Title: Independent associations of thyroid-related hormones with hepatic steatosis and insulin
resistance in euthyroid overweight/obese Chinese adults
Version: 1 Date: 18 Jul 2021
Reviewer's report:
I think this study is interesting because it addresses the relationship between NAFLD and thyroid
function in middle-aged adults with normal thyroid function. We also appreciate that the analysis
was carried out using a simple and less invasive test. However, as the authors state in the
discussion, it will be important to compare thyroid function in non-obese and non-NAFLD
patients with a similar patient background. In addition, since CAP and FLI have their limitations,
it would be important to test whether they correlate with hepatic steatosis assessed by other
modalities such as L/S ratio using CT, MRI and liver biopsy.
What are your views on the following two points?
1. Reference 26 demonstrates that the mRNA expression of leptin and D1, and activity of D1
in adipocytes are increased in obese patients compared to non-obese patients. In this study, did
you measure serum leptin? This may support your hypothesis that compensatory elevated FT3
increase energy expenditure and maintain metabolic homeostasis in obese middle-aged adults
with normal thyroid function.
2.  Do you think that supplementation with liothyronine or levothyroxine improves hepatic
steatosis, or do you have data or reports to this effect?
Title: Independent associations of thyroid-related hormones with hepatic steatosis and insulin
resistance in euthyroid overweight/obese Chinese adults
Version: 1 Date: 18 Jul 2021
Reviewer's report:
I think this study is interesting because it addresses the relationship between NAFLD and thyroid
function in middle-aged adults with normal thyroid function. We also appreciate that the analysis
was carried out using a simple and less invasive test. However, as the authors state in the
discussion, it will be important to compare thyroid function in non-obese and non-NAFLD
patients with a similar patient background. In addition, since CAP and FLI have their limitations,
it would be important to test whether they correlate with hepatic steatosis assessed by other
modalities such as L/S ratio using CT, MRI and liver biopsy.
What are your views on the following two points?
1. Reference 26 demonstrates that the mRNA expression of leptin and D1, and activity of D1
in adipocytes are increased in obese patients compared to non-obese patients. In this study, did
you measure serum leptin? This may support your hypothesis that compensatory elevated FT3
increase energy expenditure and maintain metabolic homeostasis in obese middle-aged adults
with normal thyroid function.
2.  Do you think that supplementation with liothyronine or levothyroxine improves hepatic
steatosis, or do you have data or reports to this effect?
Please review this paper.
user
Title: Independent associations of thyroid-related hormones with hepatic steatosis and insulin
resistance in euthyroid overweight/obese Chinese adults
Version: 1 Date: 18 Jul 2021
Reviewer's report:
I think this study is interesting because it addresses the relationship between NAFLD and thyroid
function in middle-aged adults with normal thyroid function. We also appreciate that the analysis
was carried out using a simple and less invasive test. However, as the authors state in the
discussion, it will be important to compare thyroid function in non-obese and non-NAFLD
patients with a similar patient background. In addition, since CAP and FLI have their limitations,
it would be important to test whether they correlate with hepatic steatosis assessed by other
modalities such as L/S ratio using CT, MRI and liver biopsy.
What are your views on the following two points?
1. Reference 26 demonstrates that the mRNA expression of leptin and D1, and activity of D1
in adipocytes are increased in obese patients compared to non-obese patients. In this study, did
you measure serum leptin? This may support your hypothesis that compensatory elevated FT3
increase energy expenditure and maintain metabolic homeostasis in obese middle-aged adults
with normal thyroid function.
2.  Do you think that supplementation with liothyronine or levothyroxine improves hepatic
steatosis, or do you have data or reports to this effect?
assistant