A multidimensional functional fitness score has a stronger association with type 2 diabetes than obesity parameters in cross sectional data

Pramod Patil; Poortata Lalwani; Harshada Vidwans; Shubhankar Kulkarni; Deepika Bais; Manawa Diwekar-Joshi; Mayur Rasal; Nikhila Bhasme; Mrinmayee Naik; Shweta Batwal; Milind Watve

doi:10.1371/journal.pone.0245093

Peer Review History

Original SubmissionJuly 30, 2020
27 Oct 2020 Decision Letter - Antonio Palazón-Bru, Editor PONE-D-20-22351 A multidimensional functional fitness score has a stronger association with type 2 diabetes than obesity parameters in cross sectional data PLOS ONE Dear Dr. Watve, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Dec 11 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Thank you for including your ethics statement: 'The study proposal was reviewed by the Institutional Ethics Committee, In-house Research, of the Deenanath Mangeshkar Hospital and Research Centre on 27th Aug 2018. Owing to the retrospective nature, the requirement for informed consent was waived by the committee and the data were anonymized before availing for analysis which was done between October to December 2018.' a. Please amend your current ethics statement to confirm that your named institutional review board or ethics committee specifically approved this study. b. Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”).For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research' 3. Thank you for stating the following in the Acknowledgments Section of your manuscript: "We thank the management of Deenanath Man geshkar Hospital and Research Center that supports the BILD clinic, Mr. Deepak Desai and Mrs. Sarita Desai for financing the study..." We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: "The authors received no specific funding for this work." Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. 5. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 6. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Abstract - No comments Introduction - The first sentence is unclear. What is the main point? - The argument is not clearly set up. It seems that the authors argue in the first paragraph that a causal relationship between obesity and T2DM does not exist. The shift in the second paragraph to measuring fitness is abrupt. - The authors contend that anthropometric measures of obesity are not as relevant as fitness, but no papers discussing how obesity relates to anthropometric measures are discussed in the introduction. It would be helpful for the authors to cite the research measuring anthropometrics in adults with obesity to explain why they feel that fitness is a more relevant measure (see below). o The association of waist circumference with walking difficulty among adults with or at risk of knee osteoarthritis: the Osteoarthritis Initiative SV Gill et al., Osteoarthritis and cartilage 25 (1), 60-66 - Overall, the introduction needs to be reworked to clearly state what the argument is. Method - What do the authors mean by abdominal plasticity? - Although the authors state what areas of fitness the HRPF measures, they do not provide any details about what the 15 tasks actually are. - Results - No comments Discussion - A significant limitation of this study is that there is no measure of percent body fat. WHR provides a rough estimate of the distribution of body fat, but a formal measure of body fat, skeletal muscle mass, etc. would provide a clearer picture about why the authors argue the limited role of anthropometric measures in understanding limitations related to obesity. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0245093.r001
Revision 1
28 Nov 2020 Author Response Dear Editor, Thanks for giving us the opportunity to revise. Please find below our specific responses (in blue) to individual issues. 2. Thank you for including your ethics statement: 'The study proposal was reviewed by the Institutional Ethics Committee, In-house Research, of the Deenanath Mangeshkar Hospital and Research Centre on 27th Aug 2018. Owing to the retrospective nature, the requirement for informed consent was waived by the committee and the data were anonymized before availing for analysis which was done between October to December 2018.' a. Please amend your current ethics statement to confirm that your named institutional review board or ethics committee specifically approved this study. b. Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”).For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research' The ethics statement is modified accordingly and corresponding change in the form made. 3. Thank you for stating the following in the Acknowledgments Section of your manuscript: "We thank the management of Deenanath Man geshkar Hospital and Research Center that supports the BILD clinic, Mr. Deepak Desai and Mrs. Sarita Desai for financing the study..." We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: "The authors received no specific funding for this work." Please include your amended statements within your cover letter; we will change the online submission form on your behalf. The funding mentioned earlier was not for this study, but for raising the clinic infrastructure. That mention in the acknowledgement is removed now. So the funding statement remains unchanged. 4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. Data availability statement remains unchanged and will make the repository address available on acceptance. 5. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. Rechecked and found appropriate. 6. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Abstract - No comments Introduction - The first sentence is unclear. What is the main point? - The argument is not clearly set up. It seems that the authors argue in the first paragraph that a causal relationship between obesity and T2DM does not exist. The shift in the second paragraph to measuring fitness is abrupt. The opening paragraph is reorganized in the revised MS for greater clarity. - The authors contend that anthropometric measures of obesity are not as relevant as fitness, but no papers discussing how obesity relates to anthropometric measures are discussed in the introduction. It would be helpful for the authors to cite the research measuring anthropometrics in adults with obesity to explain why they feel that fitness is a more relevant measure (see below). We have added a new paragraph in the introduction section with references to discuss the association and possible causation links between fat distribution, anthropometry and metabolic effects. o The association of waist circumference with walking difficulty among adults with or at risk of knee osteoarthritis: the Osteoarthritis Initiative SV Gill et al., Osteoarthritis and cartilage 25 (1), 60-66 Thanks for bringing this paper to our notice. Citing a few other papers along with this we have added a para in the discussion section that discusses the association between anthropometric parameters and functional fitness. - Overall, the introduction needs to be reworked to clearly state what the argument is. We hope in the revised and rewritten form the introduction has enhanced clarity and makes the purpose of the study clear. Method - What do the authors mean by abdominal plasticity? - Although the authors state what areas of fitness the HRPF measures, they do not provide any details about what the 15 tasks actually are. All details of the 15 tasks including abdominal plasticity are described in details in the supplementary information, which is cited in the main text in the methods section. The reviewer may have missed it. - Results - No comments Discussion - A significant limitation of this study is that there is no measure of percent body fat. WHR provides a rough estimate of the distribution of body fat, but a formal measure of body fat, skeletal muscle mass, etc. would provide a clearer picture about why the authors argue the limited role of anthropometric measures in understanding limitations related to obesity. In the paper describing the retrospective part of the study, data on body composition was not available. This can be included in a prospective study. Nevertheless we have added in the revised paper along with selected references a brief discussion on whether body fat is a better predictor of insulin resistance or T2DM. Attachments Attachment Submitted filename: response to reviewers.docx https://doi.org/10.1371/journal.pone.0245093.r002
22 Dec 2020 Decision Letter - Antonio Palazón-Bru, Editor A multidimensional functional fitness score has a stronger association with type 2 diabetes than obesity parameters in cross sectional data PONE-D-20-22351R1 Dear Dr. Watve, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Antonio Palazón-Bru, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors have satisfactorily responded to the reviewers' comments. I think that the manuscript is ready to be accepted. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No https://doi.org/10.1371/journal.pone.0245093.r003
Formally Accepted
25 Jan 2021 Acceptance Letter - Antonio Palazón-Bru, Editor PONE-D-20-22351R1 A multidimensional functional fitness score has a stronger association with type 2 diabetes than obesity parameters in cross sectional data Dear Dr. Watve: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Antonio Palazón-Bru Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0245093.r004

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