Title: Association between the triglyceride-to-high-density lipoprotein cholesterol ratio and the
incidence of metabolic dysfunction-associated fatty liver disease: A retrospective cohort study
Version: 2 Date: 17 Aug 2024
Reviewer's report:
Thank you for the opportunity to review this manuscript. Overall, this is a well-conducted
retrospective cohort study examining the association between triglyceride-to-HDL cholesterol
ratio (TG/HDL-C) and risk of developing non-alcoholic fatty liver disease (NAFLD) in a large
Chinese population. The study has several strengths, including the large sample size, long
follow-up period, and thorough statistical analyses. However, there are a few areas that could
be improved to strengthen the manuscript:
Title and Abstract:
1. The conclusion in the abstract slightly overstates the findings. Instead of stating that TG/HDL-
C "could be used as a noninvasive indicator," it should be rephrased to reflect that it "may have
potential as a noninvasive indicator," pending further validation.
Introduction:
1. The rationale for conducting this specific study could be strengthened by more clearly stating
how it addresses gaps in previous research.
2. would be helpful to explain why TG/HDL-C ratio was hypothesized as a marker of NAFLD.
3. A more explicit identification of the aim of the study would be ideal.
Materials and Methods:
1. It is interesting that 2018 guidelines were used to diagnose NAFLD via ultrasound. Prior to
these updates were there no reported cases of NAFLD?
2. The justification for the specific TG/HDL-C ratio cutoffs used for quartiles could be explained.
Discussion:
1. Thorough discussion of the subgroup analysis results.
2. Consideration of potential mechanisms linking TG/HDL-C to NAFLD risk.
3. The generalizability of the findings to other populations should be discussed.
4. The potential clinical implications of the findings could be elaborated upon.
Conclusion:
The conclusion summarizes the main findings appropriately. However:
1. As in the abstract, the language regarding the potential use of TG/HDL-C as a clinical indicator
should be slightly tempered. Ex. The results suggest ……..
2. A brief statement on future research directions would be valuable.
Overall, this is a well-conducted study with important findings. Addressing these minor points
would further strengthen an already solid manuscript.
Title: Association between the triglyceride-to-high-density lipoprotein cholesterol ratio and the
incidence of metabolic dysfunction-associated fatty liver disease: A retrospective cohort study
Version: 2 Date: 17 Aug 2024
Reviewer's report:
Thank you for the opportunity to review this manuscript. Overall, this is a well-conducted
retrospective cohort study examining the association between triglyceride-to-HDL cholesterol
ratio (TG/HDL-C) and risk of developing non-alcoholic fatty liver disease (NAFLD) in a large
Chinese population. The study has several strengths, including the large sample size, long
follow-up period, and thorough statistical analyses. However, there are a few areas that could
be improved to strengthen the manuscript:
Title and Abstract:
1. The conclusion in the abstract slightly overstates the findings. Instead of stating that TG/HDL-
C "could be used as a noninvasive indicator," it should be rephrased to reflect that it "may have
potential as a noninvasive indicator," pending further validation.
Introduction:
1. The rationale for conducting this specific study could be strengthened by more clearly stating
how it addresses gaps in previous research.
2. would be helpful to explain why TG/HDL-C ratio was hypothesized as a marker of NAFLD.
3. A more explicit identification of the aim of the study would be ideal.
Materials and Methods:
1. It is interesting that 2018 guidelines were used to diagnose NAFLD via ultrasound. Prior to
these updates were there no reported cases of NAFLD?
2. The justification for the specific TG/HDL-C ratio cutoffs used for quartiles could be explained.
Discussion:
1. Thorough discussion of the subgroup analysis results.
2. Consideration of potential mechanisms linking TG/HDL-C to NAFLD risk.
3. The generalizability of the findings to other populations should be discussed.
4. The potential clinical implications of the findings could be elaborated upon.
Conclusion:
The conclusion summarizes the main findings appropriately. However:
1. As in the abstract, the language regarding the potential use of TG/HDL-C as a clinical indicator
should be slightly tempered. Ex. The results suggest ……..
2. A brief statement on future research directions would be valuable.
Overall, this is a well-conducted study with important findings. Addressing these minor points
would further strengthen an already solid manuscript.
Please review this paper.
user
Title: Association between the triglyceride-to-high-density lipoprotein cholesterol ratio and the
incidence of metabolic dysfunction-associated fatty liver disease: A retrospective cohort study
Version: 2 Date: 17 Aug 2024
Reviewer's report:
Thank you for the opportunity to review this manuscript. Overall, this is a well-conducted
retrospective cohort study examining the association between triglyceride-to-HDL cholesterol
ratio (TG/HDL-C) and risk of developing non-alcoholic fatty liver disease (NAFLD) in a large
Chinese population. The study has several strengths, including the large sample size, long
follow-up period, and thorough statistical analyses. However, there are a few areas that could
be improved to strengthen the manuscript:
Title and Abstract:
1. The conclusion in the abstract slightly overstates the findings. Instead of stating that TG/HDL-
C "could be used as a noninvasive indicator," it should be rephrased to reflect that it "may have
potential as a noninvasive indicator," pending further validation.
Introduction:
1. The rationale for conducting this specific study could be strengthened by more clearly stating
how it addresses gaps in previous research.
2. would be helpful to explain why TG/HDL-C ratio was hypothesized as a marker of NAFLD.
3. A more explicit identification of the aim of the study would be ideal.
Materials and Methods:
1. It is interesting that 2018 guidelines were used to diagnose NAFLD via ultrasound. Prior to
these updates were there no reported cases of NAFLD?
2. The justification for the specific TG/HDL-C ratio cutoffs used for quartiles could be explained.
Discussion:
1. Thorough discussion of the subgroup analysis results.
2. Consideration of potential mechanisms linking TG/HDL-C to NAFLD risk.
3. The generalizability of the findings to other populations should be discussed.
4. The potential clinical implications of the findings could be elaborated upon.
Conclusion:
The conclusion summarizes the main findings appropriately. However:
1. As in the abstract, the language regarding the potential use of TG/HDL-C as a clinical indicator
should be slightly tempered. Ex. The results suggest ……..
2. A brief statement on future research directions would be valuable.
Overall, this is a well-conducted study with important findings. Addressing these minor points
would further strengthen an already solid manuscript.
assistant