Title: Sex difference in the associations among risk factors with gastroesophageal reflux disease
in a large Taiwanese population study
Version: 1 Date: 20 Feb 2024
Reviewer's report:
1. Please add China behind Taiwan.
2. Introduction. The authors described that “Gastroesophageal reflux disease (GERD) is a
common global health issue, with a prevalence of approximately 10% to 20% in Western
countries and less than 5% in Asia”. In general, the reported prevalence of GERD in Asia
is lower that of western countries, but not all are below 5% (i.e. a meta-analysis showed the
rate being 12.5% in China [doi: 10.3877/cma.j.issn.1674-6899.2015.01.011]), please make a
comprehensive search and provide the accurate rates range.
3. Introduction.  The authors described that “Symptoms of GERD such as heartburn,
regurgitation, belching, fullness sensation affect females more than males, while pathologic
changes are more common in males than in females”. The citation is missing, please also
described the accurate data.
4. Introduction. The authors should shorten or delete the second paragraph since it is unrelated
to GERD.
5. Introduction. The third paragraph. The authors described that “Nevertheless, few studies
have investigated sex differences in the risk factors associated with GERD”. Please provide
the detailed results and limitation of these studies to validate your further study on the same
direction.
6.Materials and methods. Please describe the method for the choose of study population for the
Taiwan Biobank and your GERD study. In which time period and how many cases are included
in the Taiwan Biobank? How do you choose participants from the Taiwan Biobank for the GERD
study? Please also provide your detailed GERD questionnaire and make a clear definition of
questionnaire-based GERD.
7. Statistical analysis. Why symptoms are not be compared and included for multivariable
analysis?
8. Discussion. The first paragraph. The authors described that “Furthermore, there were sex
differences in the risk factors associated with GERD, and older age, DM, smoking history, and
low HDL-C were more closely related to GERD in the females than in the males”. It is a little
bit different from Table 5, please modify your description accordingly.
9. Discussion. The second paragraph. The authors described that “Therefore, as women tend to
live longer than men, this may explain the higher prevalence of GERD”. According to Table
3, there is no significant difference for age between male and female, the description needs to
be modified.
10. Discussion. The interpretation for the relation of older age, DM, smoking, and low HDL-
C level with GERD is farfetched. Please describe more carefully and, if possible, provide some
actual analysis.
Title: Sex difference in the associations among risk factors with gastroesophageal reflux disease
in a large Taiwanese population study
Version: 1 Date: 20 Feb 2024
Reviewer's report:
1. Please add China behind Taiwan.
2. Introduction. The authors described that “Gastroesophageal reflux disease (GERD) is a
common global health issue, with a prevalence of approximately 10% to 20% in Western
countries and less than 5% in Asia”. In general, the reported prevalence of GERD in Asia
is lower that of western countries, but not all are below 5% (i.e. a meta-analysis showed the
rate being 12.5% in China [doi: 10.3877/cma.j.issn.1674-6899.2015.01.011]), please make a
comprehensive search and provide the accurate rates range.
3. Introduction.  The authors described that “Symptoms of GERD such as heartburn,
regurgitation, belching, fullness sensation affect females more than males, while pathologic
changes are more common in males than in females”. The citation is missing, please also
described the accurate data.
4. Introduction. The authors should shorten or delete the second paragraph since it is unrelated
to GERD.
5. Introduction. The third paragraph. The authors described that “Nevertheless, few studies
have investigated sex differences in the risk factors associated with GERD”. Please provide
the detailed results and limitation of these studies to validate your further study on the same
direction.
6.Materials and methods. Please describe the method for the choose of study population for the
Taiwan Biobank and your GERD study. In which time period and how many cases are included
in the Taiwan Biobank? How do you choose participants from the Taiwan Biobank for the GERD
study? Please also provide your detailed GERD questionnaire and make a clear definition of
questionnaire-based GERD.
7. Statistical analysis. Why symptoms are not be compared and included for multivariable
analysis?
8. Discussion. The first paragraph. The authors described that “Furthermore, there were sex
differences in the risk factors associated with GERD, and older age, DM, smoking history, and
low HDL-C were more closely related to GERD in the females than in the males”. It is a little
bit different from Table 5, please modify your description accordingly.
9. Discussion. The second paragraph. The authors described that “Therefore, as women tend to
live longer than men, this may explain the higher prevalence of GERD”. According to Table
3, there is no significant difference for age between male and female, the description needs to
be modified.
10. Discussion. The interpretation for the relation of older age, DM, smoking, and low HDL-
C level with GERD is farfetched. Please describe more carefully and, if possible, provide some
actual analysis.
Please review this paper.
user
Title: Sex difference in the associations among risk factors with gastroesophageal reflux disease
in a large Taiwanese population study
Version: 1 Date: 20 Feb 2024
Reviewer's report:
1. Please add China behind Taiwan.
2. Introduction. The authors described that “Gastroesophageal reflux disease (GERD) is a
common global health issue, with a prevalence of approximately 10% to 20% in Western
countries and less than 5% in Asia”. In general, the reported prevalence of GERD in Asia
is lower that of western countries, but not all are below 5% (i.e. a meta-analysis showed the
rate being 12.5% in China [doi: 10.3877/cma.j.issn.1674-6899.2015.01.011]), please make a
comprehensive search and provide the accurate rates range.
3. Introduction.  The authors described that “Symptoms of GERD such as heartburn,
regurgitation, belching, fullness sensation affect females more than males, while pathologic
changes are more common in males than in females”. The citation is missing, please also
described the accurate data.
4. Introduction. The authors should shorten or delete the second paragraph since it is unrelated
to GERD.
5. Introduction. The third paragraph. The authors described that “Nevertheless, few studies
have investigated sex differences in the risk factors associated with GERD”. Please provide
the detailed results and limitation of these studies to validate your further study on the same
direction.
6.Materials and methods. Please describe the method for the choose of study population for the
Taiwan Biobank and your GERD study. In which time period and how many cases are included
in the Taiwan Biobank? How do you choose participants from the Taiwan Biobank for the GERD
study? Please also provide your detailed GERD questionnaire and make a clear definition of
questionnaire-based GERD.
7. Statistical analysis. Why symptoms are not be compared and included for multivariable
analysis?
8. Discussion. The first paragraph. The authors described that “Furthermore, there were sex
differences in the risk factors associated with GERD, and older age, DM, smoking history, and
low HDL-C were more closely related to GERD in the females than in the males”. It is a little
bit different from Table 5, please modify your description accordingly.
9. Discussion. The second paragraph. The authors described that “Therefore, as women tend to
live longer than men, this may explain the higher prevalence of GERD”. According to Table
3, there is no significant difference for age between male and female, the description needs to
be modified.
10. Discussion. The interpretation for the relation of older age, DM, smoking, and low HDL-
C level with GERD is farfetched. Please describe more carefully and, if possible, provide some
actual analysis.
assistant