Title: Population-specific cut-off points of fatty liver index: A study based on the National
Health and Nutrition Examination Survey data
Version: 1 Date: 29 Jan 2022
Reviewer's report:
GENERAL COMMENT
First proposed by Bedogni, Bellentani and Tiribelli in 2006 as an aid in selecting individuals
to submit to liver ultrasonography, over time, FLI has shown an amazing wider spectrum of
uses (Reviewed in https://mtodjournal.net/article/view/4410). In a recent reappraisal of FLI, the
above authors acknowledged the limitations of FLI, one of these being not having sex-specific
cut-off values.
SPECIFIC COMMENT
MAJOR
1. Introduction is too long and must be reworked aimed at focusing on FLI and the reserach
questions addressed here. In other words, I would suggest to summarize to a substantial extent
the section on NAFLD/MAFLD and rather illustrating the importance of  sex differences as a
research priority in NAFLD arena.
2. These Authors cite some outdated articles regarding accuracy of ultrasonography in the
detection of minor extents of steatosis: these studies were conducted when machinaries were
less sensitive and a re-evaluation has indeed led to completely different findings (https://
mtodjournal.net/article/view/4301) that must be discussed here.
3. I would also recommend to highlight that NAFLD/MAFLD is a heterogeneous condition and
that such heterogeneity underlies the development of precision medicine practices. The role, if
any, of FLI in this setting should be briefly discussed.
MINOR
1. GGT: gamma glutaryl transferase---> GLUTAMYL
2. Editing of English is recommeded
Title: Population-specific cut-off points of fatty liver index: A study based on the National
Health and Nutrition Examination Survey data
Version: 1 Date: 29 Jan 2022
Reviewer's report:
GENERAL COMMENT
First proposed by Bedogni, Bellentani and Tiribelli in 2006 as an aid in selecting individuals
to submit to liver ultrasonography, over time, FLI has shown an amazing wider spectrum of
uses (Reviewed in https://mtodjournal.net/article/view/4410). In a recent reappraisal of FLI, the
above authors acknowledged the limitations of FLI, one of these being not having sex-specific
cut-off values.
SPECIFIC COMMENT
MAJOR
1. Introduction is too long and must be reworked aimed at focusing on FLI and the reserach
questions addressed here. In other words, I would suggest to summarize to a substantial extent
the section on NAFLD/MAFLD and rather illustrating the importance of  sex differences as a
research priority in NAFLD arena.
2. These Authors cite some outdated articles regarding accuracy of ultrasonography in the
detection of minor extents of steatosis: these studies were conducted when machinaries were
less sensitive and a re-evaluation has indeed led to completely different findings (https://
mtodjournal.net/article/view/4301) that must be discussed here.
3. I would also recommend to highlight that NAFLD/MAFLD is a heterogeneous condition and
that such heterogeneity underlies the development of precision medicine practices. The role, if
any, of FLI in this setting should be briefly discussed.
MINOR
1. GGT: gamma glutaryl transferase---> GLUTAMYL
2. Editing of English is recommeded
Please review this paper.
user
Title: Population-specific cut-off points of fatty liver index: A study based on the National
Health and Nutrition Examination Survey data
Version: 1 Date: 29 Jan 2022
Reviewer's report:
GENERAL COMMENT
First proposed by Bedogni, Bellentani and Tiribelli in 2006 as an aid in selecting individuals
to submit to liver ultrasonography, over time, FLI has shown an amazing wider spectrum of
uses (Reviewed in https://mtodjournal.net/article/view/4410). In a recent reappraisal of FLI, the
above authors acknowledged the limitations of FLI, one of these being not having sex-specific
cut-off values.
SPECIFIC COMMENT
MAJOR
1. Introduction is too long and must be reworked aimed at focusing on FLI and the reserach
questions addressed here. In other words, I would suggest to summarize to a substantial extent
the section on NAFLD/MAFLD and rather illustrating the importance of  sex differences as a
research priority in NAFLD arena.
2. These Authors cite some outdated articles regarding accuracy of ultrasonography in the
detection of minor extents of steatosis: these studies were conducted when machinaries were
less sensitive and a re-evaluation has indeed led to completely different findings (https://
mtodjournal.net/article/view/4301) that must be discussed here.
3. I would also recommend to highlight that NAFLD/MAFLD is a heterogeneous condition and
that such heterogeneity underlies the development of precision medicine practices. The role, if
any, of FLI in this setting should be briefly discussed.
MINOR
1. GGT: gamma glutaryl transferase---> GLUTAMYL
2. Editing of English is recommeded
assistant