Title: Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with
gastric cancer
Version: 1 Date: 07 Oct 2021
Reviewer's report:
The manuscript is of scientific interest and needs only minor revisions highlighted below:
1) Materials and methods:
- CT imaging was obtained within 1 month preoperatively and serum Cr and CysC
concentrations measured preoperatively.  When serum Cr and CysC concentrations were
obtained?
- Please check skeletal muscle threshold (isn't it -29 to +150 HU?).
- The authors defined sarcopenia as low skeletal muscle mass and low muscle strength or
physical function or only low muscle mass? Please clarify.
- The reference of cut-off values to define sarcopenia (reference 21) is correct? Please check.
- The authors did not show cox regression analysis results. Please clarify.
2) Results:
Table 1: Please replace “Fmale” to “Female” and add the number of patients with sarcopenia.
- According to the text, preoperative anemia predicted sarcopenia in univariate and multivariate
analysis.  However, the results weren’t shown in Table 2. Please check.
- Some variables predicted sarcopenia in Table 2 were not cited in the text.
- Table 2: results of serum Cr/Cys C ratio and TNM "*” are missing.
- What the authors mean by the concept of sarcopenia severity? Serum Cr/CysC ratio, and Cr
was positively correlated with SMI and SMA. Did authors perform the association between
biomarkers and sarcopenia severity (low skeletal muscle mass and low muscle strength or
physical function)? Please clarify.
3) Discussion
- If have other studies, please discuss the relationship between Cr/CysC ratio and sarcopenia in
patients with cancer.
Title: Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with
gastric cancer
Version: 1 Date: 07 Oct 2021
Reviewer's report:
The manuscript is of scientific interest and needs only minor revisions highlighted below:
1) Materials and methods:
- CT imaging was obtained within 1 month preoperatively and serum Cr and CysC
concentrations measured preoperatively.  When serum Cr and CysC concentrations were
obtained?
- Please check skeletal muscle threshold (isn't it -29 to +150 HU?).
- The authors defined sarcopenia as low skeletal muscle mass and low muscle strength or
physical function or only low muscle mass? Please clarify.
- The reference of cut-off values to define sarcopenia (reference 21) is correct? Please check.
- The authors did not show cox regression analysis results. Please clarify.
2) Results:
Table 1: Please replace “Fmale” to “Female” and add the number of patients with sarcopenia.
- According to the text, preoperative anemia predicted sarcopenia in univariate and multivariate
analysis.  However, the results weren’t shown in Table 2. Please check.
- Some variables predicted sarcopenia in Table 2 were not cited in the text.
- Table 2: results of serum Cr/Cys C ratio and TNM "*” are missing.
- What the authors mean by the concept of sarcopenia severity? Serum Cr/CysC ratio, and Cr
was positively correlated with SMI and SMA. Did authors perform the association between
biomarkers and sarcopenia severity (low skeletal muscle mass and low muscle strength or
physical function)? Please clarify.
3) Discussion
- If have other studies, please discuss the relationship between Cr/CysC ratio and sarcopenia in
patients with cancer.
Please review this paper.
user
Title: Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with
gastric cancer
Version: 1 Date: 07 Oct 2021
Reviewer's report:
The manuscript is of scientific interest and needs only minor revisions highlighted below:
1) Materials and methods:
- CT imaging was obtained within 1 month preoperatively and serum Cr and CysC
concentrations measured preoperatively.  When serum Cr and CysC concentrations were
obtained?
- Please check skeletal muscle threshold (isn't it -29 to +150 HU?).
- The authors defined sarcopenia as low skeletal muscle mass and low muscle strength or
physical function or only low muscle mass? Please clarify.
- The reference of cut-off values to define sarcopenia (reference 21) is correct? Please check.
- The authors did not show cox regression analysis results. Please clarify.
2) Results:
Table 1: Please replace “Fmale” to “Female” and add the number of patients with sarcopenia.
- According to the text, preoperative anemia predicted sarcopenia in univariate and multivariate
analysis.  However, the results weren’t shown in Table 2. Please check.
- Some variables predicted sarcopenia in Table 2 were not cited in the text.
- Table 2: results of serum Cr/Cys C ratio and TNM "*” are missing.
- What the authors mean by the concept of sarcopenia severity? Serum Cr/CysC ratio, and Cr
was positively correlated with SMI and SMA. Did authors perform the association between
biomarkers and sarcopenia severity (low skeletal muscle mass and low muscle strength or
physical function)? Please clarify.
3) Discussion
- If have other studies, please discuss the relationship between Cr/CysC ratio and sarcopenia in
patients with cancer.
assistant