Title: Associations between non-insulin-based insulin resistance surrogate markers and liver-
related outcomes in metabolic dysfunction-associated steatotic liver disease: a nationwide cohort
study in South Korea
Version: 3 Date: 07 Mar 2025
Reviewer's report:
The risks between MASLD and IR has been discussed a lot and well recognized, the novelty of
this paper is low and did not provide any new insight in this fie
1.a study using HOMA-IR and METS-IR as predictors of NAFLD prevalence indicated that both
markers demonstrated high predictive accuracy (HOMA-IR area under the receiver operating
characteristic [AUROC] 0.831, METS-IR AUROC 0.824).[15] The TyG index and TG/HDL
ratio demonstrated similar results (HOMA-IR AUROC 0.782, TyG index AUROC 0.738, TG/
HDL ratio AUROC 0.738), Therefore, did METS-IR presented statistic higher AUROC?
2. This study focus on the change of TyG index, TG/HDL ratio and METS-IR and prognosis ofd
MASLD, HOWEVER, it did not reveal the interaction effects of steatosis changes or fibrosis
regression.
3. It did not perform a regular monitoring of IR markers, therefore the change of IR markers in
such a long period  between 1 January 2013 and 31 December 2019 did not truly reveal their
relationship.
Title: Associations between non-insulin-based insulin resistance surrogate markers and liver-
related outcomes in metabolic dysfunction-associated steatotic liver disease: a nationwide cohort
study in South Korea
Version: 3 Date: 07 Mar 2025
Reviewer's report:
The risks between MASLD and IR has been discussed a lot and well recognized, the novelty of
this paper is low and did not provide any new insight in this fie
1.a study using HOMA-IR and METS-IR as predictors of NAFLD prevalence indicated that both
markers demonstrated high predictive accuracy (HOMA-IR area under the receiver operating
characteristic [AUROC] 0.831, METS-IR AUROC 0.824).[15] The TyG index and TG/HDL
ratio demonstrated similar results (HOMA-IR AUROC 0.782, TyG index AUROC 0.738, TG/
HDL ratio AUROC 0.738), Therefore, did METS-IR presented statistic higher AUROC?
2. This study focus on the change of TyG index, TG/HDL ratio and METS-IR and prognosis ofd
MASLD, HOWEVER, it did not reveal the interaction effects of steatosis changes or fibrosis
regression.
3. It did not perform a regular monitoring of IR markers, therefore the change of IR markers in
such a long period  between 1 January 2013 and 31 December 2019 did not truly reveal their
relationship.
Please review this paper.
user
Title: Associations between non-insulin-based insulin resistance surrogate markers and liver-
related outcomes in metabolic dysfunction-associated steatotic liver disease: a nationwide cohort
study in South Korea
Version: 3 Date: 07 Mar 2025
Reviewer's report:
The risks between MASLD and IR has been discussed a lot and well recognized, the novelty of
this paper is low and did not provide any new insight in this fie
1.a study using HOMA-IR and METS-IR as predictors of NAFLD prevalence indicated that both
markers demonstrated high predictive accuracy (HOMA-IR area under the receiver operating
characteristic [AUROC] 0.831, METS-IR AUROC 0.824).[15] The TyG index and TG/HDL
ratio demonstrated similar results (HOMA-IR AUROC 0.782, TyG index AUROC 0.738, TG/
HDL ratio AUROC 0.738), Therefore, did METS-IR presented statistic higher AUROC?
2. This study focus on the change of TyG index, TG/HDL ratio and METS-IR and prognosis ofd
MASLD, HOWEVER, it did not reveal the interaction effects of steatosis changes or fibrosis
regression.
3. It did not perform a regular monitoring of IR markers, therefore the change of IR markers in
such a long period  between 1 January 2013 and 31 December 2019 did not truly reveal their
relationship.
assistant