Title: The influence of muscle performance and fatigue on prognosis in patients with
compensated liver disease
Version: 2 Date: 21 Mar 2023
Reviewer's report:
Review
The authors enrolled in a longitudinal study 241 patients with chronic liver disease who were
previously participating in a study about muscle function. The latter was between 2010 and 2014.
The patients were described as "compensated chronic liver disease (Child B/C)"  which is some
how controversial. The parameters and blood tests reported  in Table 1 are much more pertinent
with patients Child A.  The low rate of mortality and LT is also in keeping  with a rather well
compensated population of cirrhotic patients. THE AUTHORS NEED TO CLARIFY THIS
POINT
Patients were followed for 5-6 years and survival or liver transplantation recorded. The number
of events was low and death was not always caused by liver disease.
As a general finding, the authors report that parameters of muscle function and fatigue were
not associated with patient’s outcome (decompensation or survival). Only one association was
found between TUG >14 sec and transplant free survival.
I am not surprise by the results.
1) The patients are different from those usually reported in studies that associate sarcopenia to
low survival.
2) Furthermore, the events are few and the time of observation rather long. In my opinion, when
the time is too long this is not a strength (as stated in discussion). Indeed,  many confounders
may take place in 100 months
3)  It is also difficult to associate parameters at enrollment with events occurring years later. A
patient who was not sarcopenic at basal may change status and become sarcopenic during time
The study should be more in keeping with the results reported which were essentially negative
results. In this light the study needs to be rearranged.
The discussion may underline the three suggested points.   Differences with previous studies
need to be discussed.
There is no justification to use a cut off > 14 seconds (which separates just 3 subjects) This
results about >14 sec need to be removed by the study. Fig 3 should present only top panels.
In Figure 3 Kaplan Meyer analysis require that the patients at risk at each time are reported
Title: The influence of muscle performance and fatigue on prognosis in patients with
compensated liver disease
Version: 2 Date: 21 Mar 2023
Reviewer's report:
Review
The authors enrolled in a longitudinal study 241 patients with chronic liver disease who were
previously participating in a study about muscle function. The latter was between 2010 and 2014.
The patients were described as "compensated chronic liver disease (Child B/C)"  which is some
how controversial. The parameters and blood tests reported  in Table 1 are much more pertinent
with patients Child A.  The low rate of mortality and LT is also in keeping  with a rather well
compensated population of cirrhotic patients. THE AUTHORS NEED TO CLARIFY THIS
POINT
Patients were followed for 5-6 years and survival or liver transplantation recorded. The number
of events was low and death was not always caused by liver disease.
As a general finding, the authors report that parameters of muscle function and fatigue were
not associated with patient’s outcome (decompensation or survival). Only one association was
found between TUG >14 sec and transplant free survival.
I am not surprise by the results.
1) The patients are different from those usually reported in studies that associate sarcopenia to
low survival.
2) Furthermore, the events are few and the time of observation rather long. In my opinion, when
the time is too long this is not a strength (as stated in discussion). Indeed,  many confounders
may take place in 100 months
3)  It is also difficult to associate parameters at enrollment with events occurring years later. A
patient who was not sarcopenic at basal may change status and become sarcopenic during time
The study should be more in keeping with the results reported which were essentially negative
results. In this light the study needs to be rearranged.
The discussion may underline the three suggested points.   Differences with previous studies
need to be discussed.
There is no justification to use a cut off > 14 seconds (which separates just 3 subjects) This
results about >14 sec need to be removed by the study. Fig 3 should present only top panels.
In Figure 3 Kaplan Meyer analysis require that the patients at risk at each time are reported
Please review this paper.
user
Title: The influence of muscle performance and fatigue on prognosis in patients with
compensated liver disease
Version: 2 Date: 21 Mar 2023
Reviewer's report:
Review
The authors enrolled in a longitudinal study 241 patients with chronic liver disease who were
previously participating in a study about muscle function. The latter was between 2010 and 2014.
The patients were described as "compensated chronic liver disease (Child B/C)"  which is some
how controversial. The parameters and blood tests reported  in Table 1 are much more pertinent
with patients Child A.  The low rate of mortality and LT is also in keeping  with a rather well
compensated population of cirrhotic patients. THE AUTHORS NEED TO CLARIFY THIS
POINT
Patients were followed for 5-6 years and survival or liver transplantation recorded. The number
of events was low and death was not always caused by liver disease.
As a general finding, the authors report that parameters of muscle function and fatigue were
not associated with patient’s outcome (decompensation or survival). Only one association was
found between TUG >14 sec and transplant free survival.
I am not surprise by the results.
1) The patients are different from those usually reported in studies that associate sarcopenia to
low survival.
2) Furthermore, the events are few and the time of observation rather long. In my opinion, when
the time is too long this is not a strength (as stated in discussion). Indeed,  many confounders
may take place in 100 months
3)  It is also difficult to associate parameters at enrollment with events occurring years later. A
patient who was not sarcopenic at basal may change status and become sarcopenic during time
The study should be more in keeping with the results reported which were essentially negative
results. In this light the study needs to be rearranged.
The discussion may underline the three suggested points.   Differences with previous studies
need to be discussed.
There is no justification to use a cut off > 14 seconds (which separates just 3 subjects) This
results about >14 sec need to be removed by the study. Fig 3 should present only top panels.
In Figure 3 Kaplan Meyer analysis require that the patients at risk at each time are reported
assistant