Review for 10.1186/s12876-024-03164-4 (2024)

Title: Non-Alcoholic Fatty Liver Disease in Tanzania: Prevalence, Determinants, and
Diagnostic Performance of Triglycerides-Glucose Index and Triglycerides-Glucose Index –
Body Mass Index Compared to the Hepatic Ultrasound in Overweight and Obese Individuals
Version: 0 Date: 05 Jan 2024
Reviewer's report:
Overall comment
This is exciting research whose findings may impact care in poor resource settings. However,
the authors have to make several changes before it can be published.
1. Title
The authors need to revise this title. They are investigating the prevalence and determinants of
NAFLD and its correlation with the TyG index in overweight and obese individuals, but there
is an assessment of the diagnostic performance of the TyG index vs abdominal ultrasound in the
diagnosis of NAFLD with the ROC analysis. This is not reflected in the title. Correlation assesses
the linear relationship between two variables rather than the performance of diagnostic tests.
Abstract
Background
A. The purpose of the study was to determine the extent ………………..What is the meaning
of extent?. The objective should be in tandem with the title of the study.
B. Why is the TyG body mass index smuggled into the abstract when it is not mentioned in
the title?
Methods
The authors should briefly explain how the data was analyzed and interpreted.
Results
The objective was to determine the prevalence of NAFLD in overweight and obese people.
The authors should restrict their results to overweight and obesity classes. Why are they also
including hypertriglyceridemia and diabetes? The prevalence should be written alongside the
actual figures, e.g. 50% %( 48/96)
Key words
Authors should write singular words, not phrases, e.g., fatty, liver ,disease, not non-alcoholic
fatty liver disease.
Background
A. Several sentences are not referenced 75,86,88,95
B.Sentence 76 is not clear; it is difficult to follow where it is coming from.
C.The objective should be rewritten to correctly tell what the study was about. It should mirror
the title of the manuscript. Relatedly, what is meant by the scope of NAFLD? The second part of
the objective doesn’t speak to what was done to compare abd U/S and TyG index in diagnosing
NAFLD.
Sample size determination
The authors should describe fully how the calculated sample was adjusted to 181 participants
and why.
Data Collection
A. Add references to sentences 121–124.
B. What does an in-depth physical examination mean? The authors should avoid subjective
writing.
C. The authors should describe fully how measurements were done. What instruments were
used?
D. Add reference to sentence 130
Statistical Analysis
The authors should ensure that the ROC analysis is supported by the title of the study, as already
alluded to.
Results
1. Characteristics of the study participants
A. The authors should provide confidence intervals for the data in line 165.
B. In line 166, provide the actual figures of females and males affected by NAFLD.
C. Provide actual figures and percentages for all the variables reported.
D. There was a slight trend of higher rate of NAFLD……………What does this statement mean?
Was your p-value of 0.06 significant?
2. Prevalence of NAFLD in different groups
A. Compared to the general public... Was the study also conducted among the general public?
B. The groups in which you wanted to assess NAFLD were clear from the outset. Why do you
introduce other groups? Is there any justification for this?
C. Why are the authors starting with two faces of prevalence?
The authors are advised to rewrite this section to resonate with the study objectives.
3. Steatosis stages
Was this part of the objective of this study? If not, this can be left out.
4. Predictors of NAFLD
For consistency’s sake, authors should stick to determinants rather than predictors.
Tables
The authors should maintain a similar number of decimal places and integers in all columns
and rows.
Discussion
A. The authors should state their key findings in the first paragraph of the discussion.
B.The second paragraph should contain a discussion of their results and how these relate to
findings from similar studies.
C.The following paragraphs should discuss the clinical applicability of the findings, limitation
and strengths of the study etc.