DIABETIC HEPATOPATHY

Abstract

Introduction: Simple steatosis or nonalcoholic steatohepatitis are liver diseases associated with diabetes mellitus (DM). However, a form of diabetic microangiopathy with hepatic sinusoidal fibrosis and basement membrane deposition without cirrhosis has been described and referred as diabetic hepatosclerosis (DH). Objective: To identify scientific studies and to deepen the knowledge on DH, and to evaluate the prevalence of DH in the main published studies in medical literature. Method: Integrative review of the literature conducted in the database PubMed/MEDLINE, and crossed the following descriptors from the Health Science Descriptors (DeCs) and MeSH: liver microangiopathy, hepatosclerosis and diabetes mellitus connected by the Boolean operator AND. Only studies that evaluated the prevalence of DH were selected, summarizing and identifying the limitations of research from 1965 to date. Results: The sample consisted of five studies published that met the inclusion criteria. Studies showed the following aspects: 1. Harrison SA, et al. (2006), described 12 patients identified from hepatic biopsy findings, all had a history of long-standing DM and a noncirrhotic form of hepatic sinusoidal fibrosis not associated with nonalcoholic steatohepatitis. 2. Chen G, et al (2009), reported a prevalence of 12% in 10-year of study. 3. Hudacko RM, et al. (2009) showed that in autopsies from 57 adults with DM, only 1 case (1.7%) of DH was identified. 4. Wang Z et al. (2012), in their study showed that pathological features of 14.2% cases were consistent with the diagnosis of DH. 5. Balakrishnan M, et al. (2015) showed that DH was significantly more prevalent among diabetic patients compared with controls: 45% versus 29%. Conclusion: We identified a small number of studies that addressed the topic, and represent a hepatic form of microvascular disease in DM, in the majority of the cases clinically silent, probably it is common but under-recognized. There is a paucity of literature about DH, and further studies are needed to precisely characterize the DH, to understand mechanisms of pathogenesis and your clinical significance.