Title: Causal relationships between neuropsychiatric disorders and nonalcoholic fatty liver
disease: A bidirectional Mendelian randomization study
Version: 2 Date: 22 Apr 2024
Reviewer:  Fuquan Zhang
Reviewer's report:
The authors performed an MR analysis to explore bidirectional causal associations between
NAFLD and mental disorders. They reported the causal effect of NAFLD on anxiety disorder
and the causal effect of MDD on NAFLD. These findings may help understand the genetic
relationships between NAFLD and mental disorders. I have some recommendations for the
authors:
1. In the abstract, the authors should state clearly which kind of results were reported. Otherwise,
readers have difficulty knowing whether the results were from the discovery stage or the
replication stage. For anxiety disorder, several different names were used, including “anxiety”
and “anxiety disorders”, please unify them into one.
2. Some datasets for mental disorders were not the largest ones available, including
schizophrenia and bipolar disorder. The authors did not include some major mental disorders in
the study, like insomnia. Please discuss the limitations. Please double-check whether the MDD
dataset contained 246,363 patients and 561,190 controls. The publicly available MDD dataset
did not contain the participants from 23andMe, therefore, did not have all these samples.
3. The manuscript can discuss the causal associations between mental disorders and other
diseases, including cardiovascular diseases and diabetes (PMID: 38395927, 36937092,
38490691), since these diseases may partially explain the associations between NAFLD and
mental disorders. Some confounding factors need to be discussed, like education and income,
given that they are vital risk factors for mental disorders (PMID: 38440407, 38007229).
Title: Causal relationships between neuropsychiatric disorders and nonalcoholic fatty liver
disease: A bidirectional Mendelian randomization study
Version: 2 Date: 22 Apr 2024
Reviewer:  Fuquan Zhang
Reviewer's report:
The authors performed an MR analysis to explore bidirectional causal associations between
NAFLD and mental disorders. They reported the causal effect of NAFLD on anxiety disorder
and the causal effect of MDD on NAFLD. These findings may help understand the genetic
relationships between NAFLD and mental disorders. I have some recommendations for the
authors:
1. In the abstract, the authors should state clearly which kind of results were reported. Otherwise,
readers have difficulty knowing whether the results were from the discovery stage or the
replication stage. For anxiety disorder, several different names were used, including “anxiety”
and “anxiety disorders”, please unify them into one.
2. Some datasets for mental disorders were not the largest ones available, including
schizophrenia and bipolar disorder. The authors did not include some major mental disorders in
the study, like insomnia. Please discuss the limitations. Please double-check whether the MDD
dataset contained 246,363 patients and 561,190 controls. The publicly available MDD dataset
did not contain the participants from 23andMe, therefore, did not have all these samples.
3. The manuscript can discuss the causal associations between mental disorders and other
diseases, including cardiovascular diseases and diabetes (PMID: 38395927, 36937092,
38490691), since these diseases may partially explain the associations between NAFLD and
mental disorders. Some confounding factors need to be discussed, like education and income,
given that they are vital risk factors for mental disorders (PMID: 38440407, 38007229).
Please review this paper.
user
Title: Causal relationships between neuropsychiatric disorders and nonalcoholic fatty liver
disease: A bidirectional Mendelian randomization study
Version: 2 Date: 22 Apr 2024
Reviewer:  Fuquan Zhang
Reviewer's report:
The authors performed an MR analysis to explore bidirectional causal associations between
NAFLD and mental disorders. They reported the causal effect of NAFLD on anxiety disorder
and the causal effect of MDD on NAFLD. These findings may help understand the genetic
relationships between NAFLD and mental disorders. I have some recommendations for the
authors:
1. In the abstract, the authors should state clearly which kind of results were reported. Otherwise,
readers have difficulty knowing whether the results were from the discovery stage or the
replication stage. For anxiety disorder, several different names were used, including “anxiety”
and “anxiety disorders”, please unify them into one.
2. Some datasets for mental disorders were not the largest ones available, including
schizophrenia and bipolar disorder. The authors did not include some major mental disorders in
the study, like insomnia. Please discuss the limitations. Please double-check whether the MDD
dataset contained 246,363 patients and 561,190 controls. The publicly available MDD dataset
did not contain the participants from 23andMe, therefore, did not have all these samples.
3. The manuscript can discuss the causal associations between mental disorders and other
diseases, including cardiovascular diseases and diabetes (PMID: 38395927, 36937092,
38490691), since these diseases may partially explain the associations between NAFLD and
mental disorders. Some confounding factors need to be discussed, like education and income,
given that they are vital risk factors for mental disorders (PMID: 38440407, 38007229).
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