Background: Diabetes (DM) is a common disorder that increase cardiovascular (CV) risk and can lead to coronary artery disease (CAD). Epicardial fat (EF) is a well-evidenced source of proatherogenic cytokines and a link between DM and CAD. Our aim was to evaluate the association between epicardial fat volume (EFV) and relative expressions of proatherogenic genes in EF and corresponding serum cytokines in patients with CAD in relation to DM. Methods: Sixty-six consecutive patients (33 with DM) with multivessel CAD scheduled for coronary artery bypass grafting were included. We obtained cardiac magnetic resonance (CMR; GE OPTIMA 1,5T) for EFV and other fat depots, serum levels of cytokines and their relative mRNA expressions in EF of the following: Receptor for Advanced Glycation Endproducts (RAGE), Proadrenomedullin (ADM), Transforming Growth Factor b (TGFb), Phospholipid Transfer Protein (PLTP) and Uncoupling Protein 1 (UCP-1). Results: There were no differences in the clinical parameters of obesity and CMR fat depots, except for total EFV, which was increased in patients with DM (105.6±38.5 vs 84±29.2ml, p=0.02) compared to individuals without DM. Patients with DM exhibited a significantly increased expression of RAGE (0.57±0.86 vs 0.14±0.17 a.u.; p<0.01) and ADM (4.27±6.1 vs 1.65±3.6 a.u.; p=0.04) in EF depot. There were no differences in the expressions of TGFb, PLTP or UCP-1 between the subgroups. None of the CMR epicardial fat volumes (total volume or regional measures of atrioventricular or apical grooves) showed any associations with mRNA expressions in EF or corresponding serum cytokines. The profile of genes expression in EF was more proatherogenic in DM (p<0.01) with no associations with CMR measures of EF. Conclusions: None of the CMR quantity measures of EF, including EFV, may be a marker of epicardial fat dysfunction and increased CV risk in patients with DM.