{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:40:15Z","timestamp":1792521615794,"version":"4.5.0"},"reference-count":0,"publisher":"American Diabetes Association","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["220027"],"award-info":[{"award-number":["220027"]}],"id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["250214"],"award-info":[{"award-number":["250214"]}],"id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The US-Ireland R&D Partnership Programme by HSC research and development division","award":["STL\/5569\/19"],"award-info":[{"award-number":["STL\/5569\/19"]}]},{"name":"The US-Ireland R&D Partnership Programme by HSC research and development division","award":["STL\/5586\/19"],"award-info":[{"award-number":["STL\/5586\/19"]}]},{"name":"Liv och H\u00e4lsa Society"},{"name":"State funding for university-level health research by Helsinki University Hospital","award":["TYH2023403"],"award-info":[{"award-number":["TYH2023403"]}]},{"DOI":"10.13039\/100010113","name":"Wilhelm och Else Stockmanns Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010113","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF23OC0082732"],"award-info":[{"award-number":["NNF23OC0082732"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Science Foundation Ireland and the Department for the Economy, Northern Ireland Investigator Program Partnership Award","award":["15\/IA\/3152"],"award-info":[{"award-number":["15\/IA\/3152"]}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MRC MC_PC_20026"],"award-info":[{"award-number":["MRC MC_PC_20026"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MRC MC_PC_22005"],"award-info":[{"award-number":["MRC MC_PC_22005"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001602","name":"Science Foundation Ireland","doi-asserted-by":"publisher","award":["21\/US\/3751"],"award-info":[{"award-number":["21\/US\/3751"]}],"id":[{"id":"10.13039\/501100001602","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Northern Ireland Kidney Research Fund"},{"DOI":"10.13039\/100015736","name":"Folkh\u00e4lsanin Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015736","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1R01DK132299-01"],"award-info":[{"award-number":["1R01DK132299-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Diabetes Research Foundation"},{"name":"Vivensa Foundation Proleptic Fellowship","award":["PF2502\/5"],"award-info":[{"award-number":["PF2502\/5"]}]},{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>To characterize accelerated epigenetic ageing in individuals with diabetic kidney disease (DKD) and type 1 diabetes, 10 epigenetic clocks were generated for those with type 1 diabetes, with (case patients) or without (control participants) DKD, within the All Ireland\u2013Warren 3\u2013Genetics of Kidneys in Diabetes UK and Belfast Renal Transplant (UK-RoI; n = 464) and Finnish Diabetic Nephropathy (FinnDiane; n = 795) cohorts. Experimentally derived and epigenetically predicted telomere lengths (TLs) were also compared. This study revealed that higher PhenoAge and shorter epigenetically predicted TL were associated with increased DKD risk (principal component [PC] with z score version (zPC) of PhenoAge: odds ratio [OR] 1.4 [95% CI 1.2\u20131.8]; P = 2.47 \u00d7 10\u22124 in UK-ROI and OR 1.8 [95% CI 1.5\u20132.1]; P = 2.30 \u00d7 10\u221212 in FinnDiane; zPC\u2013DNA methylation TL: OR 0.6 [95% CI 0.5\u20130.8]; P = 7.28 \u00d7 10\u22126 in UK-ROI and OR 0.7 [95% CI 0.6\u20130.8]; P = 1.40 \u00d7 10\u22126 in FinnDiane); age, white cell proportion, and sex adjusted). Case patients were epigenetically older than control participants by \u223c2 years (PC-PhenoAge). Results suggested a male-specific association between DunedinPACE\u2013epigenetic age acceleration (EAA) and DKD (OR 1.3 [95% CI 1.0\u20131.7]; P = 0.026 in UK-ROI and OR 1.5 [95% CI 1.3\u20131.8]; P = 1.46 \u00d7 10\u22126 in FinnDiane). Longitudinal analyses included 1) methylation at two time points a median of 7.5 years apart (n = 2 \u00d7 52) and 2) Cox regression for DKD progression in 384 case participants (median follow-up 7.7 years). Progression from normolbuminuria to severely increased albuminuria was associated with increased EAA. Chronologic age, epigenetic age, and EAA (PhenoAge-EAA P = 0.0011; hazard ratio 1.07 [95% CI 1.03\u20131.11] per year; C-index = 0.67) were significant predictors of progression to end-stage kidney disease (ESKD). Epigenetic biomarkers demonstrate accelerated biological ageing associated with DKD and progression to ESKD.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Article Highlights<\/jats:title>\n                    <jats:p>We investigated whether an association existed between epigenetic age acceleration (EAA) and diabetic kidney disease (DKD) in type 1 diabetes, using 10 clocks and two cohorts, and whether this amplified disease progression. Older EAA phenotypic age and shorter epigenetically predicted telomere lengths were significantly associated with DKD. Progression from normolbuminuria to severely increased albuminuria was associated with increased EAA, and age, epigenetic age, and EAA were significant predictors of progression to end-stage kidney disease. Results support the development of epigenetic biomarkers predicting DKD onset and progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/db26-0089","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:06:39Z","timestamp":1792519599000},"update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Accelerated Epigenetic Ageing in Diabetic Kidney Disease: A Comparison of 10 Epigenetic Clock Measures in Individuals With Type 1 Diabetes"],"prefix":"10.2337","author":[{"given":"Claire","family":"Hill","sequence":"first","affiliation":[{"name":"1Centre for Public Health, Queen\u2019s University Belfast, Belfast, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqi","family":"Luo","sequence":"additional","affiliation":[{"name":"2Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"3Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"4Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1857-2560","authenticated-orcid":false,"given":"Anna","family":"Syreeni","sequence":"additional","affiliation":[{"name":"2Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"3Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"4Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Smyth","sequence":"additional","affiliation":[{"name":"1Centre for Public Health, Queen\u2019s University Belfast, Belfast, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1271-8696","authenticated-orcid":false,"given":"Emma H.","family":"Dahlstr\u00f6m","sequence":"additional","affiliation":[{"name":"2Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"3Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"4Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seamus","family":"Duffy","sequence":"additional","affiliation":[{"name":"1Centre for Public Health, Queen\u2019s University Belfast, Belfast, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Kilner","sequence":"additional","affiliation":[{"name":"1Centre for Public Health, Queen\u2019s University Belfast, Belfast, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abubakar","family":"Mangani","sequence":"additional","affiliation":[{"name":"5Sydney Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0583-3717","authenticated-orcid":false,"given":"Alicia J.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"6Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"McKay","sequence":"additional","affiliation":[{"name":"1Centre for Public Health, Queen\u2019s University Belfast, Belfast, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander P.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"1Centre for Public Health, Queen\u2019s University Belfast, Belfast, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4908-5474","authenticated-orcid":false,"given":"Eoin P.","family":"Brennan","sequence":"additional","affiliation":[{"name":"7Diabetes Complications Research Centre, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland"},{"name":"8School of Medicine, University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Godson","sequence":"additional","affiliation":[{"name":"7Diabetes Complications Research Centre, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland"},{"name":"8School of Medicine, University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel N.","family":"Hirschhorn","sequence":"additional","affiliation":[{"name":"9Broad Institute of MIT and Harvard, Cambridge, MA"},{"name":"10Department of Genetics, Harvard Medical School, Boston, MA"},{"name":"11Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children\u2019s Hospital, Boston, MA"},{"name":"12Department of Pediatrics, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1730-9325","authenticated-orcid":false,"given":"Jose C.","family":"Florez","sequence":"additional","affiliation":[{"name":"13Programs in Metabolism and Medical & Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA"},{"name":"14Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA"},{"name":"15Department of Medicine, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per-Henrik","family":"Groop","sequence":"additional","affiliation":[{"name":"2Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"3Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"4Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland"},{"name":"6Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia"},{"name":"16Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4322-6942","authenticated-orcid":false,"given":"Niina","family":"Sandholm","sequence":"additional","affiliation":[{"name":"2Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"3Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"4Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7482-709X","authenticated-orcid":false,"given":"Amy Jayne","family":"McKnight","sequence":"additional","affiliation":[{"name":"1Centre for Public Health, Queen\u2019s University Belfast, Belfast, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"FinnDiane Study Group and the GENIE Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,10,20]]},"container-title":["Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article-pdf\/doi\/10.2337\/db26-0089\/899410\/db260089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article-pdf\/doi\/10.2337\/db26-0089\/899410\/db260089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:06:41Z","timestamp":1792519601000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article\/doi\/10.2337\/db26-0089\/172863\/Accelerated-Epigenetic-Ageing-in-Diabetic-Kidney"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2337\/db26-0089","relation":{},"ISSN":["0012-1797","1939-327X"],"issn-type":[{"value":"0012-1797","type":"print"},{"value":"1939-327X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"article-number":"db260089"}}