Reduction in Circulating Advanced Glycation End Products by Mediterranean Diet Is Associated With Increased Likelihood of Type 2 Diabetes Remission in Patients With Coronary Heart Disease: From the Cordioprev Study

SCOPE We hypothesize that a decrease in advanced glycation end products (AGEs) levels could affect T2DM remission in newly-diagnosed patients through the long-term consumption of two healthy diets. METHODS AND RESULTS We included patients from CORDIOPREV study, all with previous cardiovascular event, diagnosed with T2DM at the beginning of the study with no glucose-lowering treatment. Patients were randomized to a Mediterranean or a low-fat diet for 5 years. We found no different diabetes remission rates among diets. We measured serum levels of Methylglioxal (MG) and CarboximethylLysine (CML), dietary AGE, as well as gene expression of AGER1 and RAGE. Serum MG decreased only after the consumption of the Mediterranean diet. Moreover, a COX regression analysis showed that each SD decrease in the MG, occurring after consumption of the Mediterranean diet, increases the probability of T2DM remission with HR:2.56(1.02-6.25) and p = 0.046 and each SD increase in disposition index at baseline increases the probability of remission with HR:1.94(1.32-2.87) and p = 0.001. CONCLUSIONS We have demonstrated that the reduction of serum AGEs levels and the modulation of its metabolism, occurring after the consumption of a Mediterranean diet, might be involved in the molecular mechanism underlying the T2DM remission of newly-diagnosed patients with coronary heart disease. This article is protected by copyright. All rights reserved.