Serum alkaline phosphatase level is positively associated with metabolic syndrome: A nationwide population-based study

Background: Serum alkaline phosphatase (ALP), a useful marker of hepatobiliary or bone disorder, has recently emerged as a biomarker of chronic low-grade inflammation and cardiometabolic disease. This study aimed to examine the association of serum ALP level with metabolic syndrome (MetS) in apparently healthy adults. Methods: A cross-sectional study was conducted to examine the relationship between serum ALP level and MetS in 7,101 men and 8,873 women aged 19 to 75 years using data from the 2008 to 2011 Korean National Health and Nutrition Examination Survey. The odds ratios (ORs) and 95% confidence intervals (CIs) for MetS were calculated using multiple logistic regression analyses across serum ALP quartiles (Q1: <= 190 U/L; Q2: 191-224 U/L; Q3: 225-263 U/L; and Q4: >= 264 U/L for men and Q1: <= 163 U/L; Q2: 164-201 U/L; Q3: 202-251 U/L; and Q4: >= 252 U/L for women). Results: The mean values of most cardiometabolic variables, HOMA-IR, and leukocyte count gradually increased with serum ALP quartile. The prevalence of MetS significantly increased in accordance with serum ALP quartile. In comparison with those of individuals in the lowest quartile, the OR (95% CI) for MetS in the highest quartile was 1.32 (1.05-1.64) in men and 1.99 (1.42-3.81) in women after adjusting for age, cigarette smoking, alcohol intake, regular exercise, household income, education level, occupation, AST, ALT, and GGT levels. Conclusion: Serum ALP level was positively and independently associated with MetS in men and women.