Title: The Role of the Advanced Lung Cancer Inflammation Index (ALI) in the Risk of
Liver Fibrosis and Mortality Among US Adult MAFLD Patients: A Cross-Sectional Study of
NHANES 1999–2018
Version: 1 Date: 17 Dec 2024
Reviewer's report:
The manuscript titled "Associations of Nutrition and Inflammation with the Risk of Liver
Fibrosis and Mortality in NAFLD Adults: the Result of NHANES 1999–2018" provides an
intriguing examination of the role of the Advanced Lung Cancer Inflammation Index (ALI)
in predicting liver fibrosis and mortality in patients with Non-alcoholic Fatty Liver Disease
(NAFLD). While the study's approach and dataset are commendable, several aspects require
improvement to enhance the clarity, impact, and reliability of the findings. Below are the specific
suggestions for revision:
1. Clarify Abstract Objectives: The abstract should more explicitly state the study’s primary
objectives, including a clearer explanation of how ALI correlates with NAFLD progression and
mortality, to better align with the detailed objectives mentioned in the introduction and methods
sections.
2. Enhance Background Context: The background section should provide a more comprehensive
review of previous studies regarding ALI in other non-cancer conditions to establish a stronger
rationale for exploring its use in NAFLD.
3. Address Sample Selection Bias: Discuss the potential biases introduced by excluding
individuals with significant missing data or certain comorbidities, and how these exclusions
might affect the generalizability of the findings.
4. Interpret Non-linear Relationships: Provide a more detailed interpretation of the non-linear
relationships observed between ALI and the study outcomes. Discuss potential biological or
clinical reasons for these patterns and their implications.
5. Expand Discussion of Limitations: More thoroughly discuss the limitations associated with
using a cross-sectional design, particularly the inability to infer causality between ALI levels
and outcomes in NAFLD.
6. Enhance Novelty and Contribution: The manuscript should more explicitly highlight its novel
contributions to the existing body of knowledge. This can be achieved by adding a section or
a paragraph in the Discussion that contrasts the findings with existing literature, particularly
focusing on how this study's use of ALI in NAFLD patients adds new insights or contradicts
previous research. Detailing the unique aspects of the study's approach and findings will help to
underline its significance and justify its publication.
Title: The Role of the Advanced Lung Cancer Inflammation Index (ALI) in the Risk of
Liver Fibrosis and Mortality Among US Adult MAFLD Patients: A Cross-Sectional Study of
NHANES 1999–2018
Version: 1 Date: 17 Dec 2024
Reviewer's report:
The manuscript titled "Associations of Nutrition and Inflammation with the Risk of Liver
Fibrosis and Mortality in NAFLD Adults: the Result of NHANES 1999–2018" provides an
intriguing examination of the role of the Advanced Lung Cancer Inflammation Index (ALI)
in predicting liver fibrosis and mortality in patients with Non-alcoholic Fatty Liver Disease
(NAFLD). While the study's approach and dataset are commendable, several aspects require
improvement to enhance the clarity, impact, and reliability of the findings. Below are the specific
suggestions for revision:
1. Clarify Abstract Objectives: The abstract should more explicitly state the study’s primary
objectives, including a clearer explanation of how ALI correlates with NAFLD progression and
mortality, to better align with the detailed objectives mentioned in the introduction and methods
sections.
2. Enhance Background Context: The background section should provide a more comprehensive
review of previous studies regarding ALI in other non-cancer conditions to establish a stronger
rationale for exploring its use in NAFLD.
3. Address Sample Selection Bias: Discuss the potential biases introduced by excluding
individuals with significant missing data or certain comorbidities, and how these exclusions
might affect the generalizability of the findings.
4. Interpret Non-linear Relationships: Provide a more detailed interpretation of the non-linear
relationships observed between ALI and the study outcomes. Discuss potential biological or
clinical reasons for these patterns and their implications.
5. Expand Discussion of Limitations: More thoroughly discuss the limitations associated with
using a cross-sectional design, particularly the inability to infer causality between ALI levels
and outcomes in NAFLD.
6. Enhance Novelty and Contribution: The manuscript should more explicitly highlight its novel
contributions to the existing body of knowledge. This can be achieved by adding a section or
a paragraph in the Discussion that contrasts the findings with existing literature, particularly
focusing on how this study's use of ALI in NAFLD patients adds new insights or contradicts
previous research. Detailing the unique aspects of the study's approach and findings will help to
underline its significance and justify its publication.
Please review this paper.
user
Title: The Role of the Advanced Lung Cancer Inflammation Index (ALI) in the Risk of
Liver Fibrosis and Mortality Among US Adult MAFLD Patients: A Cross-Sectional Study of
NHANES 1999–2018
Version: 1 Date: 17 Dec 2024
Reviewer's report:
The manuscript titled "Associations of Nutrition and Inflammation with the Risk of Liver
Fibrosis and Mortality in NAFLD Adults: the Result of NHANES 1999–2018" provides an
intriguing examination of the role of the Advanced Lung Cancer Inflammation Index (ALI)
in predicting liver fibrosis and mortality in patients with Non-alcoholic Fatty Liver Disease
(NAFLD). While the study's approach and dataset are commendable, several aspects require
improvement to enhance the clarity, impact, and reliability of the findings. Below are the specific
suggestions for revision:
1. Clarify Abstract Objectives: The abstract should more explicitly state the study’s primary
objectives, including a clearer explanation of how ALI correlates with NAFLD progression and
mortality, to better align with the detailed objectives mentioned in the introduction and methods
sections.
2. Enhance Background Context: The background section should provide a more comprehensive
review of previous studies regarding ALI in other non-cancer conditions to establish a stronger
rationale for exploring its use in NAFLD.
3. Address Sample Selection Bias: Discuss the potential biases introduced by excluding
individuals with significant missing data or certain comorbidities, and how these exclusions
might affect the generalizability of the findings.
4. Interpret Non-linear Relationships: Provide a more detailed interpretation of the non-linear
relationships observed between ALI and the study outcomes. Discuss potential biological or
clinical reasons for these patterns and their implications.
5. Expand Discussion of Limitations: More thoroughly discuss the limitations associated with
using a cross-sectional design, particularly the inability to infer causality between ALI levels
and outcomes in NAFLD.
6. Enhance Novelty and Contribution: The manuscript should more explicitly highlight its novel
contributions to the existing body of knowledge. This can be achieved by adding a section or
a paragraph in the Discussion that contrasts the findings with existing literature, particularly
focusing on how this study's use of ALI in NAFLD patients adds new insights or contradicts
previous research. Detailing the unique aspects of the study's approach and findings will help to
underline its significance and justify its publication.
assistant