Title: Association between glycated hemoglobin/high-density lipoprotein ratio and
nonalcoholic fatty liver disease in a U.S. nondiabetic population: a cross-sectional study based
on NHANES 2017-2020 data
Version: 0 Date: 11 Jun 2025
Reviewer's report:
In this study, Mao et al. investigated the association between glycated hemoglobin/high-density
lipoprotein ratio and nonalcoholic fatty liver disease in a non-diabetic US population. While the
study presents an interesting perspective, there are some issues that should be addressed.
Major comments:
#1. The current study does not account for several important covariates that may influence the
results. Relevant variables such as waist circumference, waist-to-height ratio, dietary patterns,
physical activity levels, alcohol consumption, renal function markers (uric acid, creatinine,
BUN, eGFR), and the use of antihypertensive medications are all potential confounders. It is
strongly recommended that these variables be incorporated into the study.
#2. As the present study design appears to be cross-sectional or observational rather than a
longitudinal cohort study, it is methodologically inappropriate to infer causality or use terms
such as “risk.” Instead, the findings should be described in terms of associations or correlations.
#3. A thorough language and grammatical review by a native English speaker is highly
recommended.
Minor comments:
#1. I recommend specifying the study design in the title.
#2. I would like to inquire whether the appropriate sample size was calculated for this study. If
so, please include details regarding the sample size calculation in the methods section.
#3. I recommend providing a clear rationale for the study.
#4. Please specify the developer and the associated country for each software used in your
analysis.
#5. Please mention the statistical tests used to assess the normality of variables in your analysis.
#6. Please mention the method used for assessing all variables in method section :” TG, total
cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT),
aspartate aminotransferase (AST), gamma-glutamyltranspeptidase (GGT), and albumin (Alb)”
#7. I suggest providing more detailed information on how height and weight were measured and
how BMI was calculated.
#8. Please provide the criteria used to define hypertension in your study.
Title: Association between glycated hemoglobin/high-density lipoprotein ratio and
nonalcoholic fatty liver disease in a U.S. nondiabetic population: a cross-sectional study based
on NHANES 2017-2020 data
Version: 0 Date: 11 Jun 2025
Reviewer's report:
In this study, Mao et al. investigated the association between glycated hemoglobin/high-density
lipoprotein ratio and nonalcoholic fatty liver disease in a non-diabetic US population. While the
study presents an interesting perspective, there are some issues that should be addressed.
Major comments:
#1. The current study does not account for several important covariates that may influence the
results. Relevant variables such as waist circumference, waist-to-height ratio, dietary patterns,
physical activity levels, alcohol consumption, renal function markers (uric acid, creatinine,
BUN, eGFR), and the use of antihypertensive medications are all potential confounders. It is
strongly recommended that these variables be incorporated into the study.
#2. As the present study design appears to be cross-sectional or observational rather than a
longitudinal cohort study, it is methodologically inappropriate to infer causality or use terms
such as “risk.” Instead, the findings should be described in terms of associations or correlations.
#3. A thorough language and grammatical review by a native English speaker is highly
recommended.
Minor comments:
#1. I recommend specifying the study design in the title.
#2. I would like to inquire whether the appropriate sample size was calculated for this study. If
so, please include details regarding the sample size calculation in the methods section.
#3. I recommend providing a clear rationale for the study.
#4. Please specify the developer and the associated country for each software used in your
analysis.
#5. Please mention the statistical tests used to assess the normality of variables in your analysis.
#6. Please mention the method used for assessing all variables in method section :” TG, total
cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT),
aspartate aminotransferase (AST), gamma-glutamyltranspeptidase (GGT), and albumin (Alb)”
#7. I suggest providing more detailed information on how height and weight were measured and
how BMI was calculated.
#8. Please provide the criteria used to define hypertension in your study.
Please review this paper.
user
Title: Association between glycated hemoglobin/high-density lipoprotein ratio and
nonalcoholic fatty liver disease in a U.S. nondiabetic population: a cross-sectional study based
on NHANES 2017-2020 data
Version: 0 Date: 11 Jun 2025
Reviewer's report:
In this study, Mao et al. investigated the association between glycated hemoglobin/high-density
lipoprotein ratio and nonalcoholic fatty liver disease in a non-diabetic US population. While the
study presents an interesting perspective, there are some issues that should be addressed.
Major comments:
#1. The current study does not account for several important covariates that may influence the
results. Relevant variables such as waist circumference, waist-to-height ratio, dietary patterns,
physical activity levels, alcohol consumption, renal function markers (uric acid, creatinine,
BUN, eGFR), and the use of antihypertensive medications are all potential confounders. It is
strongly recommended that these variables be incorporated into the study.
#2. As the present study design appears to be cross-sectional or observational rather than a
longitudinal cohort study, it is methodologically inappropriate to infer causality or use terms
such as “risk.” Instead, the findings should be described in terms of associations or correlations.
#3. A thorough language and grammatical review by a native English speaker is highly
recommended.
Minor comments:
#1. I recommend specifying the study design in the title.
#2. I would like to inquire whether the appropriate sample size was calculated for this study. If
so, please include details regarding the sample size calculation in the methods section.
#3. I recommend providing a clear rationale for the study.
#4. Please specify the developer and the associated country for each software used in your
analysis.
#5. Please mention the statistical tests used to assess the normality of variables in your analysis.
#6. Please mention the method used for assessing all variables in method section :” TG, total
cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT),
aspartate aminotransferase (AST), gamma-glutamyltranspeptidase (GGT), and albumin (Alb)”
#7. I suggest providing more detailed information on how height and weight were measured and
how BMI was calculated.
#8. Please provide the criteria used to define hypertension in your study.
assistant