Serum alkaline phosphatase (ALP), is an indicator of hepatobiliary disorders as metabolic syndrome (MetS). To assess the association between serum ALP levels with metabolic syndrome (MetS) with or without Non-Alcoholic Fatty Liver in a cohort study in northern Iran.

The data of about 5257 subjects aged more than 18- year participating in Amol cohort were used. We extracted the required data and investigated the correlation between liver enzymes and MetS . A multiple logistic regression analyses based on serum ALP quartiles were done.

There was a positive linear trend between serum ALP levels and the numbers of MetS’ components in both genders. After adjusting for age, both genders with NAFLD were increased risk of Mets. Individuals in 2th quartile of ALP had increased risk of NAFLD that was increased in the 4th quartile. Furthermore, higher ALP levels were associated with increased risk of MetS, the association that continued to persist in women after adjusting to NAFLD.

There is a significant association between the serum ALP levels and MetS independent from the fatty liver changes, suggesting this marker as a feasible predictor for MetS.