Title: Impact of blood lead and manganese levels on metabolic dysfunction-associated steatotic
liver disease prevalence: insights from NHANES (2017–2020)
Version: 1 Date: 03 Feb 2025
Reviewer:  Peng Tang
Reviewer's report:
This article evaluated the association between blood lead, manganese and MASLD. However,
several key concerns require clarification:
1. The authors used data from the National Health and Nutrition Examination Survey to assess
the association between blood lead and manganese levels and MAFLD, and then current research
has used the data from the NHANES to assess the association. This study is also not more
innovative or otherwise different than previous studies.
(Associations of multiple toxic metal exposures with metabolic dysfunction associated fatty liver
disease: NHANES 2011-2018. DOI 10.3389/fnut.2023.1301319)
2. The full name needs to be used when the abbreviation first appears.
3. There is a difference in the definition of MASLD from previous studies, which requires further
confirmation.
(Association between the skeletal muscle mass to visceral fat area ratio and metabolic
dysfunction-associated fatty liver disease: A cross-sectional study of NHANES 2017–2018)
4. When performing regression analysis, each quartile of lead and manganese levels
corresponded to P trend values, which was inaccurate.
5. The statistical P-value needs to be shown in italics.
6. The English writing and grammar as well as the tables and figures might be further carefully
corrected or modified to increase the quality of this manuscript.
Title: Impact of blood lead and manganese levels on metabolic dysfunction-associated steatotic
liver disease prevalence: insights from NHANES (2017–2020)
Version: 1 Date: 03 Feb 2025
Reviewer:  Peng Tang
Reviewer's report:
This article evaluated the association between blood lead, manganese and MASLD. However,
several key concerns require clarification:
1. The authors used data from the National Health and Nutrition Examination Survey to assess
the association between blood lead and manganese levels and MAFLD, and then current research
has used the data from the NHANES to assess the association. This study is also not more
innovative or otherwise different than previous studies.
(Associations of multiple toxic metal exposures with metabolic dysfunction associated fatty liver
disease: NHANES 2011-2018. DOI 10.3389/fnut.2023.1301319)
2. The full name needs to be used when the abbreviation first appears.
3. There is a difference in the definition of MASLD from previous studies, which requires further
confirmation.
(Association between the skeletal muscle mass to visceral fat area ratio and metabolic
dysfunction-associated fatty liver disease: A cross-sectional study of NHANES 2017–2018)
4. When performing regression analysis, each quartile of lead and manganese levels
corresponded to P trend values, which was inaccurate.
5. The statistical P-value needs to be shown in italics.
6. The English writing and grammar as well as the tables and figures might be further carefully
corrected or modified to increase the quality of this manuscript.
Please review this paper.
user
Title: Impact of blood lead and manganese levels on metabolic dysfunction-associated steatotic
liver disease prevalence: insights from NHANES (2017–2020)
Version: 1 Date: 03 Feb 2025
Reviewer:  Peng Tang
Reviewer's report:
This article evaluated the association between blood lead, manganese and MASLD. However,
several key concerns require clarification:
1. The authors used data from the National Health and Nutrition Examination Survey to assess
the association between blood lead and manganese levels and MAFLD, and then current research
has used the data from the NHANES to assess the association. This study is also not more
innovative or otherwise different than previous studies.
(Associations of multiple toxic metal exposures with metabolic dysfunction associated fatty liver
disease: NHANES 2011-2018. DOI 10.3389/fnut.2023.1301319)
2. The full name needs to be used when the abbreviation first appears.
3. There is a difference in the definition of MASLD from previous studies, which requires further
confirmation.
(Association between the skeletal muscle mass to visceral fat area ratio and metabolic
dysfunction-associated fatty liver disease: A cross-sectional study of NHANES 2017–2018)
4. When performing regression analysis, each quartile of lead and manganese levels
corresponded to P trend values, which was inaccurate.
5. The statistical P-value needs to be shown in italics.
6. The English writing and grammar as well as the tables and figures might be further carefully
corrected or modified to increase the quality of this manuscript.
assistant