Introduction
coronary heart disease, T2DM, NSTEMI
DISEASE, CORONARY HEART DISEASE, COMPLICATIONS, EVENT
Advanced glycation end products (AGEs) are derived from the non-enzymatic glycation of various molecules, primarily proteins, but also lipids, and amino groups present in nucleic acids (Serum AGE levels do not necessarily correlate with fasting plasma glucose or HbA1c levels, as observed by both Kilhovd et al. (AGEs exert their pathogenetic action by interacting with specific cellular receptors (RAGEs) that bind AGEs in a saturable manner. Two isoforms of RAGEs have been described (Reduced levels of s-RAGE have been detected in patients with coronary heart disease compared to controls (The values of AGE and s-RAGE, taken individually within pathologies connected to the AGE–RAGE axis, are not yet of univocal interpretation. To overcome this limit, some authors have proposed studies aimed at identifying more effective markers as a predictor of disease. The AGE/s-RAGE ratio, which was found higher in non-diabetic patients with NSTEMI (non ST-segment elevation myocardial infarction) than in the control group, has been proposed as a possible biomarker/predictor for a cardiovascular event, with a better sensitivity than the s-RAGE value alone in identifying patients at risk (The aim of the present study was to evaluate the impact of two oral hypoglycaemic regimens, pioglitazone or glimepiride in association with metformin, after 5 years of treatment on the trend of the parameters AGE, s-RAGE and the cardiovascular risk marker AGE/s-RAGE ratio, in a cohort of patients with T2DM. A second objective was to investigate whether these indicators are correlated with anthropometric parameters, glyco-metabolic control, inflammatory status, and the presence of complications.