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Background and Aims: Advanced glycation end products (AGEs) are reported to be correlated with diabetic vascular complications. This study aimed to investigate the association between AGEs and carotid atherosclerosis (CAS) as a surrogate marker of cardiovascular disease (CVD)., Methods and Results: A total of 1006 patients with type 2 diabetes were included. CAS was defined as the presence of carotid arterial atherosclerotic plaque in any of bilateral carotid artery segments measured by ultrasonography. AGEs were measured by the noninvasive skin autofluorescence method. AGE age index was calculated as AGEs × age/100. Patients with CAS showed a significantly higher AGE age (P < 0.01), and the prevalence of CAS increased with ascending AGE age levels (P for trend < 0.001). Logistic regression analysis revealed that AGE age was significantly positively associated with odds of CAS, and the odds ratios of the presence of CAS across quartiles of AGE age were 1.00, 3.00 [95% confidence interval (CI) 1.90-4.74], 4.04 (95%CI 2.50-6.53) and 4.99 (95%CI 2.97-8.40) for the multivariable-adjusted model (P for trend <0.001), respectively. In the fully adjusted model, each 5.0 increase in AGE age was associated with a 0.019 mm increment in carotid intima-media thickness. Furthermore, AGE age presented an acceptable predictive value for CAS, with an optimal cutoff point of 43.2, and the sensitivity, specificity and area under the curve (AUC) were 74.5% (95%CI 70.7-78.1%), 61.9% (95%CI 57.2-66.4%) and 0.735 (0.706-0.762), respectively., Conclusion: AGE age , the noninvasive measurement of AGEs combined with age is a promising approach for triaging patients at high risk of CVDs., Competing Interests: Declaration of competing interest No competing financial interests exist., (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)