Cardiorenal Diabetes

The goal of our group is to gain deeper understanding on renal and cardiovascular diseases in patients with and without diabetes.

Rare kidney diseases (RKD) are a group of often genetic conditions with no targeted therapies. These are understudied due to their rarity, thus inadequate sample sizes and statistical power. Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. IgA Nephropathy (IgAN) in turn, has the highest prevalence of primary glomerulonephritis. We will study ADPKD and IgAN as well as chronic (CKD) and diabetic kidney disease (DKD) in a large (>500,000 participants), patient-enriched genetic cohort of the Finnish population (www.finngen.fi). In addition to GWAS analyses, whole-exome sequencing (WES) and proteomics has been performed to elucidate underlying biological mechanisms.

Renal diseases are major drivers of cardiovascular morbidity, early mortality and poor quality of life. A thorough methodology including measurement of iohexol glomerular filtration rate (iGFR), effective renal plasma flow (ERPF), renal imaging by blood oxygenation level dependent (BOLD) magnetic resonance imaging (MRI) studies and positron emission tomography/computed tomography (PET/CT) using different tracers, has been set up with the FinnDiane (www.finndiane.fi) study to investigate renal diseases. Additionally, a drug study employing this methodology has started.

Participants in this FinnDiane sub-study underwent comprehensive assessments, including brain imaging (MRI), genetic analyses (GWAS and WGS), metabolomic profiling, cognitive testing, and retinal imaging using optical coherence tomography angiography (OCTA). The main finding so far is that one in four of these asymptomatic middle-aged individuals with type 1 diabetes, showed signs of cerebral microbleeds. The final goal is to explore structural-functional associations between the brain, eye, and cognition. Three students have thus far published eight papers as part of their PhD thesis. In addition, arterial vascular beds will be investigated using ambulatory blood pressure measurements and OCTA in individuals undergoing surgical treatment for asymptomatic carotid artery stenosis.

The group has developed a collaborative network with high profile research groups nationally and internationally.

Selected publications

Gordin D, Harjutsalo V, Tinsley L, Fickweiler W, Sun JK, Forsblom C, Amenta PS, Pober D, D’Eon S, Khatri M, Stillman IE, Groop P-H, Keenan HA, King GL. Differential association of microvascular attributions with cardiovascular disease in patients with long duration of type 1 diabetes. Diabetes Care. 2018; 41:815-822.

Gordin D*, Shah H*, Shinjo T, St-Louis R, Qi W, Park K, Paniagua S, Pober DM, Wu I, Bahnam V, Brissett MJ, Tinsley LJ, Dreyfuss JM, Pan H, Dong Y, Niewczas MA, Amenta A, Sadowski T, Kannt A, Keenan HA, King GL. Characterization of glycolytic enzymes and pyruvate kinase M2 in type 1 and 2 diabetic nephropathy. Diabetes Care. 2019; 42:1263-1273.

Tynjälä A, Forsblom C, Harjutsalo V, Groop PH, Gordin D. Arterial stiffness predicts mortality in individuals with type 1 diabetes. Diabetes Care. 2020; 43:2266-2271.

Inkeri J, Tynjälä A, Forsblom C, Liebkind R, Tatlisumak T, Thorn LM, Groop PH, Shams S, Putaala J, Martola J, Gordin D. Carotid intima-media thickness and arterial stiffdness in relation to cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes. Acta Diabetologica. 2021; 58:929-937.

Inkeri J, Adeshara K, Harjutsalo V, Forsblom C, Liebkind R, Tatlisumak T, Thorn LM, Groop PH, Shams S, Martola J, Putaala J, Gordin D. Glycemic control is not related to cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes. Acta Diabetol. 2022; 59:481-49.

Tynjälä A, Harjutsalo V, Jansson Sigfrids F, Groop PH, Gordin D; FinnDiane Study Group. Higher HbA1c variability is associated with increased arterial stiffness in individuals with type 1 diabetes. Cardiovasc Diabetol. 2023; 22:47.

Mellor J, Jeyam A, Beulens JWJ, Bhandari S, Broadhead G, Chew E, Fickweiler W, van der Heijden A, Gordin D, Simó R, Snell-Bergeon J, Tynjälä A, Colhoun H. Role of Systemic Factors in Improving the Prognosis of Diabetic Retinal Disease and Predicting Response to Diabetic Retinopathy Treatment. Ophthalmol Sci. 2024; 4:100494.

van Raalte DH, Bjornstad P, Cherney DZI, de Boer IH, Fioretto P, Gordin D, Persson F, Rosas SE, Rossing P, Schaub JA, Tuttle K, Waikar SS, Heerspink HJL. Combination therapy for kidney disease in people with diabetes mellitus. Nat Rev Nephrol. 2024; 20:433-446.

Yu MG, Gordin D, Fu J, Park K, Li G, King GLK. Protective factors reduce the pathogenesis of complications in diabetes. Endocrine Rev. 2024; 45:227-252.

Simonsen JR, Vikatmaa L, Vikatmaa P, Laine M, Granroth-Wilding H, Groop PH, Tikkanen I, Gordin D. Sham-controlled randomized pilot trial on baroreflex activation therapy in resistant hypertension. Hypertension. 2024; 81:e91-e93. Tarkkonen A, Kyläheiko I, Inkeri J, Eriksson MI, Thorn LM, Summanen PA, Tatlisumak T, Groop PH, Putaala J, Gordin D*, Martola J*; FinnDiane Study Group. Progression of Cerebral Small Vessel Disease Among Neurologically Asymptomatic Middle-Aged Individuals With Type 1 Diabetes. Diabetes Care. 2025;48:776-780. *Equal contribution Kyläheiko I, Tarkkonen A, Kuusela L, Martola J, Paajanen TI, Virkkala J, Groop PH, Thorn LM, Tatlisumak T, Putaala J, Gordin D*, Jokinen H*; FinnDiane Study Group. Cerebral microbleeds are associated with deficits in cognitive processing speed and executive functions in middle-aged adults with type 1 diabetes. Diabetes Res Clin Pract. 2026;232:113080. *Equal contribution

Kyläheiko I, Tarkkonen A, Kuusela L, Martola J, Paajanen TI, Virkkala J, Fickweiler W, King GL, Sun JK, Turunen JA, Eriksson MI, Groop PH, Thorn LM, Tatlisumak T, Putaala J, Jokinen H*, Gordin D*; FinnDiane Study Group. Associations between retinal microvasculature and cognition in middle-aged adults with type 1 diabetes without overt neurological symptoms. Cereb Circ Cogn Behav. 2026 in press *Equal contribution

External funding

Academy of Finland
Biomedicum Helsinki Foundation
Finnish Governmental Grant
Helsinki University Hospital
Medicinska understödsföreningen Liv och Hälsa r.f.
Mary K. Iacocca Foundation
Medical Society of Finland
Minerva Foundation
Päivikki and Sakari Sohlberg Foundation
Sigrid Juselius Foundation
University of Helsinki
Wilhelm and Else Stockmann Foundation