Title: The Role of C-reactive protein to lymphocyte ratio in NAFLD and  Mortality Among
NAFLD Patients
Version: 2 Date: 16 Feb 2025
Reviewer's report:
1. It is recommended to avoid abbreviations in the title. Please replace "CLR" with its complete
form, "C-reactive protein to lymphocyte ratio."
2. In the results section of the abstract, the term "Model 3" is used without prior explanation.
Please clarify what "Model 3" refers to.
3. Specify the duration of follow-up for the all-cause mortality outcome. Additionally, provide
the number of NAFLD participants who died during the follow-up period.
4. Ensure consistency in reporting statistical values. P-values are presented with three decimal
places; all other values, such as confidence intervals, should also be noted with three decimal
places.
5. Cholesterol, triglycerides, and HDL are reported, but LDL is notably absent. Please clarify
why LDL was not included. Additionally, it would be beneficial to include hepatic biomarkers
such as AST and ALT.
6. The authors do not account for critical comorbidities such as heart failure or stroke. If possible,
please consider including these conditions in the medical history covariates.
7. While all-cause mortality is assessed, it would strengthen the study to determine specific
causes of death among NAFLD patients and perform subgroup analyses based on these causes.
8. Including Kaplan-Meier survival curves for all-cause mortality, stratified by CLR quartiles,
in NAFLD patients would enhance the study.
9. Abbreviations such as hazard ratio (HR) are introduced multiple times. Please ensure that
each abbreviation is defined once upon first use.
10. In Figure 1, it is stated that 1849 participants were excluded from 5921 participants with
complete data, leaving 4027 participants. However, 5921 minus 1849 equals 4072, not 4027.
Please correct this discrepancy. Additionally, all abbreviations used in Figure 1 should be
defined.
11. The title of Figure 3 uses the abbreviation "CLP," which seems incorrect. Please revise it
to "CLR."
12. Machine learning methods such as Random Forest and K-Nearest Neighbors are mentioned
in the discussion and in the abbreviation section (line 261). However, these methods are not
described in the methods or results sections. Please provide details on whether these methods
are employed.
13. In Table 1, Clarify if the "high cholesterol" classification is based on a specific cutoff. Correct
the misspelling of "Diabetes."
14. Although the study aims to highlight CLR as a significant biomarker in NAFLD patients,
it would be more robust to compare CLR with other established biomarkers for NAFLD in the
discussion section.
Title: The Role of C-reactive protein to lymphocyte ratio in NAFLD and  Mortality Among
NAFLD Patients
Version: 2 Date: 16 Feb 2025
Reviewer's report:
1. It is recommended to avoid abbreviations in the title. Please replace "CLR" with its complete
form, "C-reactive protein to lymphocyte ratio."
2. In the results section of the abstract, the term "Model 3" is used without prior explanation.
Please clarify what "Model 3" refers to.
3. Specify the duration of follow-up for the all-cause mortality outcome. Additionally, provide
the number of NAFLD participants who died during the follow-up period.
4. Ensure consistency in reporting statistical values. P-values are presented with three decimal
places; all other values, such as confidence intervals, should also be noted with three decimal
places.
5. Cholesterol, triglycerides, and HDL are reported, but LDL is notably absent. Please clarify
why LDL was not included. Additionally, it would be beneficial to include hepatic biomarkers
such as AST and ALT.
6. The authors do not account for critical comorbidities such as heart failure or stroke. If possible,
please consider including these conditions in the medical history covariates.
7. While all-cause mortality is assessed, it would strengthen the study to determine specific
causes of death among NAFLD patients and perform subgroup analyses based on these causes.
8. Including Kaplan-Meier survival curves for all-cause mortality, stratified by CLR quartiles,
in NAFLD patients would enhance the study.
9. Abbreviations such as hazard ratio (HR) are introduced multiple times. Please ensure that
each abbreviation is defined once upon first use.
10. In Figure 1, it is stated that 1849 participants were excluded from 5921 participants with
complete data, leaving 4027 participants. However, 5921 minus 1849 equals 4072, not 4027.
Please correct this discrepancy. Additionally, all abbreviations used in Figure 1 should be
defined.
11. The title of Figure 3 uses the abbreviation "CLP," which seems incorrect. Please revise it
to "CLR."
12. Machine learning methods such as Random Forest and K-Nearest Neighbors are mentioned
in the discussion and in the abbreviation section (line 261). However, these methods are not
described in the methods or results sections. Please provide details on whether these methods
are employed.
13. In Table 1, Clarify if the "high cholesterol" classification is based on a specific cutoff. Correct
the misspelling of "Diabetes."
14. Although the study aims to highlight CLR as a significant biomarker in NAFLD patients,
it would be more robust to compare CLR with other established biomarkers for NAFLD in the
discussion section.
Please review this paper.
user
Title: The Role of C-reactive protein to lymphocyte ratio in NAFLD and  Mortality Among
NAFLD Patients
Version: 2 Date: 16 Feb 2025
Reviewer's report:
1. It is recommended to avoid abbreviations in the title. Please replace "CLR" with its complete
form, "C-reactive protein to lymphocyte ratio."
2. In the results section of the abstract, the term "Model 3" is used without prior explanation.
Please clarify what "Model 3" refers to.
3. Specify the duration of follow-up for the all-cause mortality outcome. Additionally, provide
the number of NAFLD participants who died during the follow-up period.
4. Ensure consistency in reporting statistical values. P-values are presented with three decimal
places; all other values, such as confidence intervals, should also be noted with three decimal
places.
5. Cholesterol, triglycerides, and HDL are reported, but LDL is notably absent. Please clarify
why LDL was not included. Additionally, it would be beneficial to include hepatic biomarkers
such as AST and ALT.
6. The authors do not account for critical comorbidities such as heart failure or stroke. If possible,
please consider including these conditions in the medical history covariates.
7. While all-cause mortality is assessed, it would strengthen the study to determine specific
causes of death among NAFLD patients and perform subgroup analyses based on these causes.
8. Including Kaplan-Meier survival curves for all-cause mortality, stratified by CLR quartiles,
in NAFLD patients would enhance the study.
9. Abbreviations such as hazard ratio (HR) are introduced multiple times. Please ensure that
each abbreviation is defined once upon first use.
10. In Figure 1, it is stated that 1849 participants were excluded from 5921 participants with
complete data, leaving 4027 participants. However, 5921 minus 1849 equals 4072, not 4027.
Please correct this discrepancy. Additionally, all abbreviations used in Figure 1 should be
defined.
11. The title of Figure 3 uses the abbreviation "CLP," which seems incorrect. Please revise it
to "CLR."
12. Machine learning methods such as Random Forest and K-Nearest Neighbors are mentioned
in the discussion and in the abbreviation section (line 261). However, these methods are not
described in the methods or results sections. Please provide details on whether these methods
are employed.
13. In Table 1, Clarify if the "high cholesterol" classification is based on a specific cutoff. Correct
the misspelling of "Diabetes."
14. Although the study aims to highlight CLR as a significant biomarker in NAFLD patients,
it would be more robust to compare CLR with other established biomarkers for NAFLD in the
discussion section.
assistant