Abstract: Objective To evaluate whether epicardial fat volume (EFV) is related to biochemical and inflammatory indices in chronic kidney disease (CKD) patients. Method A total of 30 healthy people from medical checkup center as the control group and 120 CKD patients were subjected to heart scanning by multislice
computed tomography. Cross-sectional tomographic cardiac slices from base to apex were traced semiautomatically using a volume viewer of AW4.3 off-line workstation. EFV was measured by assigning Hounsfield units ranging from -30 to -250 for fat. Serological indicators including serum albumin, creatinine (Scr), calcium, phosphorus (P), alkaline phosphatase, fasting glucose, parathyroid hormone (iPTH), high-sensitivity C-reactive protein (hs-CRP), high density lipoprotein (HDL) and low density lipoprotein (LDL) were measured. Age and body mass index (BMI) were collected. The relationship between EFV and changes of biochemical and inflammatory indices was then analyzed in CKD patients. Results ①EFV was apparently higher in CKD patients at stage 4, 5 and 5D compared with the control group (140.03 ± 54.71, 145.01 ± 64.56, 141.45±62.04 and 92.42±39.56 cm³ for stage 4, 5 and 5D CKD patients and healthy controls, respectively; P=0.007, 0.015 and 0.001 compared with control for stage 4, 5 and 5D patients, respectively). ②In CKD patients at stage 3, 4, 5, and 5D, EFV was positively correlated with Scr, hs-CRP and age (for Scr: r=0.675, P=0.006; r=0.512, P=0.043; r=0.794, P=0.011; r=0.449, P=0.013; for hs-CRP: r=0.723, P=0.005; r=0.604, P=0.022; r=0.593, P=0.020; r=0.574, P=0.005; for age: r=0.292, P=0.005; r=0.605, P=0.013; r=0.502, P=0.008; r=0.662, P=0.005), and was negatively correlated with HDL (r=- 0.625, P=0.013; r=- 0.608, P=0.012; r=-0.679, P=0.005; r=- 0.433, P=0.024). In CKD patients at stage 4, 5 and 5D, EFV was positively correlated with P, iPTH and BMI (for P: r=0.556, P=0.025; r=0.713, P=0.031; r=0.417, P=0.022; for iPTH: r=0.510, P=0.044; r=0.811, P=0.001; r=0.399, P=0.032; for BMI: r=0.256, P=0.026; r=0.521, P=0.046; r=0.648, P=0.009). (c) Multiple linear regression showed that EFV was significantly correlated with age (β =0.250, P=0.005), BMI (β=0.192, P=0.020), P (β=0.309, P＜0.001), HDL (β =-0.335, P＜0.001) and hs-CRP (β=0.186, P= 0.023). Conclusions Measurement of EFV may provide a useful and noninvasive indicator for coronary artery calcification in CKD patients with mineral and bone disorder.

Key words: chronic kidney disease, epicardial fat volume, Serum phosphorus