PONE-D-23-01333Association between low internal health locus of control, psychological distress and insulin resistance, a cross-sectional study

PLOS ONE

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Another additional comment to that of the reviewers is the need to specify in the title that it is an exproratory study, the following title is suggested: "Association between low internal health locus of control, psychological distress and insulin resistance. An exploratory study"

Reviewer 1

This cross-sectional study examines the relationship between insulin resistance, internal locus of control, and psychological stress in a random sample of individuals from southwestern Sweden. The method and results sections are adequately presented.

Every table should be self-explanatory. Tables 2 and 3 have imprecise titles (to the extent that the footnotes of the two tables indicate which is the outcome variable and which are the adjustment variables, which is unnecessary). A suggestion would be:  Table 2. Association of insulin resistance (HOMA-ir) with psychological distress (PD) and low internal locus of control (IHLC). Similarly, the description of the transformation of estimates to percentages is unnecessary because it has already been covered in the section on data analysis.

Even though the study is exploratory, it would be helpful to provide more evidence for the hypotheses about the physiological mechanisms behind the links found in the study.

Reviewer 2

The results presented are interesting, however, the authors report that only 5% of the population they studied met the criteria that decided to associate low internal health locus of control and phychological distress with insulin resistance (HOMA-ir).

Therefore, they decided to add other variables to the mathematical model that they proposed, such as physical activity in a stratified manner, which was not contemplated at the beginning.

The authors decided to add variable by variable to the mathematical model until it stopped giving statistically significant results, so they stopped focusing their article on the initial proposal, to assess the hypothesis that low internal health locus of control (IHLC) and psychological Distress (PD) are associated with insulin resistance.

I believe that the results must be ordered and focus on the initial proposal.

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Partly

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This cross-sectional study examines the relationship between insulin resistance, internal locus of control, and psychological stress in a random sample of individuals from southwestern Sweden. The method and results sections are adequately presented.

Every table should be self-explanatory. Tables 2 and 3 have imprecise titles (to the extent that the footnotes of the two tables indicate which is the outcome variable and which are the adjustment variables, which is unnecessary). Una sugerencia sería: Table 2. Association of insulin resistance (HOMA-ir) with psychological distress (PD) and low internal locus of control (IHLC). Similarly, the description of the transformation of estimates to percentages is unnecessary because it has already been covered in the section on data analysis.

Even though the study is exploratory, it would be helpful to provide more evidence for the hypotheses about the physiological mechanisms behind the links found in the study.

Reviewer #2: The results presented are interesting, however, the authors report that only 5% of the population they studied met the criteria that decided to associate low internal health locus of control and phychological distress with insulin resistance (HOMA-ir).

Therefore, they decided to add other variables to the mathematical model that they proposed, such as physical activity in a stratified manner, which was not contemplated at the beginning.

The authors decided to add variable by variable to the mathematical model until it stopped giving statistically significant results, so they stopped focusing their article on the initial proposal, to assess the hypothesis that low internal health locus of control (IHLC) and psychological Distress (PD) are associated with insulin resistance.

I believe that the results must be ordered and focus on the initial proposal.

**********

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Reviewer #1: No

Reviewer #2: No

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Association between low internal health locus of control, psychological distress and insulin resistance. An exploratory study.

PONE-D-23-01333R1

Dear Dr. Maria Eriksson

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.

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Kind regards,

Victor Manuel Mendoza-Nuñez, PhD

Academic Editor

PLOS ONE