Title: Association of liver related biomarkers with incident cardiovascular disease and all-
cause mortality in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a
population-based cohort study
Version: 2 Date: 17 May 2025
Reviewer's report:
Here are my comments:
1# The authors excluded participants with prevalent CVD at baseline, defined as
electrocardiogram indicating major Q wave abnormalities or minor Q, QS waves with ST or T
abnormalities. However, the definition of CVD is not very rigorous; please provide a reference
for the definition of CVD.
2# The method of dietary data collection is unclear. The authors claim that dietary intake was
assessed using two 24-hour food recalls administered several months apart. Do the authors mean
that this cohort underwent two 24-hour dietary recalls every few months starting from 2008 and
2011, continuously until 2017 or the present? Furthermore, is there uncertainty regarding the
time interval between dietary assessments? Otherwise, why would the authors use the vague
term “several”?
3# Some abbreviations in the article are unclear, such as LFTs (in the statistical analysis section)
and “yr” in the FIB-4 calculation formula.
4# The title of the article is inconsistent with the content of the analysis. The title only emphasizes
liver enzymes, but from the methods and results sections, the analysis of liver enzymes is only
a part of the study. In addition, the mention of “elevated ALT/AST” appears abrupt, and it
is unclear why the focus is placed specifically on analyzing ALT/AST, as the article actually
examines many indicators.
Title: Association of liver related biomarkers with incident cardiovascular disease and all-
cause mortality in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a
population-based cohort study
Version: 2 Date: 17 May 2025
Reviewer's report:
Here are my comments:
1# The authors excluded participants with prevalent CVD at baseline, defined as
electrocardiogram indicating major Q wave abnormalities or minor Q, QS waves with ST or T
abnormalities. However, the definition of CVD is not very rigorous; please provide a reference
for the definition of CVD.
2# The method of dietary data collection is unclear. The authors claim that dietary intake was
assessed using two 24-hour food recalls administered several months apart. Do the authors mean
that this cohort underwent two 24-hour dietary recalls every few months starting from 2008 and
2011, continuously until 2017 or the present? Furthermore, is there uncertainty regarding the
time interval between dietary assessments? Otherwise, why would the authors use the vague
term “several”?
3# Some abbreviations in the article are unclear, such as LFTs (in the statistical analysis section)
and “yr” in the FIB-4 calculation formula.
4# The title of the article is inconsistent with the content of the analysis. The title only emphasizes
liver enzymes, but from the methods and results sections, the analysis of liver enzymes is only
a part of the study. In addition, the mention of “elevated ALT/AST” appears abrupt, and it
is unclear why the focus is placed specifically on analyzing ALT/AST, as the article actually
examines many indicators.
Please review this paper.
user
Title: Association of liver related biomarkers with incident cardiovascular disease and all-
cause mortality in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a
population-based cohort study
Version: 2 Date: 17 May 2025
Reviewer's report:
Here are my comments:
1# The authors excluded participants with prevalent CVD at baseline, defined as
electrocardiogram indicating major Q wave abnormalities or minor Q, QS waves with ST or T
abnormalities. However, the definition of CVD is not very rigorous; please provide a reference
for the definition of CVD.
2# The method of dietary data collection is unclear. The authors claim that dietary intake was
assessed using two 24-hour food recalls administered several months apart. Do the authors mean
that this cohort underwent two 24-hour dietary recalls every few months starting from 2008 and
2011, continuously until 2017 or the present? Furthermore, is there uncertainty regarding the
time interval between dietary assessments? Otherwise, why would the authors use the vague
term “several”?
3# Some abbreviations in the article are unclear, such as LFTs (in the statistical analysis section)
and “yr” in the FIB-4 calculation formula.
4# The title of the article is inconsistent with the content of the analysis. The title only emphasizes
liver enzymes, but from the methods and results sections, the analysis of liver enzymes is only
a part of the study. In addition, the mention of “elevated ALT/AST” appears abrupt, and it
is unclear why the focus is placed specifically on analyzing ALT/AST, as the article actually
examines many indicators.
assistant