Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 0 Date: 07 Dec 2024
Reviewer's report:
Thank you for submitting your manuscript titled "Metabolic Outcomes in Non-Alcoholic and
Alcoholic Steatotic Liver Disease among Korean and American Adults" for consideration. After
a thorough review, I have several comments and suggestions that could help improve the quality
and impact of your work.
Title and Abstract:
1. The title is clear and concise, effectively summarizing the focus of the study.
2. The abstract provides a good overview of the study, but it could benefit from a more detailed
description of the methods used.
Introduction:
1. The background section effectively sets the stage for the study, but it could be strengthened
by providing more specific details on the prevalence of steatotic liver disease (SLD) in the study
populations.
Methods:
1.The study population and data sources are well-described. However, it would be beneficial to
have a more detailed explanation of the preprocessing steps taken to merge and clean the data.
2.The use of logistic regression to assess the prevalence of chronic diseases is appropriate, but
the authors should ensure that the models are not overfitted by including too many covariates
relative to the number of events. A rule of thumb is to have at least 10 events per covariate.
3.The authors should also report goodness-of-fit measures for the logistic regression models,
such as the Hosmer-Lemeshow test, to assess the calibration of the models.
4.The use of Cox regression for longitudinal data is appropriate, but the proportional hazards
assumption should be formally tested and reported. Violations of this assumption could lead to
biased estimates of the hazard ratios.
5.While the authors have adjusted for potential confounders, it is unclear how these variables
were selected. The authors should provide a rationale for the inclusion of each covariate and
consider using a more systematic approach, such as directed acyclic graphs (DAGs), to identify
and adjust for confounding.
Results:
1.The results are presented clearly.
Discussion:
1. The discussion of the potential mechanisms underlying the observed associations is lacking.
It would be beneficial to have a more detailed discussion of these mechanisms, particularly in
the context of MetALD.
2. The implications of the findings for clinical practice are not fully explored. It would be helpful
to have a more detailed discussion of how these findings might influence clinical decision-
making.
Conclusion:
1.The conclusion effectively summarizes the key findings of the study. However, it could be
strengthened by a more detailed discussion of the implications of these findings for future
research and clinical practice.
Other Comments:
I recommend that you enhance the introduction and discussion sections by referencing the
following key publication: PMID: 34234521.
Overall, the study addresses an important topic and provides valuable insights into the
relationship between SLD and chronic metabolic diseases.
Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 0 Date: 07 Dec 2024
Reviewer's report:
Thank you for submitting your manuscript titled "Metabolic Outcomes in Non-Alcoholic and
Alcoholic Steatotic Liver Disease among Korean and American Adults" for consideration. After
a thorough review, I have several comments and suggestions that could help improve the quality
and impact of your work.
Title and Abstract:
1. The title is clear and concise, effectively summarizing the focus of the study.
2. The abstract provides a good overview of the study, but it could benefit from a more detailed
description of the methods used.
Introduction:
1. The background section effectively sets the stage for the study, but it could be strengthened
by providing more specific details on the prevalence of steatotic liver disease (SLD) in the study
populations.
Methods:
1.The study population and data sources are well-described. However, it would be beneficial to
have a more detailed explanation of the preprocessing steps taken to merge and clean the data.
2.The use of logistic regression to assess the prevalence of chronic diseases is appropriate, but
the authors should ensure that the models are not overfitted by including too many covariates
relative to the number of events. A rule of thumb is to have at least 10 events per covariate.
3.The authors should also report goodness-of-fit measures for the logistic regression models,
such as the Hosmer-Lemeshow test, to assess the calibration of the models.
4.The use of Cox regression for longitudinal data is appropriate, but the proportional hazards
assumption should be formally tested and reported. Violations of this assumption could lead to
biased estimates of the hazard ratios.
5.While the authors have adjusted for potential confounders, it is unclear how these variables
were selected. The authors should provide a rationale for the inclusion of each covariate and
consider using a more systematic approach, such as directed acyclic graphs (DAGs), to identify
and adjust for confounding.
Results:
1.The results are presented clearly.
Discussion:
1. The discussion of the potential mechanisms underlying the observed associations is lacking.
It would be beneficial to have a more detailed discussion of these mechanisms, particularly in
the context of MetALD.
2. The implications of the findings for clinical practice are not fully explored. It would be helpful
to have a more detailed discussion of how these findings might influence clinical decision-
making.
Conclusion:
1.The conclusion effectively summarizes the key findings of the study. However, it could be
strengthened by a more detailed discussion of the implications of these findings for future
research and clinical practice.
Other Comments:
I recommend that you enhance the introduction and discussion sections by referencing the
following key publication: PMID: 34234521.
Overall, the study addresses an important topic and provides valuable insights into the
relationship between SLD and chronic metabolic diseases.
Please review this paper.
user
Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 0 Date: 07 Dec 2024
Reviewer's report:
Thank you for submitting your manuscript titled "Metabolic Outcomes in Non-Alcoholic and
Alcoholic Steatotic Liver Disease among Korean and American Adults" for consideration. After
a thorough review, I have several comments and suggestions that could help improve the quality
and impact of your work.
Title and Abstract:
1. The title is clear and concise, effectively summarizing the focus of the study.
2. The abstract provides a good overview of the study, but it could benefit from a more detailed
description of the methods used.
Introduction:
1. The background section effectively sets the stage for the study, but it could be strengthened
by providing more specific details on the prevalence of steatotic liver disease (SLD) in the study
populations.
Methods:
1.The study population and data sources are well-described. However, it would be beneficial to
have a more detailed explanation of the preprocessing steps taken to merge and clean the data.
2.The use of logistic regression to assess the prevalence of chronic diseases is appropriate, but
the authors should ensure that the models are not overfitted by including too many covariates
relative to the number of events. A rule of thumb is to have at least 10 events per covariate.
3.The authors should also report goodness-of-fit measures for the logistic regression models,
such as the Hosmer-Lemeshow test, to assess the calibration of the models.
4.The use of Cox regression for longitudinal data is appropriate, but the proportional hazards
assumption should be formally tested and reported. Violations of this assumption could lead to
biased estimates of the hazard ratios.
5.While the authors have adjusted for potential confounders, it is unclear how these variables
were selected. The authors should provide a rationale for the inclusion of each covariate and
consider using a more systematic approach, such as directed acyclic graphs (DAGs), to identify
and adjust for confounding.
Results:
1.The results are presented clearly.
Discussion:
1. The discussion of the potential mechanisms underlying the observed associations is lacking.
It would be beneficial to have a more detailed discussion of these mechanisms, particularly in
the context of MetALD.
2. The implications of the findings for clinical practice are not fully explored. It would be helpful
to have a more detailed discussion of how these findings might influence clinical decision-
making.
Conclusion:
1.The conclusion effectively summarizes the key findings of the study. However, it could be
strengthened by a more detailed discussion of the implications of these findings for future
research and clinical practice.
Other Comments:
I recommend that you enhance the introduction and discussion sections by referencing the
following key publication: PMID: 34234521.
Overall, the study addresses an important topic and provides valuable insights into the
relationship between SLD and chronic metabolic diseases.
assistant