Reviewer’s report
Title: 
Effect of body mass index (BMI) on phenotypic features of polycystic
ovary syndrome (PCOS) in Singapore women: A prospective cross-sectional
study
Version: 
1 
Date: 
22 Jan 2021
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses a
testable research question(s) (brief or other article types: is there a clear
objective)?
No - there are major issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor
to allow confidence in the results?
No - there are major issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work
technically sound? If not, can revisions be made to make the work technically
sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: 
Poor study, conflicting findings, nothing really new, not weel presented data.
REQUESTED REVISIONS: 
They should re-write the paper with a more clear objective, different distribution
of subjects evaluated and a rational behind the statistics applied.
ADDITIONAL REQUESTS/SUGGESTIONS: 
This paper addresses a matter of debate, the impact of BMI on PCOS phenotypic
characteristics. Nevertheless, it suffers from some issues, which make it
unsuitable for publication at the current form.
1. A linguistic revision is needed, given that misuse of English makes this
manuscript difficult to read. For example replace hirsuteness with hirsutism, the
universal term for excess body hair in PCOS.
2. Abstract: State the number of subjects studied, and their distribution to lean
and obese for both patients and controls. Additionally, state the number of
groups evaluated (4) instead of the three you describe.
3. Before analyzing the effect of weight on several parameters studied, you
should provide a table of comparison between PCOS and control women
classified as normal weight and overweight/obese, firstly because this
information is mandatory to the reader. Second, based on the differences found
you could comment on the characteristics potentially exacerbated by weight, by
comparing lean to obese PCOS and by comparing lean and obese controls, in an
attempt to identify inherent factors, if any, in PCOS pathophysiology despite
BMI.
4. You should provide a rational for the models you used and why these
comparisons uncover the effect of weight on PCOS features. Furthermore, these
methods although are statistically accepted, they confront against classical PCOS
approach, that lean and obese PCOS are two distinct metabolic/hormonal
subgroups.
5. The conclusions that high BMI is associated with increased FAI and
consequently increased hirsutism, are well expected and do not offer something
new in the literature. Probably, the opposite finding of nit causing oligomenorhea
and anovulation should be discussed, since this is usually the case in Caucasian
women with PCOS.
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Declaration of competing interests
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes