AIM: To explore any gender-related differences in prevalence of and condition-associated factors related to an elevated serum alanine aminotransferase (ALT) level amongst residents of Kinmen, Taiwan.METHODS: A total of 11 898 of a potential 20 112 regional residents aged 30 years or more completed a related questionnaire that was carried out by the Yang-Ming Crusade between 1991 and 1994 inclusively, with blood samples being collected by public nurses. The overall questionnaire response rate was 59.3% (52.4% for males and 66.0% for females).RESULTS: The prevalence of an elevated serum ALT level for this sub-population was found to be 7,2%, the prevalence revealing a statistically significant decrease with increasing population age (P＜0.0001). Males exhibited a greater prevalence of elevated serum ALT level than did females (9.4% vs 5.3%, P＜0.0001). Using multiple logistic regression analysis, in addition to male gender, a younger age, greater waist circumference,presence of type-2 diabetes and hyperuricemia were the significant factors associated with an elevated serum ALT level for both males and females. Gender-related differences as regards associated factors were also revealed. For males, obesity was significantly related to an elevated serum ALT level (OR = 1.28, 95%CI: 1.00-1.66)but this was not so for females (OR = 1.09, 95%CI:0.84-1.42). Hypertriglyceridemia (OR = 1.80, 95%CI:1.36-2.39) and hyperuricemia (OR = 1.61, 95%CI:1.03-2.52) were significantly related to elevated serum ALT levels only for females.CONCLUSION: Several gender-related differences were noted pertaining to the prevalence of and relationship between obesity, hypertriglyceridemia and hyperuricemia and elevated serum ALT level in the present study.(c)2005 The WJG Press and Elsevier Ihc. All rights reserved.