Cardiorenal Diabetes

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

Renal studies

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. We will study ADPKD in a large (>500.000) patient-enriched sample of the Finnish population (www.finngen.fi). The goal of this study is to improve understanding of ADPKD by assessing clinical, and genetic tools, as well as systems biology.

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.

Cerebrovascular study in type 1 diabetes

Individuals part of this study underwent brain imaging (MRI), genetic (GWAS, WGS), metabolomic, cognitive and retinal evaluations (Optical coherence tomography angiography, OCTA) as part of this FinnDiane sub-study. The main finding so far is that one in four of these asymptomatic middle-aged individuals with T1D, 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 five papers as part of their PhD thesis.

Collaboration

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

Selected publications

Gordin D, Hiilesmaa V, Fagerudd J, Rönnback M, Forsblom C, Kaaja R, Teramo K, Groop P-H, Finn-Diane Study Group. Preeclampsia but not pregnancy induced hypertension is a risk factor for diabetic nephropathy in type 1 diabetes. Diabetologia 2007;50:516-22.

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.

Niiranen TJ, Gordin D. Initial Treatment of Hypertension Letter to the Editor. N Engl J Med 2018;378:1952.

Thorn LM*, Shams S*, Gordin D, Liebkind R, Forsblom C, Summanen P, Hägg-Holmberg S, Tatlisumak T, Salonen O, Putaala J, Martola J, Groop PH on behalf of the FinnDiane Study Group. Clinical and magnetic resonance imaging features of cerebral small vessel disease in type 1 diabetes. Diabetes Care 2019;2:327-330.

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.

Yu MG, Gordin D, Fu J, Park K, Li G, King GLK. Protective factors reduce the pathogenesis of complications in diabetes. Endocrine Reviews in press

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