Title: Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the
diagnosis of sarcopenia in cirrhotic patients.
Version: 2 Date: 15 Dec 2021
Reviewer:  Kuen-chang Hsieh
Reviewer's report:
Title: Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the
diagnosis of sarcopenia in cirrhotic patients
This study compared the diagnosis of sarcopenia patients with CT, BIA and grip strength in
cirrhotic patients. The research topic has clinical significance. There are still some problems
in the manuscript. It is recommended that the authors clarify them in order to increase the
readability and completeness of this research.
Please provide the approved IRB number.
On page 8, the authors have stated that "the calculation of the abdominal muscle cross-section
was performed by Matlab". I personally think it should be the software developed by the authors
themselves. But how to determine that the software can correctly calculate the muscle area of
the cross-section, the authors need to explain it.
In Table 1, the average age of without sarcopenia is 58, 63, respectively. Why is the total average
value 63? There should be a problem, please confirm with the authors.
In this study, the cross-sectional area muscle mass obtained by CT was used as the comparison
standard for the study, and it is called the gold standard. Why? For the authors should cite the
literature [7]. What is the difference between the reference value of CT and other existing judging
sarcopenia indicators? Please clarify it.
On the seventh page, in the measurement section of BIA, there were two indicators, SMI and
ASM. SMI is skeletal muscle index, ASM is appendicular skeletal muscle. But in the description
of this paragraph, it was mentioned that "The SMI cut-off by BIA for the diagnosis of sarcopenia
was based on the JSH criteria...". I think the "SMI" should be "ASM". please confirm.
Page 10, Line 1, "CT was 43 and 31 cm2/m2," The correct label should be "cm2/m2". Many
of the superscripts in the manuscript were not used correctly, and it is recommended to correct
them.
Why was the height of the abdominal muscle cross-section obtained from the CT scan L3. Please
indicate the source of the reference.
The description of the preparation conditions for BIA measurement was too few, please add it.
Correlation coefficient (R) is recommended to be written as r in order to distinguish it from
resistance (R).
Although the correlation between MC780 and CT presented in the manuscript was not
good, whether it can support the conclusion "Nonetheless, for the BIA, the current cut-off
demonstrated unacceptable sensitivity to detect sarcopenia.", the authors should be reconsider.
The correlation between HSG and CT was not good. Why was there such a big difference in
the evaluation results of BIA and HSG, which are commonly used to judge sarcopenic? Please
add an explanation to discuss it.
Title: Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the
diagnosis of sarcopenia in cirrhotic patients.
Version: 2 Date: 15 Dec 2021
Reviewer:  Kuen-chang Hsieh
Reviewer's report:
Title: Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the
diagnosis of sarcopenia in cirrhotic patients
This study compared the diagnosis of sarcopenia patients with CT, BIA and grip strength in
cirrhotic patients. The research topic has clinical significance. There are still some problems
in the manuscript. It is recommended that the authors clarify them in order to increase the
readability and completeness of this research.
Please provide the approved IRB number.
On page 8, the authors have stated that "the calculation of the abdominal muscle cross-section
was performed by Matlab". I personally think it should be the software developed by the authors
themselves. But how to determine that the software can correctly calculate the muscle area of
the cross-section, the authors need to explain it.
In Table 1, the average age of without sarcopenia is 58, 63, respectively. Why is the total average
value 63? There should be a problem, please confirm with the authors.
In this study, the cross-sectional area muscle mass obtained by CT was used as the comparison
standard for the study, and it is called the gold standard. Why? For the authors should cite the
literature [7]. What is the difference between the reference value of CT and other existing judging
sarcopenia indicators? Please clarify it.
On the seventh page, in the measurement section of BIA, there were two indicators, SMI and
ASM. SMI is skeletal muscle index, ASM is appendicular skeletal muscle. But in the description
of this paragraph, it was mentioned that "The SMI cut-off by BIA for the diagnosis of sarcopenia
was based on the JSH criteria...". I think the "SMI" should be "ASM". please confirm.
Page 10, Line 1, "CT was 43 and 31 cm2/m2," The correct label should be "cm2/m2". Many
of the superscripts in the manuscript were not used correctly, and it is recommended to correct
them.
Why was the height of the abdominal muscle cross-section obtained from the CT scan L3. Please
indicate the source of the reference.
The description of the preparation conditions for BIA measurement was too few, please add it.
Correlation coefficient (R) is recommended to be written as r in order to distinguish it from
resistance (R).
Although the correlation between MC780 and CT presented in the manuscript was not
good, whether it can support the conclusion "Nonetheless, for the BIA, the current cut-off
demonstrated unacceptable sensitivity to detect sarcopenia.", the authors should be reconsider.
The correlation between HSG and CT was not good. Why was there such a big difference in
the evaluation results of BIA and HSG, which are commonly used to judge sarcopenic? Please
add an explanation to discuss it.
Please review this paper.
user
Title: Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the
diagnosis of sarcopenia in cirrhotic patients.
Version: 2 Date: 15 Dec 2021
Reviewer:  Kuen-chang Hsieh
Reviewer's report:
Title: Utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) in the
diagnosis of sarcopenia in cirrhotic patients
This study compared the diagnosis of sarcopenia patients with CT, BIA and grip strength in
cirrhotic patients. The research topic has clinical significance. There are still some problems
in the manuscript. It is recommended that the authors clarify them in order to increase the
readability and completeness of this research.
Please provide the approved IRB number.
On page 8, the authors have stated that "the calculation of the abdominal muscle cross-section
was performed by Matlab". I personally think it should be the software developed by the authors
themselves. But how to determine that the software can correctly calculate the muscle area of
the cross-section, the authors need to explain it.
In Table 1, the average age of without sarcopenia is 58, 63, respectively. Why is the total average
value 63? There should be a problem, please confirm with the authors.
In this study, the cross-sectional area muscle mass obtained by CT was used as the comparison
standard for the study, and it is called the gold standard. Why? For the authors should cite the
literature [7]. What is the difference between the reference value of CT and other existing judging
sarcopenia indicators? Please clarify it.
On the seventh page, in the measurement section of BIA, there were two indicators, SMI and
ASM. SMI is skeletal muscle index, ASM is appendicular skeletal muscle. But in the description
of this paragraph, it was mentioned that "The SMI cut-off by BIA for the diagnosis of sarcopenia
was based on the JSH criteria...". I think the "SMI" should be "ASM". please confirm.
Page 10, Line 1, "CT was 43 and 31 cm2/m2," The correct label should be "cm2/m2". Many
of the superscripts in the manuscript were not used correctly, and it is recommended to correct
them.
Why was the height of the abdominal muscle cross-section obtained from the CT scan L3. Please
indicate the source of the reference.
The description of the preparation conditions for BIA measurement was too few, please add it.
Correlation coefficient (R) is recommended to be written as r in order to distinguish it from
resistance (R).
Although the correlation between MC780 and CT presented in the manuscript was not
good, whether it can support the conclusion "Nonetheless, for the BIA, the current cut-off
demonstrated unacceptable sensitivity to detect sarcopenia.", the authors should be reconsider.
The correlation between HSG and CT was not good. Why was there such a big difference in
the evaluation results of BIA and HSG, which are commonly used to judge sarcopenic? Please
add an explanation to discuss it.
assistant