Situational Analysis of Low-density Lipoprotein Cholesterol Control and the Use of Statin Therapy in Diabetes Patients Treated in Community Hospitals in Nanjing, China

Background：Comprehensive management of diabetes should include management of its comorbid conditions,especially cardiovascular complications,which are the leading cause of morbidity and mortality among patients with diabetes.Dyslipidemia is a comorbid condition of diabetes and a risk factor for cardiovascular complications.Therefore,lipid level management is a key of managing patients with diabetes successfully.However,it is not clear that how well dyslipidemia is managed in patients with diabetes in local Chinese health-care communities.This study aimed to assess how well low-density lipoprotein cholesterol （LDL-C） was managed in Nanjing community hospitals,China.Methods：We reviewed clinical records of 7364 diabetic patients who were treated in eleven community hospitals in Nanjing from October 2005 to October 2014.Information regarding LDL-C level,cardiovascular risk factors,and use of lipid-lowering agents were collected.Results：In patients without history of cardiovascular disease （CVD）,92.1% had one or more CVD risk factors,and the most common CVD risk factor was dyslipidemia.The overall average LDL-C level was 2.80 ± 0.88 mmol/L,which was 2.62 ± 0.90 mmol/L and 2.82 ± 0.87 mmol/L in patients with and without CVD history respectively.Only 38% of all patients met the target goal and 37.3% of patients who took lipid-lowering agents met target goal.Overall,24.5% of all patients were on lipid-lowering medication,and 36.3% of patients with a CVD history and 20.9% of patients without CVD history took statins for LDL-C management.The mean statin dosage was 13.9 ± 8.9 mg.Conclusions：Only a small portion of patients achieved target LDL-C level,and the rate of using statins to control LDL-C was low.Managing LDL-C with statins in patients with diabetes should be promoted,especially in patients without a CVD history and with one or more CVD risk factors.

Approaches towards the core pentasaccharide in N-linked glycans

All eukaryotic cells share a common core pentasaccharide, Man3GlcNAc2 （M3）, which is found in both dolichol-linked oligosaccharides （DLOs） and N-linked glycoproteins. A pentasaccharide M3 can be elongated and elaborated by various glycosyltransferases and is thus considered as the key intermediate in the in vitro synthetic pathway of N-glycans. In this review, we describe the progresses in the preparation of M3 by chemical and chemoenzymatic methods. We first draw a brief schematic view of the typical N-glycan biological pathway and then focus on the requirements and challenges in obtaining core pentasaccharides. Representative methods and recent reported findings, especially research progress in chemoenzymatic synthesis, are highlighted. In addition, the opportunities in exploiting novel methods for constructing N-glycans, as well as their applications, are discussed.