Title: The relationship between Sarcopenia and Metabolic dysfunction-associated fatty liver
disease among the young and middle-aged populations
Version: 0 Date: 03 Oct 2023
Reviewer's report:
Thank you for the opportunity to review this paper. I have several concerns about this
manuscript.
1. Terminology - the paper is predicated on the terminology MAFLD - which is not incorrect but
as authors will know, in June 2023, a global consensus suggested a change to the term MASLD.
This may well influence the approach to the entire manuscript. I the authors wish to use the
term MAFLD, can they please explain why this is so and what their justification is. It appears
the article was constructed before June 2023, but having only been submitted now, materially
influences the position of the term MAFLD. Using the term may well be reasonable but needs
justification.
2. The results section in the abstract needs to be re-written to contain actual results not
interpretation e.g."The relationship between the MAFLD and sarcopenia were mediated by C-
reactive protein and high-density lipoprotein cholesterol" - no indication of the actual data?
3. Conclusion (in abstract) -"Sarcopenia patients are more prone to MAFLD and MAFLD with
liver fibrosis." This does not make sense. Are you trying to say MAFLD is a risk factor for
sarcopenia and this risk increases with increasing liver fibrosis??
4. Line 212:"The association between MAFLD and sarcopenia was significant for both alcohol
drinkers [OR = 2.86 (95% CI: 1.46-5.61)] and people who sit for higher than three hours per
day [OR = 3.26 (95% CI: 1.91-5.57)], ..." How much alcohol?  Is this accounted for?
5. Is there a proposed pathogenic mechanism for HDL effect in mediating sarcopenia?
6. Line 56 and elsewhere : "Research" not researches
Overall the paper makes for interesting analyses. However I am of the view the manuscript
seemingly confuses aspects such as the proposed nomenclature change from NAFLD to MAFLD
(which is seemingly obsolete) .  The paper can well do with significant review in trimming down
many superfluous aspects and producing a clear message that sarcopenia associates with fatty
liver disease and this risk increases with increasing fibrosis.
Title: The relationship between Sarcopenia and Metabolic dysfunction-associated fatty liver
disease among the young and middle-aged populations
Version: 0 Date: 03 Oct 2023
Reviewer's report:
Thank you for the opportunity to review this paper. I have several concerns about this
manuscript.
1. Terminology - the paper is predicated on the terminology MAFLD - which is not incorrect but
as authors will know, in June 2023, a global consensus suggested a change to the term MASLD.
This may well influence the approach to the entire manuscript. I the authors wish to use the
term MAFLD, can they please explain why this is so and what their justification is. It appears
the article was constructed before June 2023, but having only been submitted now, materially
influences the position of the term MAFLD. Using the term may well be reasonable but needs
justification.
2. The results section in the abstract needs to be re-written to contain actual results not
interpretation e.g."The relationship between the MAFLD and sarcopenia were mediated by C-
reactive protein and high-density lipoprotein cholesterol" - no indication of the actual data?
3. Conclusion (in abstract) -"Sarcopenia patients are more prone to MAFLD and MAFLD with
liver fibrosis." This does not make sense. Are you trying to say MAFLD is a risk factor for
sarcopenia and this risk increases with increasing liver fibrosis??
4. Line 212:"The association between MAFLD and sarcopenia was significant for both alcohol
drinkers [OR = 2.86 (95% CI: 1.46-5.61)] and people who sit for higher than three hours per
day [OR = 3.26 (95% CI: 1.91-5.57)], ..." How much alcohol?  Is this accounted for?
5. Is there a proposed pathogenic mechanism for HDL effect in mediating sarcopenia?
6. Line 56 and elsewhere : "Research" not researches
Overall the paper makes for interesting analyses. However I am of the view the manuscript
seemingly confuses aspects such as the proposed nomenclature change from NAFLD to MAFLD
(which is seemingly obsolete) .  The paper can well do with significant review in trimming down
many superfluous aspects and producing a clear message that sarcopenia associates with fatty
liver disease and this risk increases with increasing fibrosis.
Please review this paper.
user
Title: The relationship between Sarcopenia and Metabolic dysfunction-associated fatty liver
disease among the young and middle-aged populations
Version: 0 Date: 03 Oct 2023
Reviewer's report:
Thank you for the opportunity to review this paper. I have several concerns about this
manuscript.
1. Terminology - the paper is predicated on the terminology MAFLD - which is not incorrect but
as authors will know, in June 2023, a global consensus suggested a change to the term MASLD.
This may well influence the approach to the entire manuscript. I the authors wish to use the
term MAFLD, can they please explain why this is so and what their justification is. It appears
the article was constructed before June 2023, but having only been submitted now, materially
influences the position of the term MAFLD. Using the term may well be reasonable but needs
justification.
2. The results section in the abstract needs to be re-written to contain actual results not
interpretation e.g."The relationship between the MAFLD and sarcopenia were mediated by C-
reactive protein and high-density lipoprotein cholesterol" - no indication of the actual data?
3. Conclusion (in abstract) -"Sarcopenia patients are more prone to MAFLD and MAFLD with
liver fibrosis." This does not make sense. Are you trying to say MAFLD is a risk factor for
sarcopenia and this risk increases with increasing liver fibrosis??
4. Line 212:"The association between MAFLD and sarcopenia was significant for both alcohol
drinkers [OR = 2.86 (95% CI: 1.46-5.61)] and people who sit for higher than three hours per
day [OR = 3.26 (95% CI: 1.91-5.57)], ..." How much alcohol?  Is this accounted for?
5. Is there a proposed pathogenic mechanism for HDL effect in mediating sarcopenia?
6. Line 56 and elsewhere : "Research" not researches
Overall the paper makes for interesting analyses. However I am of the view the manuscript
seemingly confuses aspects such as the proposed nomenclature change from NAFLD to MAFLD
(which is seemingly obsolete) .  The paper can well do with significant review in trimming down
many superfluous aspects and producing a clear message that sarcopenia associates with fatty
liver disease and this risk increases with increasing fibrosis.
assistant