Title: Analysis of the association between dietary patterns and nonalcoholic fatty liver disease
in a county in Guangxi
Version: 2 Date: 27 May 2023
Reviewer's report:
In the present manuscript the Authors report the results of a cross-sectional study investigating
the association between dietary pattern and presence of NAFLD in Chinese individuals. The
topic is of some interest given the prevalence of NAFLD in the general population, as well as
the importance of dietary factor on its development and progression.
I have the following comments:
1. Please make it clear that NAFLD was diagnosed based on ultrasound in the abstract as the
readers should be able to know that from the beginning.
2. Please better describe the exclusion criteria (e.g. serious medical condition) and provide a
flowchart to show how many participants were excluded and for what reasons.
3. There is no mention of exclusion of participants based on viral hepatitis. Did you perform
serology? Did you exclude all participants with viral hepatitis? If not please include this aspect
as a limitation of the study in the discussion section,
4. I suggest reporting the features described in the Additional File 1 in Table 2 as part of the
main manuscript.
5. I suggest looking at biomarkers of fibrosis as well (such as FIB-4 or NALFD fibrosis score)
to evaluate whether dietary patterns impacts not only steatosis but also fibrosis, which is more
important as a predictor of poor liver outcomes. If you do not have the data to calculate these
indexes this should be included as a limitation of the current study in the discussion section.
6. I suggest mentioning a recent study investigating the importance not only of BMI but also of
fat distribution in the development of NAFLD and fibrosis (10.1093/ajcn/nqac059)
Title: Analysis of the association between dietary patterns and nonalcoholic fatty liver disease
in a county in Guangxi
Version: 2 Date: 27 May 2023
Reviewer's report:
In the present manuscript the Authors report the results of a cross-sectional study investigating
the association between dietary pattern and presence of NAFLD in Chinese individuals. The
topic is of some interest given the prevalence of NAFLD in the general population, as well as
the importance of dietary factor on its development and progression.
I have the following comments:
1. Please make it clear that NAFLD was diagnosed based on ultrasound in the abstract as the
readers should be able to know that from the beginning.
2. Please better describe the exclusion criteria (e.g. serious medical condition) and provide a
flowchart to show how many participants were excluded and for what reasons.
3. There is no mention of exclusion of participants based on viral hepatitis. Did you perform
serology? Did you exclude all participants with viral hepatitis? If not please include this aspect
as a limitation of the study in the discussion section,
4. I suggest reporting the features described in the Additional File 1 in Table 2 as part of the
main manuscript.
5. I suggest looking at biomarkers of fibrosis as well (such as FIB-4 or NALFD fibrosis score)
to evaluate whether dietary patterns impacts not only steatosis but also fibrosis, which is more
important as a predictor of poor liver outcomes. If you do not have the data to calculate these
indexes this should be included as a limitation of the current study in the discussion section.
6. I suggest mentioning a recent study investigating the importance not only of BMI but also of
fat distribution in the development of NAFLD and fibrosis (10.1093/ajcn/nqac059)
Please review this paper.
user
Title: Analysis of the association between dietary patterns and nonalcoholic fatty liver disease
in a county in Guangxi
Version: 2 Date: 27 May 2023
Reviewer's report:
In the present manuscript the Authors report the results of a cross-sectional study investigating
the association between dietary pattern and presence of NAFLD in Chinese individuals. The
topic is of some interest given the prevalence of NAFLD in the general population, as well as
the importance of dietary factor on its development and progression.
I have the following comments:
1. Please make it clear that NAFLD was diagnosed based on ultrasound in the abstract as the
readers should be able to know that from the beginning.
2. Please better describe the exclusion criteria (e.g. serious medical condition) and provide a
flowchart to show how many participants were excluded and for what reasons.
3. There is no mention of exclusion of participants based on viral hepatitis. Did you perform
serology? Did you exclude all participants with viral hepatitis? If not please include this aspect
as a limitation of the study in the discussion section,
4. I suggest reporting the features described in the Additional File 1 in Table 2 as part of the
main manuscript.
5. I suggest looking at biomarkers of fibrosis as well (such as FIB-4 or NALFD fibrosis score)
to evaluate whether dietary patterns impacts not only steatosis but also fibrosis, which is more
important as a predictor of poor liver outcomes. If you do not have the data to calculate these
indexes this should be included as a limitation of the current study in the discussion section.
6. I suggest mentioning a recent study investigating the importance not only of BMI but also of
fat distribution in the development of NAFLD and fibrosis (10.1093/ajcn/nqac059)
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