Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 14 Feb 2025
Reviewer's report:
This manuscript examines the association between hs-CRP and other systemic inflammatory
markers and evaluates the diagnostic performance of hs-CRP in predicting MASLD severity.
The topic holds clinical significance; however, the study lacks sufficient evidence, and the
manuscript structure requires improvement.
1. A substantial amount of essential information is presented in the supplemental materials,
making the main manuscript unclear. Key details such as subgroup definitions and statistical
methods are completely missing from the Methods section. Even if constrained by word limits,
the main manuscript must contain essential methodological details. The authors should consider
condensing other sections to ensure critical information is included within the main text.
2. Lack of background on systemic inflammatory markers: The Introduction does not provide
sufficient context on MHR, NHR, NLR, PLR, and LMR, as well as liver injury indicators.
The authors should explain their physiological roles, relevance to MASLD, and expected
relationships with disease severity.
3. Figure 1 – The figure lacks a clear definition of "overlap"—does it represent the proportion
of participants with elevated biomarkers? If so, what threshold was used? Additionally, are the
elevations statistically significant? These clarifications are necessary for accurate interpretation.
4. Figure 2 – It is unclear which group is represented here, and the total number sums to 401,
which does not align with the stated cohort. The authors should clarify how participants were
selected for this analysis.
5. Figure 3 – Figure 3 is referenced in Section 3.3 (Correlation Analysis), but it does not contain
correlation-related information. It is also cited in Section 3.4 (Validation Analysis), but its
relevance is unclear. The authors should double-check the figure contents and ensure proper
referencing.
6. Table 3 presents correlation analyses with significant p-values, but the correlation
coefficients for independent variables are low, indicating weak associations. The authors should
acknowledge this limitation and discuss its implications for clinical relevance.
Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 14 Feb 2025
Reviewer's report:
This manuscript examines the association between hs-CRP and other systemic inflammatory
markers and evaluates the diagnostic performance of hs-CRP in predicting MASLD severity.
The topic holds clinical significance; however, the study lacks sufficient evidence, and the
manuscript structure requires improvement.
1. A substantial amount of essential information is presented in the supplemental materials,
making the main manuscript unclear. Key details such as subgroup definitions and statistical
methods are completely missing from the Methods section. Even if constrained by word limits,
the main manuscript must contain essential methodological details. The authors should consider
condensing other sections to ensure critical information is included within the main text.
2. Lack of background on systemic inflammatory markers: The Introduction does not provide
sufficient context on MHR, NHR, NLR, PLR, and LMR, as well as liver injury indicators.
The authors should explain their physiological roles, relevance to MASLD, and expected
relationships with disease severity.
3. Figure 1 – The figure lacks a clear definition of "overlap"—does it represent the proportion
of participants with elevated biomarkers? If so, what threshold was used? Additionally, are the
elevations statistically significant? These clarifications are necessary for accurate interpretation.
4. Figure 2 – It is unclear which group is represented here, and the total number sums to 401,
which does not align with the stated cohort. The authors should clarify how participants were
selected for this analysis.
5. Figure 3 – Figure 3 is referenced in Section 3.3 (Correlation Analysis), but it does not contain
correlation-related information. It is also cited in Section 3.4 (Validation Analysis), but its
relevance is unclear. The authors should double-check the figure contents and ensure proper
referencing.
6. Table 3 presents correlation analyses with significant p-values, but the correlation
coefficients for independent variables are low, indicating weak associations. The authors should
acknowledge this limitation and discuss its implications for clinical relevance.
Please review this paper.
user
Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 14 Feb 2025
Reviewer's report:
This manuscript examines the association between hs-CRP and other systemic inflammatory
markers and evaluates the diagnostic performance of hs-CRP in predicting MASLD severity.
The topic holds clinical significance; however, the study lacks sufficient evidence, and the
manuscript structure requires improvement.
1. A substantial amount of essential information is presented in the supplemental materials,
making the main manuscript unclear. Key details such as subgroup definitions and statistical
methods are completely missing from the Methods section. Even if constrained by word limits,
the main manuscript must contain essential methodological details. The authors should consider
condensing other sections to ensure critical information is included within the main text.
2. Lack of background on systemic inflammatory markers: The Introduction does not provide
sufficient context on MHR, NHR, NLR, PLR, and LMR, as well as liver injury indicators.
The authors should explain their physiological roles, relevance to MASLD, and expected
relationships with disease severity.
3. Figure 1 – The figure lacks a clear definition of "overlap"—does it represent the proportion
of participants with elevated biomarkers? If so, what threshold was used? Additionally, are the
elevations statistically significant? These clarifications are necessary for accurate interpretation.
4. Figure 2 – It is unclear which group is represented here, and the total number sums to 401,
which does not align with the stated cohort. The authors should clarify how participants were
selected for this analysis.
5. Figure 3 – Figure 3 is referenced in Section 3.3 (Correlation Analysis), but it does not contain
correlation-related information. It is also cited in Section 3.4 (Validation Analysis), but its
relevance is unclear. The authors should double-check the figure contents and ensure proper
referencing.
6. Table 3 presents correlation analyses with significant p-values, but the correlation
coefficients for independent variables are low, indicating weak associations. The authors should
acknowledge this limitation and discuss its implications for clinical relevance.
assistant