Title: Association of insulin resistance indicators with hepatic steatosis and fibrosis in patients
with metabolic syndrome
Version: 0 Date: 05 Nov 2023
Reviewer's report:
The manuscript entitled as ‘Association of insulin resistance indicators with hepatic steatosis and
fibrosis in patients with metabolic syndrome’ by Kuo, et al. used the data of 876 participants with
MetS from the National Health and Nutrition Examination Survey 2017-2018, and investigate
the association of four insulin resistance (IR) indicators with hepatic steatosis and fibrosis, and
compare the diagnostic value of these indicators in identifying hepatic steatosis and fibrosis.
They showed that HOMA-IR, TyG-WHtR, and METS-IR is associated with the risk of hepatic
steatosis and fibrosis among the U.S. adult population with MetS. Additionally, TyG-WHtR is
a good predictive factor for hepatic steatosis and hepatic fibrosis. However, there are several
concerns for publication.
1. While HOMA-IR, TyG, TyG-WHtR, and METS-IR are each considered indicators of insulin
resistance, I am curious as to why only TyG did not emerge as a significant factor in predicting
hepatic fibrosis. It is important for the authors to provide an explanation for this finding.
2. The authors conducted a subgroup analysis by age and gender. However, it would be even
more intriguing to investigate whether there are variations in the relationship with insulin
resistance based on the extent of hepatic steatosis and fibrosis. Additional analysis is warranted.
3. The definitions of certain diseases and conditions, such as MetS, drinking status, hepatitis, and
CVD, lack clarity in the manuscript. It is necessary for the authors to provide clear definitions
for these terms within the scope of their study.
4. It would be of interest to have information on the diagnostic accuracy, Positive Predictive
Value (PPV), Negative Predictive Value (NPV), Sensitivity, and Specificity of each insulin
resistance indicator. We recommend that the results be included in the presentation.
5. While this study was conducted using data from the United States, a study utilizing Chinese
data would carry more significance if it were reported from China.
Title: Association of insulin resistance indicators with hepatic steatosis and fibrosis in patients
with metabolic syndrome
Version: 0 Date: 05 Nov 2023
Reviewer's report:
The manuscript entitled as ‘Association of insulin resistance indicators with hepatic steatosis and
fibrosis in patients with metabolic syndrome’ by Kuo, et al. used the data of 876 participants with
MetS from the National Health and Nutrition Examination Survey 2017-2018, and investigate
the association of four insulin resistance (IR) indicators with hepatic steatosis and fibrosis, and
compare the diagnostic value of these indicators in identifying hepatic steatosis and fibrosis.
They showed that HOMA-IR, TyG-WHtR, and METS-IR is associated with the risk of hepatic
steatosis and fibrosis among the U.S. adult population with MetS. Additionally, TyG-WHtR is
a good predictive factor for hepatic steatosis and hepatic fibrosis. However, there are several
concerns for publication.
1. While HOMA-IR, TyG, TyG-WHtR, and METS-IR are each considered indicators of insulin
resistance, I am curious as to why only TyG did not emerge as a significant factor in predicting
hepatic fibrosis. It is important for the authors to provide an explanation for this finding.
2. The authors conducted a subgroup analysis by age and gender. However, it would be even
more intriguing to investigate whether there are variations in the relationship with insulin
resistance based on the extent of hepatic steatosis and fibrosis. Additional analysis is warranted.
3. The definitions of certain diseases and conditions, such as MetS, drinking status, hepatitis, and
CVD, lack clarity in the manuscript. It is necessary for the authors to provide clear definitions
for these terms within the scope of their study.
4. It would be of interest to have information on the diagnostic accuracy, Positive Predictive
Value (PPV), Negative Predictive Value (NPV), Sensitivity, and Specificity of each insulin
resistance indicator. We recommend that the results be included in the presentation.
5. While this study was conducted using data from the United States, a study utilizing Chinese
data would carry more significance if it were reported from China.
Please review this paper.
user
Title: Association of insulin resistance indicators with hepatic steatosis and fibrosis in patients
with metabolic syndrome
Version: 0 Date: 05 Nov 2023
Reviewer's report:
The manuscript entitled as ‘Association of insulin resistance indicators with hepatic steatosis and
fibrosis in patients with metabolic syndrome’ by Kuo, et al. used the data of 876 participants with
MetS from the National Health and Nutrition Examination Survey 2017-2018, and investigate
the association of four insulin resistance (IR) indicators with hepatic steatosis and fibrosis, and
compare the diagnostic value of these indicators in identifying hepatic steatosis and fibrosis.
They showed that HOMA-IR, TyG-WHtR, and METS-IR is associated with the risk of hepatic
steatosis and fibrosis among the U.S. adult population with MetS. Additionally, TyG-WHtR is
a good predictive factor for hepatic steatosis and hepatic fibrosis. However, there are several
concerns for publication.
1. While HOMA-IR, TyG, TyG-WHtR, and METS-IR are each considered indicators of insulin
resistance, I am curious as to why only TyG did not emerge as a significant factor in predicting
hepatic fibrosis. It is important for the authors to provide an explanation for this finding.
2. The authors conducted a subgroup analysis by age and gender. However, it would be even
more intriguing to investigate whether there are variations in the relationship with insulin
resistance based on the extent of hepatic steatosis and fibrosis. Additional analysis is warranted.
3. The definitions of certain diseases and conditions, such as MetS, drinking status, hepatitis, and
CVD, lack clarity in the manuscript. It is necessary for the authors to provide clear definitions
for these terms within the scope of their study.
4. It would be of interest to have information on the diagnostic accuracy, Positive Predictive
Value (PPV), Negative Predictive Value (NPV), Sensitivity, and Specificity of each insulin
resistance indicator. We recommend that the results be included in the presentation.
5. While this study was conducted using data from the United States, a study utilizing Chinese
data would carry more significance if it were reported from China.
assistant