Abstract Background Chronic coronary artery disease (CAD) remains the leading cause of death worldwide. Its complex pathophysiology is influenced by multiple risk factors, with diabetes being one of the most significant. In recent years, advanced glycation end products (AGE) have gained attention as key markers of diabetes-related cardiovascular complications. Carboxymethyl-lysine (CML), a major product of oxidative modification of glycated proteins, is widely recognized as a biomarker of oxidative stress and long-term protein damage in aging, atherosclerosis, and diabetes. However, much contradictory information regarding the low-AGE diet and its precise clinical implications remains incompletely understood. Purpose To evaluate the impact of a low-AGE diet on plasma CML concentration and glucose and lipid profiles in patients with chronic coronary artery disease (CAD) and type 2 diabetes. Methods A randomized controlled trial was conducted in patients with type 2 diabetes (glucose level ≥126 mg/dL) and chronic coronary artery disease (CAD) over 15 days. Participants were randomly assigned to either a control group following their usual diet or an intervention group adhering to a low-AGE diet. Carboxymethyl-lysine (CML), triglycerides, total cholesterol, HDL-C, LDL-C, glucose, and insulin plasma concentration were measured at baseline and after 15 days of dietary intervention. Results 36 participants were included, of which 17 were allocated to the low-AGE diet group. The mean age was 60±3 years. At 15 days of intervention, the low-AGE diet group had a lower CML (2.77±1.23 vs. 2.24±0.94; p=0.014) and glucose (145±44.5 vs. 132±31.3 mg/dL; p=0.039) plasma concentration. Moreover, the low-AGE diet group also showed significant effects on dietary lipids (74.60±35.43 vs. 60.53±36.49 g; p=0.004), dietary cholesterol (390.15±189.77 vs. 301.07±224.86 mg; p0.001), and dietary AGE (16506.15±9182.04 vs. 12061.36±9182.04 kU; p0.001) content. However, no changes were observed for both groups in triglycerides, total cholesterol, HDL-C, LDL-C, C-reactive protein, and insulin plasma concentration (Table). Conclusion A diet poor in AGE reduced glucose levels in patients with chronic CAD and type 2 diabetes, and this diet intervention could improve diabetes control and reduce cardiovascular events in diabetic patients. Future studies with more patients and higher follow-up are needed.Table
Kuwabara et al. (Sat,) studied this question.
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