A nationwide assessment of blood pressure control and the associated factors in Chinese type 2 diabetes mellitus patients.

A subgroup analysis of the nationwide, cross-sectional 3B STUDY was performed to understand the current blood pressure (BP) control status and treatment patterns in Chinese diabetes patients as well as to identify factors associated with BP control. The demographic data, anthropometric parameters, and laboratory results were collected from 24 512 type 2 diabetes patients. The BP goal was a systolic BP <130 mm Hg and a diastolic BP <80 mm Hg regardless of a history of hypertension or current antihypertensive treatment. The overall prevalence of hypertension was 59.9% with geographical differences. Among the diabetes patients with hypertension, 76.9% received antihypertensive medicines. Calcium channel blockers (39.3%), angiotensin II receptor antagonists (26.6%), and then ß-blockers (14.0%) or angiotensin-converting enzyme inhibitors (13.6%) were frequently used for BP control. Only 17.5% (n = 2658) of diabetes patients with hypertension reached the recommended target BP. Body mass index <24 kg/m2 , urban resident, frequent physical activity, good adherence to medication, comorbidity with cardiovascular disease, achieving glycemic goal (HbA1c <7.0%), achieving lipid goal (low-density lipoprotein cholesterol <2.59 mmol/L) were independent factors that predicted achievement of target BP goal. On the contrary, comorbidity with chronic kidney disease predicted failure to achieve target BP goal. Patients who were treated in a cardiology department or lived in the North were more likely to achieve BP goals. A considerable proportion of diabetic patients failed to achieve guideline-recommended BP targets. More aggressive efforts should be made to overcome the diverse barriers and facilitate the optimization of diabetes management.

Association of obesity with glucose, blood pressure, and lipid goals attainment in patients with concomitant diabetes and hypertension.

OBJECTIVE: 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. METHODS AND RESULTS: 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. CONCLUSION: 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.

Genome-wide transcriptional profiles of the berry skin of two red grape cultivars (Vitis vinifera) in which anthocyanin synthesis is sunlight-dependent or -independent.

Global gene expression was analyzed in the berry skin of two red grape cultivars, which can ('Jingyan') or cannot ('Jingxiu') synthesize anthocyanins after sunlight exclusion from fruit set until maturity. Gene transcripts responding to sunlight exclusion in 'Jingyan' were less complex than in 'Jingxiu'; 528 genes were induced and 383 repressed in the former, whereas 2655 genes were induced and 205 suppressed in 'Jingxiu'. They were regulated either in the same or opposing manner in the two cultivars, or in only one cultivar. In addition to VvUFGT and VvMYBA1, some candidate genes (e.g. AOMT, GST, and ANP) were identified which are probably involved in the differential responses of 'Jingxiu' and 'Jingyan' to sunlight exclusion. In addition, 26 MYB, 14 bHLH and 23 WD40 genes responded differently to sunlight exclusion in the two cultivars. Interestingly, all of the 189 genes classified as being relevant to ubiquitin-dependent protein degradation were down-regulated by sunlight exclusion in 'Jingxiu', but the majority (162) remained unchanged in 'Jingyan' berry skin. It would be of interest to determine the precise role of the ubiquitin pathway following sunlight exclusion, particularly the role of COP9 signalosome, cullins, RING-Box 1, and COP1-interacting proteins. Only a few genes in the light signal system were found to be regulated by sunlight exclusion in either or both cultivars. This study provides a valuable overview of the transcriptome changes and gives insight into the genetic background that may be responsible for sunlight-dependent versus -independent anthocyanin biosynthesis in berry skin.

Differential proteomic analysis of grapevine leaves by iTRAQ reveals responses to heat stress and subsequent recovery.

BACKGROUND: High temperature is a major environmental factor limiting grape yield and affecting berry quality. Thermotolerance includes the direct response to heat stress and the ability to recover from heat stress. To better understand the mechanism of the thermotolerance of Vitis, we combined a physiological analysis with iTRAQ-based proteomics of Vitis vinifera cv Cabernet Sauvignon, subjected to 43°C for 6 h, and then followed by recovery at 25/18°C. RESULTS: High temperature increased the concentrations of TBARS and inhibited electronic transport in photosynthesis apparatus, indicating that grape leaves were damaged by heat stress. However, these physiological changes rapidly returned to control levels during the subsequent recovery phase from heat stress. One hundred and seventy-four proteins were differentially expressed under heat stress and/or during the recovery phase, in comparison to unstressed controls, respectively. Stress and recovery conditions shared 42 proteins, while 113 and 103 proteins were respectively identified under heat stress and recovery conditions alone. Based on MapMan ontology, functional categories for these dysregulated proteins included mainly photosynthesis (about 20%), proteins (13%), and stress (8%). The subcellular localization using TargetP showed most proteins were located in the chloroplasts (34%), secretory pathways (8%) and mitochondrion (3%). CONCLUSION: On the basis of these findings, we proposed that some proteins related to electron transport chain of photosynthesis, antioxidant enzymes, HSPs and other stress response proteins, and glycolysis may play key roles in enhancing grapevine adaptation to and recovery capacity from heat stress. These results provide a better understanding of the proteins involved in, and mechanisms of thermotolerance in grapevines.