PONE-D-22-07130Dynamic physical examination indicators of cardiovascular health: A single-center study in Shanghai, ChinaPLOS ONE

Dear Dr. Yu,

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PLOS ONE

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Reviewers' comments:

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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: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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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

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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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: The authors of the present manuscript highlight the importance of the full utilization of physical examination databases in China. They performed a prospective study including 14,044 participants and a three-year follow-up. Overall, this manuscript is well prepared and organized. My major concerns are as listed as below:

1. The definition of healthy people is unclear. People with routine physical examinations are not qualified enough to be healthy. Accordingly, for the inclusion criterion, the authors should clearly mention that all the participants are initially without systemic diseases, especially are free of cardiovascular disease (CVD). If they didn’t strictly follow this criterion, they better reanalyze data (excluding individuals with diseases) or use a more accurate word to describe participants instead of “healthy individuals”.

2. They didn’t mention whether these participants developed new-onset CVD or with CVD-targeted medication treatments during the three-year period, which has a strong effect on these indicators they collected. Ignoring these factors may result in incorrect conclusions. If all the participants were finally free of CVD, in the exclusion criterion section, they should mention people developing CVD are excluded; Otherwise, they better analyze the percentage of people developing CVD and with CVD-targeted medication treatments. If these data are unavailable to the authors, they better explain them in the discussion part.

3. The age-based analysis of blood pressure and lipids levels are kinds of inconsistent with the major publications, and the references the authors referred to for this part are not convinced enough. The authors better do a deeper discussion about the potential factors or increase the inclusion criterion to get a more accurate conclusion.

Reviewer #2: 1. Incremental findings: Previous studies have reported that increasing SBP, DBP, BMI, and TG, LDL-C, and Glu levels and decreasing HDL-C levels increases the risk of CVDs. Combined with the results of this study, the SBP, DBP, BMI, and TG, LDL-C, and Glu levels of men were higher than those of women for each year, while their HDL-C levels were lower than those of women. Therefore, these findings will provide explicit evidence for early identification and timely intervention in high-risk male populations based on the changing trend of the indicators mentioned above.

2. Dietary habits, exercise habits, and sleep characteristics were not enrolled.

3. I suggest do analysis between male and female group.

4. There is Meta-analyzed publish related to this paper, suggest add to discussion.

5. The manuscript, particularly the results, need to be better organized to improve the readability.

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Attachments

Attachment

Submitted filename: plos-Wenya Yu.docx

Dynamic physical examination indicators of cardiovascular health: A single-center study in Shanghai, China

PONE-D-22-07130R1

Dear Dr. Yu,

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.

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Kind regards,

Yajing Wang

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

Reviewer #2: All comments have been addressed

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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

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: 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

Reviewer #2: Yes

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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

Reviewer #2: 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 manuscript looks fine now, just with one minor error:

In Page 4; lines 74-76,

“Healthy individuals in this study refers to the participants that initially has no systemic diseases, and were particularly free of CVDs.” is supposed to be “Healthy individuals in this study refers to the participants that initially have no systemic diseases, and were particularly free of CVDs.”

Reviewer #2: Incremental findings: Previous studies have reported that increasing SBP, DBP, BMI, and TG, LDL-C, and Glu levels and decreasing HDL-C levels increases the risk of CVDs. Combined with the results of this study, the SBP, DBP, BMI, and TG, LDL-C, and Glu levels of men were higher than those of women for each year, while their HDL-C levels were lower than those of women. Therefore, these findings will provide explicit evidence for early identification and timely intervention in high-risk male populations based on the changing trend of the indicators mentioned above. The manuscript readability was improved.

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Reviewer #1: Yes: Fujie Zhao

Reviewer #2: No

Attachments

Attachment

Submitted filename: plos-Wenya Yu.docx