Title: Impact of Steatotic Liver Disease Subtypes, Sarcopenia, and Fibrosis on All-cause and
Cause-specific Mortality: A 15.7-year Cohort Study
Version: 0 Date: 29 Dec 2024
Reviewer:  Valeria Fernandez
Reviewer's report:
This manuscript reviews all cause-mortality and cause-specific mortality across different SLD
categories (MASLD, MetALD, and other etiology SLD), as well as the previous definition
“MAFLD” and sarcopenia. I enjoyed reading your manuscript and believe your research
provides value to the field. I also consider your article within the journal’s scope. However, in
light of strengthening your manuscript, these are my comments and suggestions:
* I suggest a study flow chart to provide a visual overview about how many subjects were
identified, excluded, and included in the final analysis.
* I appreciate the recognition of using two non-invasive indices (and not biopsy or FibroScan)
as an important limitation when defining advanced liver fibrosis.
* I would suggest clarifying the term “unfavorable metabolic profiles”, how many of these
patients were also diabetic? Since diabetes is associated with  liver and non-liver related adverse
outcomes (including mortality), I would suggest including this diagnosis in table 1.
* What percentage of your study sample were using glucose-lowering or cardiovascular
medications?
* You mentioned that the Fatty Liver Index (FLI) was used to identify subjects with steatotic
liver disease. There is evidence that the Fatty Liver Index (FLI) indicates future development
of cardiovascular disease, which means that patients with higher FLI values could potentially
experience worse outcomes.
Title: Impact of Steatotic Liver Disease Subtypes, Sarcopenia, and Fibrosis on All-cause and
Cause-specific Mortality: A 15.7-year Cohort Study
Version: 0 Date: 29 Dec 2024
Reviewer:  Valeria Fernandez
Reviewer's report:
This manuscript reviews all cause-mortality and cause-specific mortality across different SLD
categories (MASLD, MetALD, and other etiology SLD), as well as the previous definition
“MAFLD” and sarcopenia. I enjoyed reading your manuscript and believe your research
provides value to the field. I also consider your article within the journal’s scope. However, in
light of strengthening your manuscript, these are my comments and suggestions:
* I suggest a study flow chart to provide a visual overview about how many subjects were
identified, excluded, and included in the final analysis.
* I appreciate the recognition of using two non-invasive indices (and not biopsy or FibroScan)
as an important limitation when defining advanced liver fibrosis.
* I would suggest clarifying the term “unfavorable metabolic profiles”, how many of these
patients were also diabetic? Since diabetes is associated with  liver and non-liver related adverse
outcomes (including mortality), I would suggest including this diagnosis in table 1.
* What percentage of your study sample were using glucose-lowering or cardiovascular
medications?
* You mentioned that the Fatty Liver Index (FLI) was used to identify subjects with steatotic
liver disease. There is evidence that the Fatty Liver Index (FLI) indicates future development
of cardiovascular disease, which means that patients with higher FLI values could potentially
experience worse outcomes.
Please review this paper.
user
Title: Impact of Steatotic Liver Disease Subtypes, Sarcopenia, and Fibrosis on All-cause and
Cause-specific Mortality: A 15.7-year Cohort Study
Version: 0 Date: 29 Dec 2024
Reviewer:  Valeria Fernandez
Reviewer's report:
This manuscript reviews all cause-mortality and cause-specific mortality across different SLD
categories (MASLD, MetALD, and other etiology SLD), as well as the previous definition
“MAFLD” and sarcopenia. I enjoyed reading your manuscript and believe your research
provides value to the field. I also consider your article within the journal’s scope. However, in
light of strengthening your manuscript, these are my comments and suggestions:
* I suggest a study flow chart to provide a visual overview about how many subjects were
identified, excluded, and included in the final analysis.
* I appreciate the recognition of using two non-invasive indices (and not biopsy or FibroScan)
as an important limitation when defining advanced liver fibrosis.
* I would suggest clarifying the term “unfavorable metabolic profiles”, how many of these
patients were also diabetic? Since diabetes is associated with  liver and non-liver related adverse
outcomes (including mortality), I would suggest including this diagnosis in table 1.
* What percentage of your study sample were using glucose-lowering or cardiovascular
medications?
* You mentioned that the Fatty Liver Index (FLI) was used to identify subjects with steatotic
liver disease. There is evidence that the Fatty Liver Index (FLI) indicates future development
of cardiovascular disease, which means that patients with higher FLI values could potentially
experience worse outcomes.
assistant