Title: The Impact of Serum Neuregulin 4 (NRG#4) Levels on Non-Alcoholic Fatty Liver
Disease (NAFLD): A Systematic Review and Meta-Analysis
Version: 3 Date: 21 Mar 2025
Reviewer:  Ali Jafari
Reviewer's report:
Dear Authors,
I had the privilege of reviewing the article " The Impact of Serum Neuregulin 4 (NRG#4) Levels
on Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis."
While the topic is highly relevant, the manuscript presents several methodological and linguistic
issues. I have substantial concerns regarding its current form and believe it is not suitable for
publication until these issues are comprehensively addressed. I commend the authors for their
valuable contribution and kindly request that they consider the following points:
1.  The search is outdated; please update it.
2. Why did you use JBI to assess the quality of the studies? What was the reason for not using
the Newcastle-Ottawa Scale?
3. It would be better to include demographic characteristics in the abstract.
4.  The introduction is a critical part of the manuscript, as it prepares the reader for the study's
topic. Consider revising it to enhance clarity and coherence.
5.   Why were other databases, such as WOS and proquest, not included in the search strategy?
6.   The manuscript should adhere to the PRISMA 2020 guidelines for reporting systematic
reviews. Figure 1 should be updated accordingly.
7.   The authors have reported results following the PRISMA checklist. Please provide a copy
of the PRISMA checklist (with page numbers indicated for each section) as a supplementary
appendix, as required.
8.   Have you considered including grey literature as a potential source of relevant studies?
9.   The data screening and selection process should include kappa statistics to assess inter-rater
agreement between authors.
10.   The discussion section is well-written and engaging. However, adding two additional
sections—"Clinical Implications" and "Future Directions"—could further enhance the study’s
impact.
11.   It would be better to list the studies in Table 1 chronologically by year.
12.   As per PRISMA guidelines, provide a table of excluded studies (those assessed in full text
but excluded for specific reasons) as a supplementary file.
13.   To ensure reproducibility, include the full electronic search strategy for all databases,
specifying any applied limits, as a supplementary file.
Title: The Impact of Serum Neuregulin 4 (NRG#4) Levels on Non-Alcoholic Fatty Liver
Disease (NAFLD): A Systematic Review and Meta-Analysis
Version: 3 Date: 21 Mar 2025
Reviewer:  Ali Jafari
Reviewer's report:
Dear Authors,
I had the privilege of reviewing the article " The Impact of Serum Neuregulin 4 (NRG#4) Levels
on Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis."
While the topic is highly relevant, the manuscript presents several methodological and linguistic
issues. I have substantial concerns regarding its current form and believe it is not suitable for
publication until these issues are comprehensively addressed. I commend the authors for their
valuable contribution and kindly request that they consider the following points:
1.  The search is outdated; please update it.
2. Why did you use JBI to assess the quality of the studies? What was the reason for not using
the Newcastle-Ottawa Scale?
3. It would be better to include demographic characteristics in the abstract.
4.  The introduction is a critical part of the manuscript, as it prepares the reader for the study's
topic. Consider revising it to enhance clarity and coherence.
5.   Why were other databases, such as WOS and proquest, not included in the search strategy?
6.   The manuscript should adhere to the PRISMA 2020 guidelines for reporting systematic
reviews. Figure 1 should be updated accordingly.
7.   The authors have reported results following the PRISMA checklist. Please provide a copy
of the PRISMA checklist (with page numbers indicated for each section) as a supplementary
appendix, as required.
8.   Have you considered including grey literature as a potential source of relevant studies?
9.   The data screening and selection process should include kappa statistics to assess inter-rater
agreement between authors.
10.   The discussion section is well-written and engaging. However, adding two additional
sections—"Clinical Implications" and "Future Directions"—could further enhance the study’s
impact.
11.   It would be better to list the studies in Table 1 chronologically by year.
12.   As per PRISMA guidelines, provide a table of excluded studies (those assessed in full text
but excluded for specific reasons) as a supplementary file.
13.   To ensure reproducibility, include the full electronic search strategy for all databases,
specifying any applied limits, as a supplementary file.
Please review this paper.
user
Title: The Impact of Serum Neuregulin 4 (NRG#4) Levels on Non-Alcoholic Fatty Liver
Disease (NAFLD): A Systematic Review and Meta-Analysis
Version: 3 Date: 21 Mar 2025
Reviewer:  Ali Jafari
Reviewer's report:
Dear Authors,
I had the privilege of reviewing the article " The Impact of Serum Neuregulin 4 (NRG#4) Levels
on Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis."
While the topic is highly relevant, the manuscript presents several methodological and linguistic
issues. I have substantial concerns regarding its current form and believe it is not suitable for
publication until these issues are comprehensively addressed. I commend the authors for their
valuable contribution and kindly request that they consider the following points:
1.  The search is outdated; please update it.
2. Why did you use JBI to assess the quality of the studies? What was the reason for not using
the Newcastle-Ottawa Scale?
3. It would be better to include demographic characteristics in the abstract.
4.  The introduction is a critical part of the manuscript, as it prepares the reader for the study's
topic. Consider revising it to enhance clarity and coherence.
5.   Why were other databases, such as WOS and proquest, not included in the search strategy?
6.   The manuscript should adhere to the PRISMA 2020 guidelines for reporting systematic
reviews. Figure 1 should be updated accordingly.
7.   The authors have reported results following the PRISMA checklist. Please provide a copy
of the PRISMA checklist (with page numbers indicated for each section) as a supplementary
appendix, as required.
8.   Have you considered including grey literature as a potential source of relevant studies?
9.   The data screening and selection process should include kappa statistics to assess inter-rater
agreement between authors.
10.   The discussion section is well-written and engaging. However, adding two additional
sections—"Clinical Implications" and "Future Directions"—could further enhance the study’s
impact.
11.   It would be better to list the studies in Table 1 chronologically by year.
12.   As per PRISMA guidelines, provide a table of excluded studies (those assessed in full text
but excluded for specific reasons) as a supplementary file.
13.   To ensure reproducibility, include the full electronic search strategy for all databases,
specifying any applied limits, as a supplementary file.
assistant