Title: An updated systematic review and meta-analysis: Correlation between circulating
Plasminogen Activator Inhibitor-1 levels and Metabolic Dysfunction-Associated Steatotic Liver
Disease
Version: 1 Date: 06 Mar 2025
Reviewer:  Bryan Adrian Priego-Parra
Reviewer's report:
Thank you for inviting me to review this manuscript, in which the authors conducted a systematic
review and meta-analysis to evaluate the correlation between plasminogen and MAFLD. They
found that plasminogen levels in MAFLD are elevated compared to control individuals.
The study is well-designed, registered with the NIH, and correctly followed the PROSPERO
protocol, the GRADE system, and PRISMA guidelines. It is an interesting, well-written article,
though I have some suggestions to consider, listed below:
General Comments:
1. Statistical notation: Use lowercase "p" for statistical p-values in both the text and figures.
2. Introduction: Before discussing plasminogen, briefly introduce the diagnosis of MAFLD.
Address the limitations of liver biopsy as the gold standard for MAFLD (e.g., invasiveness,
sampling variability, cost) to provide context for readers unfamiliar with the field. Emphasize
the need to explore new biomarkers.
Specific Edits:
• Line 153: Replace "gender" with "sex."
• Line 211: Add a space after "respectively."
• Line 294: Insert the appropriate citation immediately after "Alsharoh et al."
Discussion Section Additions:
1. Discuss sex- and ethnicity-related differences in the diagnostic performance of biomarkers
for NAFLD/MAFLD/MASLD. Consider citing:
o PMIDs: 38760802, 30924946, 38809396, 38901566, 39980852, 40035953, 40029148.
Additional Suggestions:
• Did the authors perform a sex-based analysis? If so, include it; if not, mention this as a
limitation.
Thank you again for the invitation to review this work.
Title: An updated systematic review and meta-analysis: Correlation between circulating
Plasminogen Activator Inhibitor-1 levels and Metabolic Dysfunction-Associated Steatotic Liver
Disease
Version: 1 Date: 06 Mar 2025
Reviewer:  Bryan Adrian Priego-Parra
Reviewer's report:
Thank you for inviting me to review this manuscript, in which the authors conducted a systematic
review and meta-analysis to evaluate the correlation between plasminogen and MAFLD. They
found that plasminogen levels in MAFLD are elevated compared to control individuals.
The study is well-designed, registered with the NIH, and correctly followed the PROSPERO
protocol, the GRADE system, and PRISMA guidelines. It is an interesting, well-written article,
though I have some suggestions to consider, listed below:
General Comments:
1. Statistical notation: Use lowercase "p" for statistical p-values in both the text and figures.
2. Introduction: Before discussing plasminogen, briefly introduce the diagnosis of MAFLD.
Address the limitations of liver biopsy as the gold standard for MAFLD (e.g., invasiveness,
sampling variability, cost) to provide context for readers unfamiliar with the field. Emphasize
the need to explore new biomarkers.
Specific Edits:
• Line 153: Replace "gender" with "sex."
• Line 211: Add a space after "respectively."
• Line 294: Insert the appropriate citation immediately after "Alsharoh et al."
Discussion Section Additions:
1. Discuss sex- and ethnicity-related differences in the diagnostic performance of biomarkers
for NAFLD/MAFLD/MASLD. Consider citing:
o PMIDs: 38760802, 30924946, 38809396, 38901566, 39980852, 40035953, 40029148.
Additional Suggestions:
• Did the authors perform a sex-based analysis? If so, include it; if not, mention this as a
limitation.
Thank you again for the invitation to review this work.
Please review this paper.
user
Title: An updated systematic review and meta-analysis: Correlation between circulating
Plasminogen Activator Inhibitor-1 levels and Metabolic Dysfunction-Associated Steatotic Liver
Disease
Version: 1 Date: 06 Mar 2025
Reviewer:  Bryan Adrian Priego-Parra
Reviewer's report:
Thank you for inviting me to review this manuscript, in which the authors conducted a systematic
review and meta-analysis to evaluate the correlation between plasminogen and MAFLD. They
found that plasminogen levels in MAFLD are elevated compared to control individuals.
The study is well-designed, registered with the NIH, and correctly followed the PROSPERO
protocol, the GRADE system, and PRISMA guidelines. It is an interesting, well-written article,
though I have some suggestions to consider, listed below:
General Comments:
1. Statistical notation: Use lowercase "p" for statistical p-values in both the text and figures.
2. Introduction: Before discussing plasminogen, briefly introduce the diagnosis of MAFLD.
Address the limitations of liver biopsy as the gold standard for MAFLD (e.g., invasiveness,
sampling variability, cost) to provide context for readers unfamiliar with the field. Emphasize
the need to explore new biomarkers.
Specific Edits:
• Line 153: Replace "gender" with "sex."
• Line 211: Add a space after "respectively."
• Line 294: Insert the appropriate citation immediately after "Alsharoh et al."
Discussion Section Additions:
1. Discuss sex- and ethnicity-related differences in the diagnostic performance of biomarkers
for NAFLD/MAFLD/MASLD. Consider citing:
o PMIDs: 38760802, 30924946, 38809396, 38901566, 39980852, 40035953, 40029148.
Additional Suggestions:
• Did the authors perform a sex-based analysis? If so, include it; if not, mention this as a
limitation.
Thank you again for the invitation to review this work.
assistant