Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 2 Date: 06 Oct 2024
Reviewer:  Masatsugu Ohara
Reviewer's report:
Comment
In this manuscript, the authors demonstrated a positive association between elevated ALI levels
and both CAP and LSM levels, highlighting the importance of inflammation and nutritional
status in diagnosing hepatic steatosis and fibrosis. This is the first report on the utility of ALI
in relation to CAP and LSM.
However, the current findings provide limited evidence to support the use of ALI as a necessary
tool for evaluating CAP and LSM in fatty liver disease. There are several issues that need to
be addressed.
Major comments
1. To validate the utility of ALI, it is essential to compare it with established markers of fibrosis
and nutrition, such as the FIB-4 index, GNRI, and GLIM, which have been reported in relation
to liver disease.
2. In Table 2, the authors compare AHF (advanced hepatic fibrosis) with non-AHF. However, it
may be more appropriate to evaluate these cases within the context of NAFLD (AHF vs non AHF
in NAFLD), as there is already a difference in ALI between non-NAFLD and NAFLD patients.
Minor comment
In addition to the figure titles, legends may also be necessary for clarity. Furthermore, the graph's
X-axis and Y-axis lack unit labels; please consider adding these.
Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 2 Date: 06 Oct 2024
Reviewer:  Masatsugu Ohara
Reviewer's report:
Comment
In this manuscript, the authors demonstrated a positive association between elevated ALI levels
and both CAP and LSM levels, highlighting the importance of inflammation and nutritional
status in diagnosing hepatic steatosis and fibrosis. This is the first report on the utility of ALI
in relation to CAP and LSM.
However, the current findings provide limited evidence to support the use of ALI as a necessary
tool for evaluating CAP and LSM in fatty liver disease. There are several issues that need to
be addressed.
Major comments
1. To validate the utility of ALI, it is essential to compare it with established markers of fibrosis
and nutrition, such as the FIB-4 index, GNRI, and GLIM, which have been reported in relation
to liver disease.
2. In Table 2, the authors compare AHF (advanced hepatic fibrosis) with non-AHF. However, it
may be more appropriate to evaluate these cases within the context of NAFLD (AHF vs non AHF
in NAFLD), as there is already a difference in ALI between non-NAFLD and NAFLD patients.
Minor comment
In addition to the figure titles, legends may also be necessary for clarity. Furthermore, the graph's
X-axis and Y-axis lack unit labels; please consider adding these.
Please review this paper.
user
Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 2 Date: 06 Oct 2024
Reviewer:  Masatsugu Ohara
Reviewer's report:
Comment
In this manuscript, the authors demonstrated a positive association between elevated ALI levels
and both CAP and LSM levels, highlighting the importance of inflammation and nutritional
status in diagnosing hepatic steatosis and fibrosis. This is the first report on the utility of ALI
in relation to CAP and LSM.
However, the current findings provide limited evidence to support the use of ALI as a necessary
tool for evaluating CAP and LSM in fatty liver disease. There are several issues that need to
be addressed.
Major comments
1. To validate the utility of ALI, it is essential to compare it with established markers of fibrosis
and nutrition, such as the FIB-4 index, GNRI, and GLIM, which have been reported in relation
to liver disease.
2. In Table 2, the authors compare AHF (advanced hepatic fibrosis) with non-AHF. However, it
may be more appropriate to evaluate these cases within the context of NAFLD (AHF vs non AHF
in NAFLD), as there is already a difference in ALI between non-NAFLD and NAFLD patients.
Minor comment
In addition to the figure titles, legends may also be necessary for clarity. Furthermore, the graph's
X-axis and Y-axis lack unit labels; please consider adding these.
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