Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 11 Feb 2025
Reviewer's report:
In this manuscript entitled “High sensitivity C-reactive protein Implicates Heterogeneous
Metabolic Phenotypes and Severity in Metabolic Dysfunction Associated-Steatotic Liver
Disease”, the authors examined the association between MASLD and high sensitivity CRP.
Although this is an interesting topic, there are several points which should be clarified in the
current paper.
1. In the introduction, the authors should explain the epidemiology of MASLD in general and
overweight or obese population (PMID: 38398471).
2. The study examines the role of hs-CRP in MASLD, but its clinical relevance as a diagnostic
or prognostic marker remains unclear. The manuscript states that hs-CRP levels are associated
with liver fat content (LFC) in overweight/obese individuals and liver stiffness in lean MASLD
patients, yet the reported AUC values suggest weak predictive ability (AUC < 0.7).
3. Although the study adjusts for several confounders, it does not clearly discuss the impact of
other key metabolic and inflammatory conditions, such as insulin resistance, chronic infections,
or comorbid conditions like cardiovascular disease. These factors could influence both hs-CRP
levels and MASLD severity.
4. The study validates findings in a biopsy-proven MASLD subgroup, but the results appear
inconsistent. While hs-CRP correlates with steatosis severity in overweight/obese MASLD
patients, it does not seem to predict MASH or fibrosis effectively. This raises concerns about
its utility in histologically confirmed MASLD cases.
5. Body fat accumulation is associated with steatotic liver disease and systemic inflammation.
The authors should make a discussion in this point (PMID: 37143429).
Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 11 Feb 2025
Reviewer's report:
In this manuscript entitled “High sensitivity C-reactive protein Implicates Heterogeneous
Metabolic Phenotypes and Severity in Metabolic Dysfunction Associated-Steatotic Liver
Disease”, the authors examined the association between MASLD and high sensitivity CRP.
Although this is an interesting topic, there are several points which should be clarified in the
current paper.
1. In the introduction, the authors should explain the epidemiology of MASLD in general and
overweight or obese population (PMID: 38398471).
2. The study examines the role of hs-CRP in MASLD, but its clinical relevance as a diagnostic
or prognostic marker remains unclear. The manuscript states that hs-CRP levels are associated
with liver fat content (LFC) in overweight/obese individuals and liver stiffness in lean MASLD
patients, yet the reported AUC values suggest weak predictive ability (AUC < 0.7).
3. Although the study adjusts for several confounders, it does not clearly discuss the impact of
other key metabolic and inflammatory conditions, such as insulin resistance, chronic infections,
or comorbid conditions like cardiovascular disease. These factors could influence both hs-CRP
levels and MASLD severity.
4. The study validates findings in a biopsy-proven MASLD subgroup, but the results appear
inconsistent. While hs-CRP correlates with steatosis severity in overweight/obese MASLD
patients, it does not seem to predict MASH or fibrosis effectively. This raises concerns about
its utility in histologically confirmed MASLD cases.
5. Body fat accumulation is associated with steatotic liver disease and systemic inflammation.
The authors should make a discussion in this point (PMID: 37143429).
Please review this paper.
user
Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 11 Feb 2025
Reviewer's report:
In this manuscript entitled “High sensitivity C-reactive protein Implicates Heterogeneous
Metabolic Phenotypes and Severity in Metabolic Dysfunction Associated-Steatotic Liver
Disease”, the authors examined the association between MASLD and high sensitivity CRP.
Although this is an interesting topic, there are several points which should be clarified in the
current paper.
1. In the introduction, the authors should explain the epidemiology of MASLD in general and
overweight or obese population (PMID: 38398471).
2. The study examines the role of hs-CRP in MASLD, but its clinical relevance as a diagnostic
or prognostic marker remains unclear. The manuscript states that hs-CRP levels are associated
with liver fat content (LFC) in overweight/obese individuals and liver stiffness in lean MASLD
patients, yet the reported AUC values suggest weak predictive ability (AUC < 0.7).
3. Although the study adjusts for several confounders, it does not clearly discuss the impact of
other key metabolic and inflammatory conditions, such as insulin resistance, chronic infections,
or comorbid conditions like cardiovascular disease. These factors could influence both hs-CRP
levels and MASLD severity.
4. The study validates findings in a biopsy-proven MASLD subgroup, but the results appear
inconsistent. While hs-CRP correlates with steatosis severity in overweight/obese MASLD
patients, it does not seem to predict MASH or fibrosis effectively. This raises concerns about
its utility in histologically confirmed MASLD cases.
5. Body fat accumulation is associated with steatotic liver disease and systemic inflammation.
The authors should make a discussion in this point (PMID: 37143429).
assistant