{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:52:28Z","timestamp":1790189548656,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005036","name":"Universitetet i Bergen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005036","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Intrauterine undernutrition is associated with increased risk of type 2 diabetes. Children born premature or small for gestational age were reported to have abnormal retinal vascularization. However, whether intrauterine famine act as a trigger for diabetes complications, including retinopathy, is unknown. The aim of the current study was to evaluate long\u2010term effects of perinatal famine on the risk of proliferative diabetic retinopathy (PDR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied the risk for PDR among type 2 diabetes patients exposed to perinatal famine in two independent cohorts: the Ukrainian National Diabetes Registry (UNDR) and the Hong Kong Diabetes Registry (HKDR). We analysed individuals born during the Great Famine (the Holodomor, 1932\u20131933) and the WWII (1941\u20131945) famine in 101\u2009095 (3601 had PDR) UNDR participants. Among 3021 (251 had PDR) HKDR participants, we studied type 2 diabetes patients exposed to perinatal famine during the WWII Japanese invasion in 1942\u20131945.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the Holodomor and WWII, perinatal famine was associated with a 1.76\u2010fold (p\u2009=\u20090.019) and 3.02\u2010fold (p\u2009=\u20090.001) increased risk of severe PDR in the UNDR. The risk for PDR was 1.66\u2010fold elevated among individuals born in 1942 in the HKDR (p\u2009&lt;\u20090.05). The associations between perinatal famine and PDR remained statistically significant after corrections for HbA1c in available 18\u2009507 UNDR (p<jats:sub>additive interaction<\/jats:sub>\u2009&lt;\u20090.001) and in 3021 HKDR type 2 diabetes patients (p\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, type 2 diabetes patients, exposed to perinatal famine, have increased risk of PDR compared to those without perinatal famine exposure. Further studies are needed to understand the underlying mechanisms and to extend this finding to other diabetes complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14948","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T05:08:06Z","timestamp":1624597686000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Perinatal famine is associated with excess risk of proliferative retinopathy in patients with type 2 diabetes"],"prefix":"10.1111","volume":"100","author":[{"given":"Olena","family":"Fedotkina","sequence":"first","affiliation":[{"name":"Department of Clinical Science Center for Diabetes Research University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Luk","sequence":"additional","affiliation":[{"name":"Hong Kong Institute of Diabetes and Obesity Prince of Wales Hospital The Chinese University of Hong Kong Hong 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