis and thus a diagnosis of diabetic hepatosclerosis was made. Comparison with a biopsy performed 11\u00a0years previously at a different trust due to elevated alkaline phosphatase levels revealed slow progression of the sinusoidal fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This case describes the longest reported clinical course of diabetic hepatosclerosis, spanning 11\u00a0years, in which time the patient did not develop evidence of cirrhosis or portal hypertension. It is difficult to estimate the clinical relevance of this condition because little is known regarding its clinical course and effect on morbidity and mortality.<\/jats:p><jats:p>Identified patients should undergo low\u2010intensity, long\u2010term follow\u2010up to improve understanding of its clinical sequelae and relevance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12898","type":"journal-article","created":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T11:08:51Z","timestamp":1440760131000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Diabetic hepatosclerosis: another diabetes microvascular complication?"],"prefix":"10.1111","volume":"33","author":[{"given":"R. J.","family":"King","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology Leeds Teaching Hospitals NHS Trust St James\u2019 University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Hepatology Leeds Teaching Hospitals NHS Trust St James\u2019 University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. G.","family":"Gilbey","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Leeds Teaching Hospitals NHS Trust St James\u2019 University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Santhakumar","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Leeds Teaching Hospitals NHS Trust St James\u2019 University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Department of Pathology Leeds Teaching Hospitals NHS Trust St James\u2019 University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Hepatology Leeds Teaching Hospitals NHS Trust St James\u2019 University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. J.","family":"Bodansky","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Leeds Teaching Hospitals NHS Trust St James\u2019 University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,18]]},"reference":[{"issue":"4","key":"e_1_2_7_2_1","first-page":"989","article-title":"Mauriac syndrome: growth failure and type\u00a01 diabetes mellitus","volume":"5","author":"Kim MS","year":"2008","journal-title":"Pediatr Endocrinol Rev"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPQBFF42ZZXXRQ"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2008.01956.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5858\/2006-130-27-DHDMOT","article-title":"Diabetic hepatosclerosis: diabetic microangiopathy of the liver","volume":"130","author":"Harrison SA","year":"2006","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-1762"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21349"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.12898","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.12898","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.12898","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T17:18:42Z","timestamp":1696353522000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.12898"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,18]]},"references-count":6,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1111\/dme.12898"],"URL":"https:\/\/doi.org\/10.1111\/dme.12898","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,18]]},"assertion":[{"value":"2015-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-08-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-01-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}