Summary Alanine aminotransferase (ALT), aspartate transaminase (AST), and glutamyl transpeptidase (GGT) were three key enzymes in the hepatic metabolism. This study aimed to investigate the effect of homocysteine (Hcy) metabolism gene polymorphisms and serum Hcy and folate level on the hepatic functions in a Chinese hypertensive population. A representative sample with 480 subjects aged 28-75 was enrolled in 2005.9-2005.12 from six hospitals in different Chinese regions. Serum ALT, AST and GGT were measured by using an automatic biochemistry analyzer. Serum Hcy was measured by high-performance liquid chromatography, and serum folate was measured by chemiluminescent immunoassay. Known genotypes were detected by PCR-RFLP methods. The results showed that the MTHFR C677T mutation was related a decreased serum AST level (r520.11, p50.026), whereas the MTHFR A1298C mutation elevated serum AST level (r50.11, p50.032). Furthermore, multiple regression analysis showed that folate deficiency was associated with higher serum ALT (b (SE): 0.13 (0.06), p50.031) and GGT level (b (SE): 0.18 (0.07), p50.011). However, serum Hcy level may not affect the hepatic functions. Our data suggested that hepatic functions were affected by MTHFR gene polymorphisms and serum folate level. Further studies are needed to confirm these correlations in a larger population. Key Words folate deficiency, MTHFR gene polymorphisms, alanine aminotransferase, aspartate transaminase, glutamyl transpeptidase Fatty liver disease (FLD), including primary non-alcoholic fatty liver disease (NAFLD) and the severe form, non-alcoholic steatohepatitis (NASH) is the most common form of liver disease and is increasing throughout the world (1). In Western adults, the prevalence of NAFLD assessed by ultrasound is 20-30% and the prevalence of NASH is 3-16% (2). Alanine aminotransferase (ALT), aspartate transaminase (AST) and glutamyl transpeptidase (GGT) are three key enzymes in the liver metabolism. Studies showed that high levels of ALT, AST and GGT were associated with liver disease (3). Furthermore, serum ALT and AST levels showed relevance with the histopathological changes in liver biopsies of hepatitis C patients (4). In one carbon metabolism, folate is closely related to many important biochemical processes in vivo. A mouse experiment suggested that maternal low folate and selenium diet altered liver gene expression patterns in the offspring after weaning (5). And a previous study showed that folate supplementation reduced the serum ALT level in high baseline ALT (.40 IU/L) individuals (6). In addition, a higher serum homocysteine (Hcy) level also showed strongly correlation with liver disease (7,8).Methylenetetrahydrofolate reductase (MTHFR), methionine synthase (MTR) and methionine synthase reductase (MTRR) are three key regulatory enzymes in the folate and Hcy metabolisms (9). MTHFR catalyses the reduction of 5,10-methylenetetrahydrofolate (5,10-MTHF) to 5-methyltetrahydrofolate (5-MTHF) and 5-MTHF is a cofactor for Hcy methylation to methionine when cata...