PONE-D-23-38330Clusters of longitudinal risk profile trajectories are associated with cardiometabolic diseases: results from the population-based KORA cohortPLOS ONE

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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

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: No

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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

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: General comments:

This is a very interesting manuscript dealing with a topic of importance in the field of cardiology.

Specific comments:

Methods, Study sample, last paragraph, Page 5: the authors should state the population that was accounted for the analysis e.g. participants with the 3 exams and endpoint at follow-up, and from there indicating the excluded participants.

Methods, association of trajectory clusters with cardiometabolic events, Page 8: the authors do not state the population on which they performed kaplan meïer methods which may be different than participants with 3 exams.

Methods, association of trajectory clusters with cardiometabolic events, Page 8: in a more general aspect definition of clusters of trajectory should be made clear for each analysis e.g. prevalent cardiometabolic events, Kaplan-Meïer analysis and incident cardiometabolic events. This is not clear in the methods.

Results, Study sample, Page 8: Authors may also give antihypertensive consumption in the analysed population during the exams, along with decreasing mean levels of blood pressure.

Results, Characterisation of longitunal trajectory clusters, Page 9: a better description of the clusters would be nice to have with a charaterisation of each (what is it exactly?) instead of only interpreting values comparatively. The high risk cluster seem to have a different behavior for DBP, BMI, HBA1c, Total and LDL cholesterol both in emn and women and this should be mentionned. Is it also possible to validate the cluster against established and published severity values of the different risk factors?

Results: I as not able to find results of the Kaplan Meïer except sensitivity analyses in appendix.

Reviewer #2: In this manuscript, the authors explored the effects of joint longitudinal trajectories of multiple risk factors in cardiometabolic events from the population-based cohort. The single time-point measure of metabolic parameters provides limit evidences in predicting cardiovascular events, while the assessment of cumulative effects of metabolic disorders are prominent in predicting the clinical outcomes. This manuscript is well written and the conclusion is convincing. While there are some concerns needed to be solved before the publication.

1. The “nine cardiometabolic risk factors” in abstract should be described.

2. The population were divided into three cluster according to Calinski-Harabasz criterion. Therefore, the clinical characteristics should be provided and compared among these clusters.

3. The data were analyzed in the sex-specific trajectory clusters, while the difference between the cardiometabolic events were solely attributed to sex hormones in the Discussion.

4. The discussion should be more precise.

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Reviewer #1: Yes: Michel Vaillant, PhD

Reviewer #2: No

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Clusters of longitudinal risk profile trajectories are associated with cardiometabolic diseases: results from the population-based KORA cohort

PONE-D-23-38330R1

Dear Dr. Rospleszcz,

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,

Peng Gao, Ph.D.

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

**********

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: No

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: All previous comments were addressed. The added precisions and supplementary materials are sufficient for the reader to fully understand and follow the work in the article. There is no further comment.

Reviewer #2: The maniscript is well-written and the results are further interpreted. The concerns have been clearly addressed and i am statisficed with this revised version.

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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: Yes: Michel Vaillant

Reviewer #2: No

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