Objective:To investigate the association between skin advanced glycation end products (AGEs) and carotid atherosclerosis (AS) in subjects with normal glucose regulation (NGR).Methods:This was a cross-sectional study. Data from the Health Management Center of the First Affiliated Hospital of University of Science and Technology between January 2019 to June 2019 were collected. A total of 902 NGR subjects aged 40-79 were enrolled and categorized into control group (530 cases), carotid intima-media thickness (IMT) thickening group (150 cases), and carotid atherosclerosis plaque group (222 cases) based on the carotid ultrasound results. Data as follows were collected, gender, age, blood pressure, body mass index (BMI), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c) and skin AGEs. Comparison via ANOVA analysis were carried out among the 3 groups. Logistic regression analysis was used to screen the independent influencing factors of carotid atherosclerosis plaque. Spearman correlation analysis was used to evaluate the correlation between AGEs and other parameters, and receiver operating characteristic (ROC) curve was used to evaluate the efficiency of skin AGEs in predicting carotid atherosclerosis plaque in NGR subjects. Results:Among the control group, IMT thickening group and carotid atherosclerosis plaque group, gender, age, systolic blood pressure (SBP), diastolic blood pressure (DBP), TC, LDL-C, FPG, HbA 1c, AGEs were significantly different (all P<0.05). Compared with IMT thickening group, the age, SBP and AGEs of carotid atherosclerotic plaque group were higher [55 (50, 60) vs 53 (49, 56) year; 132 (122, 141) vs 126 (115, 142) mmHg(1 mmHg=0.133 kPa); 74 (67, 81) vs 72 (67, 78) AU] (all P<0.001); compared with the control group, age, LDL-C, HbA 1c and AGEs of IMT thickening group were higher [53 (49, 56) vs 48 (45, 52) year; (2.8±0.7) vs (2.7±0.7) mmol/L; 5.4% (5.2, 5.6)% vs 5.4% (5.1, 5.6)%; 72 (67, 78) vs 70 (66, 76)] (all P<0.05). Age ( OR=1.179, 95% CI: 1.107-1.255), SBP ( OR=1.045, 95% CI: 1.013-1.077), LDL-C ( OR=2.028, 95% CI: 1.036-3.969), AGEs ( OR=1.049, 95% CI: 1.000-1.100) were independent influencing factors of carotid atherosclerotic plaque in population with normal glucose regulated (all P<0.05). AGEs was positively correlated with age, HbA 1c and carotid atherosclerosis plaque ( r=0.407, 0.092, 0.172) (all P<0.01). The area under the ROC curve of skin AGEs for identifying carotid atherosclerotic plaque in NGR population was 0.650 (95% CI 0.601-0.698), the best cutoff value was 70.5, the sensitivity was 65.8%, and the specificity was 56.9%. Conclusion:Skin AGEs level is closely associated with the occurrence of carotid atherosclerosis in NGR subjects.