University of Oulu

Winther, S.A., Mannerla, M.M., Frimodt-Møller, M. et al. Faecal biomarkers in type 1 diabetes with and without diabetic nephropathy. Sci Rep 11, 15208 (2021).

Faecal biomarkers in type 1 diabetes with and without diabetic nephropathy

Saved in:
Author: Winther, Signe Abitz1,2; Mannerla, Miia Maininki3,4,5; Frimodt-Møller, Marie1;
Organizations: 1Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark
2Novo Nordisk A/S, Måløv, Denmark
3Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
4Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
5Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
6Medical Microbiology and Immunology, Unit of Biomedicine, University of Oulu, Oulu, Finland
7Medical Research Center, Nordlab Oulu University Hospital and University of Oulu, Oulu, Finland
8Department of Gastrointestinal Microbiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
9Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
10University of Copenhagen, Copenhagen, Denmark
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.4 MB)
Persistent link:
Language: English
Published: Springer Nature, 2021
Publish Date: 2021-10-11


Gastrointestinal dysbiosis is common among persons with type 1 diabetes (T1D), but its potential impact on diabetic nephropathy (DN) remains obscure. We examined whether faecal biomarkers, previously associated with low-grade gastrointestinal inflammation, differ between healthy controls and T1D subjects with and without DN. Faecal samples were analyzed for levels of calprotectin, intestinal alkaline phosphatase (IAP), short-chain fatty acids (SCFA) and immunoglobulins in subjects with T1D (n = 159) and healthy controls (NDC; n = 50). The subjects with T1D were stratified based on albuminuria: normoalbuminuria (< 30 mg/g; n = 49), microalbuminuria (30–299 mg/g; n = 50) and macroalbuminuria (≥ 300 mg/g; n = 60). aecal calprotectin, IAP and immunoglobulin levels did not differ between the T1D albuminuria groups. However, when subjects were stratified based on faecal calprotectin cut-off level (50 µg/g), macroalbuminuric T1D subjects exceeded the threshold more frequently than NDC (p = 0.02). Concentrations of faecal propionate and butyrate were lower in T1D subjects compared with NDC (p = 0.04 and p = 0.03, respectively). Among T1D subjects, levels of branched SCFA (BCFA) correlated positively with current albuminuria level (isobutyrate, p = 0.03; isovalerate, p = 0.005). In our study cohort, fatty acid metabolism seemed to be altered among T1D subjects and those with albuminuria compared to NDC. This may reflect gastrointestinal imbalances associated with T1D and renal complications.

see all

Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 11
Issue: 1
Article number: 15208
DOI: 10.1038/s41598-021-94747-8
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Academy of Finland (275614 and 316664), Novo Nordisk Foundation (#NNF OC0013659), Signe and Ane Gyllenberg Foundation, Folkhälsan Research Foundation, Helsinki University Hospital Research Funds, Diabetes Research Foundation, Wilhelm and Else Stockmann Foundation and Päivikki and Sakari Sohlberg foundation supported this study. MM was also supported by Waldemar von Frenckell Foundation and Kidney Foundation (Munuaissäätiö).
Copyright information: © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit