Title: Serum Uric Acid as a Biomarker for Metabolic Dysfunction-Associated Steatotic Liver
Disease: Insights from Ultrasound Elastography in a Chinese Cohort
Version: 1 Date: 09 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The abstract and methods sections mention serum uric acid (SUA) levels, but it is unclear
whether these levels were measured at a single time point or longitudinally. If the SUA
measurements were taken only at one time point, the potential for fluctuations over time—due
to factors such as diet, medications, or other influences—may limit the interpretation of the
relationship between SUA and MASLD. It would be helpful to clarify this to better assess the
reliability of SUA as a biomarker for MASLD.
-Although the statistical models account for various potential confounders, including metabolic
factors and medications, it is possible that residual confounding remains, particularly due to
unmeasured factors such as dietary habits or genetic predispositions. A brief acknowledgment
of this limitation in the abstract and methods sections would enhance clarity.
-The analysis mentions the use of restricted cubic splines (RCS) to assess non-linearity.
However, the results of these analyses should be clarified further in the manuscript or abstract,
especially regarding the lack of a non-linear relationship found (P for nonlinearity = 0.8451).
A concise explanation of why a linear model was considered appropriate would help readers
understand the statistical reasoning behind the chosen models.
-Additionally, it would be beneficial to include a brief explanation of the rationale for using a
CAP > 248 dB/m as the cutoff for defining hepatic steatosis.
-While the discussion suggests that interventions aimed at lowering SUA levels could reduce
the risk of MASLD, it would be useful to elaborate on potential treatment strategies. For
example, lifestyle interventions such as dietary modifications or exercise programs targeting
SUA could be discussed in more detail. Furthermore, mentioning pharmacological options like
urate-lowering therapies (e.g., allopurinol) would be valuable, as their impact on MASLD risk
remains an area of interest for future research.
Title: Serum Uric Acid as a Biomarker for Metabolic Dysfunction-Associated Steatotic Liver
Disease: Insights from Ultrasound Elastography in a Chinese Cohort
Version: 1 Date: 09 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The abstract and methods sections mention serum uric acid (SUA) levels, but it is unclear
whether these levels were measured at a single time point or longitudinally. If the SUA
measurements were taken only at one time point, the potential for fluctuations over time—due
to factors such as diet, medications, or other influences—may limit the interpretation of the
relationship between SUA and MASLD. It would be helpful to clarify this to better assess the
reliability of SUA as a biomarker for MASLD.
-Although the statistical models account for various potential confounders, including metabolic
factors and medications, it is possible that residual confounding remains, particularly due to
unmeasured factors such as dietary habits or genetic predispositions. A brief acknowledgment
of this limitation in the abstract and methods sections would enhance clarity.
-The analysis mentions the use of restricted cubic splines (RCS) to assess non-linearity.
However, the results of these analyses should be clarified further in the manuscript or abstract,
especially regarding the lack of a non-linear relationship found (P for nonlinearity = 0.8451).
A concise explanation of why a linear model was considered appropriate would help readers
understand the statistical reasoning behind the chosen models.
-Additionally, it would be beneficial to include a brief explanation of the rationale for using a
CAP > 248 dB/m as the cutoff for defining hepatic steatosis.
-While the discussion suggests that interventions aimed at lowering SUA levels could reduce
the risk of MASLD, it would be useful to elaborate on potential treatment strategies. For
example, lifestyle interventions such as dietary modifications or exercise programs targeting
SUA could be discussed in more detail. Furthermore, mentioning pharmacological options like
urate-lowering therapies (e.g., allopurinol) would be valuable, as their impact on MASLD risk
remains an area of interest for future research.
Please review this paper.
user
Title: Serum Uric Acid as a Biomarker for Metabolic Dysfunction-Associated Steatotic Liver
Disease: Insights from Ultrasound Elastography in a Chinese Cohort
Version: 1 Date: 09 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The abstract and methods sections mention serum uric acid (SUA) levels, but it is unclear
whether these levels were measured at a single time point or longitudinally. If the SUA
measurements were taken only at one time point, the potential for fluctuations over time—due
to factors such as diet, medications, or other influences—may limit the interpretation of the
relationship between SUA and MASLD. It would be helpful to clarify this to better assess the
reliability of SUA as a biomarker for MASLD.
-Although the statistical models account for various potential confounders, including metabolic
factors and medications, it is possible that residual confounding remains, particularly due to
unmeasured factors such as dietary habits or genetic predispositions. A brief acknowledgment
of this limitation in the abstract and methods sections would enhance clarity.
-The analysis mentions the use of restricted cubic splines (RCS) to assess non-linearity.
However, the results of these analyses should be clarified further in the manuscript or abstract,
especially regarding the lack of a non-linear relationship found (P for nonlinearity = 0.8451).
A concise explanation of why a linear model was considered appropriate would help readers
understand the statistical reasoning behind the chosen models.
-Additionally, it would be beneficial to include a brief explanation of the rationale for using a
CAP > 248 dB/m as the cutoff for defining hepatic steatosis.
-While the discussion suggests that interventions aimed at lowering SUA levels could reduce
the risk of MASLD, it would be useful to elaborate on potential treatment strategies. For
example, lifestyle interventions such as dietary modifications or exercise programs targeting
SUA could be discussed in more detail. Furthermore, mentioning pharmacological options like
urate-lowering therapies (e.g., allopurinol) would be valuable, as their impact on MASLD risk
remains an area of interest for future research.
assistant