Title: The Newly Proposed Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein
Cholesterol Ratio Serves as A Simple and Practical Indicator for Screening Metabolic
Associated Fatty Liver Disease: An Observational Study Based on A Physical Examination
Population
Version: 0 Date: 24 Jun 2024
Reviewer's report:
He S, et al reported the manuscript entitled “The newly proposed plasma-glycosylated
hemoglobin A1c/high density lipoprotein cholesterol ratio serves as a simple and practical
indicator for assessing non-alcoholic fatty liver disease: an observational study based on a
physical examination population”. They concluded that the newly proposed HbA1c/HDL-C
ratio serves as a simple and practical indicator for assessing NAFLD. Many biomarkers have
been reported for the screening of NAFLD from many countries. For this purpose cost benefit,
high sensitivity, and high specificity are required. This paper is interesting and describes
important points, however, there are some questionable results.
Major points
1. In Table 1 baseline characteristics of the subjects are classified into 4 groups, in which
the percentage of women in Q4 is significantly lower than other 3 groups. Subjects in Q4
is the highest risk population for the development of NAFLD. It has been reported that the
development of NAFLD in females is significantly increased after menopause. However, the
present result is opposite compared to previous reports. How do you explain this point?
2. In Fig 3 AUROCs for the screening of NAFLD between HbA1c/HDL-C and HDL-C are very
close. Is there any clinically meaningful point to use HbA1c/HDL-C instead of HDL-C alone?
Did you compare the diagnostic ability of the HbA1c/HDL-C with previously reported NITs for
the screening of NAFLD?
Title: The Newly Proposed Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein
Cholesterol Ratio Serves as A Simple and Practical Indicator for Screening Metabolic
Associated Fatty Liver Disease: An Observational Study Based on A Physical Examination
Population
Version: 0 Date: 24 Jun 2024
Reviewer's report:
He S, et al reported the manuscript entitled “The newly proposed plasma-glycosylated
hemoglobin A1c/high density lipoprotein cholesterol ratio serves as a simple and practical
indicator for assessing non-alcoholic fatty liver disease: an observational study based on a
physical examination population”. They concluded that the newly proposed HbA1c/HDL-C
ratio serves as a simple and practical indicator for assessing NAFLD. Many biomarkers have
been reported for the screening of NAFLD from many countries. For this purpose cost benefit,
high sensitivity, and high specificity are required. This paper is interesting and describes
important points, however, there are some questionable results.
Major points
1. In Table 1 baseline characteristics of the subjects are classified into 4 groups, in which
the percentage of women in Q4 is significantly lower than other 3 groups. Subjects in Q4
is the highest risk population for the development of NAFLD. It has been reported that the
development of NAFLD in females is significantly increased after menopause. However, the
present result is opposite compared to previous reports. How do you explain this point?
2. In Fig 3 AUROCs for the screening of NAFLD between HbA1c/HDL-C and HDL-C are very
close. Is there any clinically meaningful point to use HbA1c/HDL-C instead of HDL-C alone?
Did you compare the diagnostic ability of the HbA1c/HDL-C with previously reported NITs for
the screening of NAFLD?
Please review this paper.
user
Title: The Newly Proposed Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein
Cholesterol Ratio Serves as A Simple and Practical Indicator for Screening Metabolic
Associated Fatty Liver Disease: An Observational Study Based on A Physical Examination
Population
Version: 0 Date: 24 Jun 2024
Reviewer's report:
He S, et al reported the manuscript entitled “The newly proposed plasma-glycosylated
hemoglobin A1c/high density lipoprotein cholesterol ratio serves as a simple and practical
indicator for assessing non-alcoholic fatty liver disease: an observational study based on a
physical examination population”. They concluded that the newly proposed HbA1c/HDL-C
ratio serves as a simple and practical indicator for assessing NAFLD. Many biomarkers have
been reported for the screening of NAFLD from many countries. For this purpose cost benefit,
high sensitivity, and high specificity are required. This paper is interesting and describes
important points, however, there are some questionable results.
Major points
1. In Table 1 baseline characteristics of the subjects are classified into 4 groups, in which
the percentage of women in Q4 is significantly lower than other 3 groups. Subjects in Q4
is the highest risk population for the development of NAFLD. It has been reported that the
development of NAFLD in females is significantly increased after menopause. However, the
present result is opposite compared to previous reports. How do you explain this point?
2. In Fig 3 AUROCs for the screening of NAFLD between HbA1c/HDL-C and HDL-C are very
close. Is there any clinically meaningful point to use HbA1c/HDL-C instead of HDL-C alone?
Did you compare the diagnostic ability of the HbA1c/HDL-C with previously reported NITs for
the screening of NAFLD?
assistant