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Base editing using CRISPR technologies is an invaluable tool for crop breeding. One of the major base editors, the adenine base editor (ABE), has been successfully used in both model plants and many crops. However, owing to limited editing efficiency, the ABE has been difficult to apply in polyploid crops such as allohexaploid bread wheat that often require simultaneous mutation of multiple alleles for fast breeding. We have designed a wheat high-efficiency ABE (WhieABE), using the newly developed high-activity adenosine deaminase TadA8e. In vivo and in vitro analysis demonstrated the improved applicability of TadA8e over the commonly used TadA7.10. Dinitroaniline is a widely used herbicide with high effectiveness and low toxicity to animals. However, wheat cultivars with tolerance to dinitroaniline are rare, limiting the application of dinitroaniline in wheat planting. Using A-to-G editing with WhieABE, we found that a Met-to-Thr mutation in wheat tubulin alleles located on chromosomes 1A, 1B, 1D, 4A, and 4D increased the resistance of wheat to dinitroaniline, revealing a dosage effect of edited tubulins in resistance. The WhieABE promises to be a valuable editing tool for accelerating crop improvement and developing herbicide-resistant wheat germplasm.

Aims/Introduction To investigate the prevalence and risk factors of metabolic syndrome (MetS) in Chinese type 2 diabetes mellitus patients, and assess the effect of MetS on the treatment patterns and blood glucose, blood pressure and blood lipids goal achievements. Materials and Methods Data from 25,454 type 2 diabetes mellitus patients including demographic data, anthropometric measurements, treatment patterns, and blood glucose and lipid profiles were retrospectively analyzed. Results Using modified Adult Treatment Panel III MetS criteria, the prevalence of MetS was 57.4% in type 2 diabetes mellitus patients. Multivariable logistic regression analysis showed that type 2 diabetes mellitus patients, who also fulfilled the criteria for MetS, tended to be women, living in the northeast, with a diabetes duration ≥5 years and leading a sedentary lifestyle. Most MetS (53.4%) and non-MetS (57%) diabetes patients received oral hypoglycemic drugs. Insulin or insulin combination therapies were more applied in MetS (37.5%) than in non-MetS (33.1%) diabetes patients, and the percentages of MetS diabetes patients receiving antihypertensive and lipid-modulating drugs were 52.9% and 28.2% vs 38.3% and 19.3% of the non-MetS diabetes patients. Just 37.5%, 15.6% and 32.9% of the MetS diabetes patients vs 54.6%, 45.6% and 40.4% of the non-MetS diabetes patients achieved the individual target goals for control of blood glucose (glycosylated hemoglobin

This subanalysis of a cross-sectional, nationwide study was undertaken to assess the relationship between healthy lifestyle behaviors and multiple cardiovascular risk factors among people with type 2 diabetes mellitus (T2DM). Data collected from 25,454 participants, including demographics, lifestyle behaviors and cardiovascular risk profiles, were analyzed. Blood pressure control as well as blood glucose and blood lipid (3Bs) levels were measured as multi-risk factors for cardiovascular disease. Healthy lifestyle behaviors included regular exercise, nonsmoking status and no alcohol consumption. The relationship between the healthy lifestyle behavior(s) and control of 3B(s) was calculated. Of the 25,454 eligible participants, 4171 (16.4%) were current smokers, 2011 (7.9%) currently consumed alcohol, and 11,174 (43.9%) did not exercise. In total, 654 (2.6%) reported all three unhealthy lifestyle behaviors. Most participants (71.1%) had received at least a high school education and were more likely to smoke and drink as compared to those with lower education. Unhealthy lifestyle behaviors were commonly found in participants with low atherosclerosis risk, such as non-elderly people and those with an above-college education level. Unhealthy lifestyle is associated with poor 3B control and worse medication adherence. Unhealthy lifestyles are common in Chinese people with T2DM, especially in people who are non-elderly and above-college educated. Interventions aimed at changing risky lifestyle behaviors are required for improved outcomes for Chinese patients with T2DM.

ᅟ The present study comprised 17,096 Chinese hypertensive dyslipidemia patients who received lipid-lowering treatment for > 3 months in order to investigate blood pressure (BP) as well as low-density lipoprotein cholesterol (LDL-C) goal attainment rates in Chinese hypertensive dyslipidemia patients on antidyslipidemia drugs. The factors that interfered with BP, or BP and LDL-C goal attainment rates and antihypertensive treatment patterns, were analyzed. In total, 89.9% of the 17,096 hypertensive dyslipidemia patients received antihypertensive medications mainly consisting of a calcium channel blocker (CCB) (48.7%), an angiotensin receptor antagonist (ARB) (25.4%) and an angiotensin-converting enzyme inhibitor (ACEI) (15.1%). In cardiology departments, usage rates of β-blockers (19.2%) were unusually high compared to other departments (4.0–8.3%), whereas thiazide diuretics were prescribed at the lowest rate (0.3% vs 1.2–3.6%). The overall goal attainment rates for combined BP and LDL-C as well as BP or LDL-C targets were 22.9, 31.9 and 60.1%, respectively. The lowest BP, LDL-C and BP combined with LDL-C goal attainment rates were achieved in endocrine departments (19.9, 48.9 and 12.4%, respectively). Combination therapies showed no benefit particularly for BP goal achievement. A multivariate logistic regression analysis showed that age < 65 years, alcohol consumption, diabetes, coronary heart disease (CHD), cerebrovascular disease (CVD), chronic kidney disease (CKD), body mass index (BMI) ≥ 28 kg/m2 and not achieving total cholesterol goals were independent predictors for achieving BP, LDL-C or combined BP and LDL-C goals. In summary, the BP and LDL-C goal achievement rates in Chinese dyslipidemia outpatients with hypertension were low, especially in endocrine departments. Combination therapies were not associated with improvement of the goal achievement rates. Trial registration Clinical trial registration number NCT01732952 Electronic supplementary material The online version of this article (10.1186/s12944-019-0974-y) contains supplementary material, which is available to authorized users.

To investigate the associations between obesity and any significant improvements in glycemic control, blood pressure, and lipid targets in Chinese patients with concomitant type 2 diabetes mellitus (T2DM) and hypertension.A total of 3041 dyslipidemia patients with an average age of 65.7 ± 10.53 years and comorbid conditions of T2DM and hypertension from the DYSlipidemia International Study (DYSIS) - China were included in the present subgroup analysis. Patients' demographic data, medication use, blood glucose, and lipid parameters were analyzed retrospectively. Body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WtHR) differed significantly among participants according to the attainment of treatment targets. Among female patients, significant differences in the rate of target attainment were observed among different WC, WtHR, and BMI quartile groups, whereas no significant differences in goal attainment were found according to WC and WtHR quartiles in male patients. Among the female patients, the results of logistic regression supported a significant association of anthropometric indices and the achievement of targets.A considerable proportion of dyslipidemia patients failed to achieve guideline-recommended targets in China, and this apparent treatment gap was more pronounced among women with central adiposity and patients with an elevated BMI. Based on the limitations of this cross-sectional study, further investigation of the mechanism at the molecular level is necessary.

Objective This study aimed to investigate the effect of physicians’ characteristics and knowledge of LDL–C target goals on the quality of lipid management in China. Methods A total of 25 317 dyslipidemia patients who had taken lipid–lowering medication for >3 months were enrolled in our study. Patients’ demographic data, medical history, lipid profile, their physician’s specialty and professional title and their hospital level as well as their LDL–C goal opinions were recorded. Results Questionnaires were completed by 926 physicians with 6 different specialties and 4 professional statuses, in 3 different–level hospitals. Most (74.5%) of the physicians recognized the importance of considering LDL–C serum concentration for treating dyslipidemia, and set target LDL–C goals according to the 2007 Chinese guidelines for 83.4% of their patients. The LDL–C goal achievement rate was significantly higher for patients whose physicians’ knowledge of LDL–C target goals was consistent with guideline recommendations, compared with those whose physicians’ knowledge was inconsistent with the guidelines (60.4% vs 31.1%, P

Primary care facilities are the base for hypercholesterolemia treatment. However, data regarding the effectiveness of lipid management in primary care are lacking.To evaluate lipid management in the primary care setting in China, we compared patients' characteristics and lipid management outcomes between 6100 outpatients treated at primary care versus 19,217 patients in non-primary settings using data from the DYSlipidemia International Study-China (DYSIS-CHINA). Compared to patients treated at non-primary hospitals, patients who received treatment at primary settings were younger, thinner, and were more likely to be female and to have a family history of premature CVD. Overall, 26.8% of very high-risk and 40.8% of high-risk patients achieved the LDL-C target with primary care treatment, whereas these target rates were 41.2% (p0.001) and 58.6% (p0.001), respectively, among patients treated at non-primary hospitals. High-dose statin therapy was underused in primary care patients compared to non-primary hospital patients (p0.001). Logistic regression analysis showed that female gender, diabetes, and obesity were negative factors, whereas life-style modification and use of high-dose statin (40mg/d simvastatin equivalent) were favorable factors in predicting LDL-C target attainment in the primary care setting.Sedentary life style, alcohol drinking, and use of suboptimal statin dosage are key factors that unfavorably affect the LDL-C target rate among patients treated at primary care facilities in China. Sufficient training for primary care physicians regarding proper statin use and support for the combined use of a statin with ezetimibe could promote LDL-C target attainment in primary care.

Background Low socioeconomic status (SES) is associated with adverse cardiovascular risk factor patterns and poor outcomes in patients with diabetes. The aim of this study was to determine whether SES is associated with the control of blood glucose, blood pressure, blood cholesterol (3Bs), and diabetic complications in Chinese adults with type 2 diabetes. Methods Data regarding patients’ demographics, social economics, diabetes complications, and cardiovascular risk profiles were analyzed for 25,454 patients. The outcomes of interest were the proportions of patients with HbA1c

To objectively evaluate lipid-lowering therapy and low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) goal attainment in metabolic syndrome (MetS) patients in China.Data regarding patient demographics, lipid-lowering agents, lipid parameters, and cardiovascular risk profiles were analyzed for 25,317 patients of the Dyslipidemia International Study-China. MetS was defined according to criteria of the NCEP-ATP III and the 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults.The prevalence of MetS was 39.9% and 37.4% according to the NCEP-ATP III and 2007 Chinese Guidelines, respectively. LDL-C goal attainment occurred less frequently among MetS patients than in those without MetS (NCEP-ATP III: 46.9% vs 68.6%; 2007 Chinese Guidelines: 52.2% vs 67.1%; p 0.001). Similar results were obtained for non-HDL-C goal attainment (2007 Chinese Guidelines: 51.0% vs 72.0%; p 0.001). As the risk class increased, LDL-C and non-HDL-C goal attainment decreased. In multivariate logistic regression analysis, DM, CHD, ischemic cerebrovascular disease, and higher SBP were independently associated with failure to achieve LDL-C and non-HDL-C goal attainment. The type of lipid-lowering agent was not significantly correlated with LDL-C not at goal attainment but was correlated with non-HDL-C not at goal attainment.Goal attainment for both LDL-C and non-HDL-C occurs less frequently in MetS patients than in those without MetS. The residual risk due to elevated non-HDL-C levels should be considered in MetS patients. Strategies for controlling multiple risk factors in order to decrease the residual risk related to dyslipidemia in MetS patients should be recommended in future guidelines.