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740 (95% CI 0.726-0.754, P.001), with 71.2% and 63.4% sensitivity and specificity, respectively, in women. The AUROC of serum ALP in women was larger than that in men [0.575 (95% CI 0.559-0.59, P.001]. Serum ALP is independently associated with arterial stiffness and 10-year CVD risk. Our results imply that serum ALP may be a promising marker to identify an increased risk for subclinical atherosclerosis in women needing further evaluation. Serum ALP is independently associated with arterial stiffness and 10-year CVD risk. Our results imply