PONE-D-23-34240Nonlinear dose-response association of moderate-to-vigorous physical activity with hyperuricemia in US adults: NHANES 2007-2018PLOS ONE

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PLOS 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: No

Reviewer #2: Yes

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

Reviewer #1: No

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?

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: No

Reviewer #2: No

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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: Zeng et al. aimed to explore the dose-response association of physical activity levels with hyperuricemia (HUA) by utilizing the National Health and Nutrition Examination Survey (NHANES, 2007–2018) data. They found that the low moderate-to-vigorous physical activity (MVPA) was associated with a higher odds ratio of HUA. Although the results seemed to be interesting, the reviewer has several concerns to be addressed.

1. Although hypertension was listed in the baseline characteristics, the authors did not adjust it. Aside from hypertension, many other comorbidities like diabetes, chronic kidney disease, heart failure, etc., are known to be highly correlated with HUA. These important covariates are not adjusted in the study.

2. To better delineate the relationship between MVPA and HUA, a time-to-event analysis is recommended.

3. Relevant biochemical data like fasting blood glucose, lipid profiles, glomerular filtration rate, etc., should be also included in the statistical models.

Reviewer #2: The results of this manuscript indicate that this study based on a nationally representative population of American adults found that compared with the moderate-to-vigorous physical activity (MVPA) level, the low MVPA level was associated with the higher risk of hyperuricemia (HUA). There was a-U-shaped dose-response relationship between MVPA level and HUA. The manuscript is interesting and sample size is sound. However, there are several concerns in it.

Major comments:

1) Page 9, lines 156-158: How did authors deal with sports time activity?

2) Page 9, lines 167-169: It might be a good idea to divide into 5 groups rather than 3 groups. Because the division of 5 groups may be a good shape when authors want to express a U-shaped relationship.

3) Page 17, Table 2: In model 3, there was not a significant positive association of HUA for participants in the high PA group: ≥3000 MET-min/wk compared to moderate group. Can authors say this is a U-shaped relationship among 3 groups?

4) Totally, some sentences are redundant. For examples; page 20, line 360-361: “To our knowledge, this was the first time” and page 21, line 382: “To the best of our knowledge, this was the first study” are almost same.

Minor comments:

1) Page 6, line 94: Rather than “Shu Yuan”, “Yuan S, et al.” may be better.

2) Page 6, line 98: “[15-17]” is better.

3) Page 7, line 113: “Methods” should be moved down one line.

4) Page 11, line 208: “groups.” is correct.

5) Page 11, line 219: “sex, and race/ethnicity” is correct.

6) Page 15, line 272: “BMI was” may be better.

7) Page 20, line 366: “Xiong Z, et al.” is correct.

8) Page 20, line 369: “elevation [41].” is correct.

9) Page 20, line 377: “previous studies” needs some references.

10) Page numbers of most of the references should be correctly omitted. For examples, Ref. “2177-80” may be correct.

11) Ref. 39: not “J Diabetes” but “J Diabetes.”

12) Page 30, line 585: not *: p≤0.05 but p<0.05.

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Reviewer #1: No

Reviewer #2: No

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Nonlinear dose-response association of moderate-to-vigorous physical activity with hyperuricemia in US adults: NHANES 2007-2018

PONE-D-23-34240R1

Dear Dr. Yang,

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,

Yuichiro Nishida

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 #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 #2: Yes

**********

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

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 #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 #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 #2: The revised manuscript has been much improved according to the reviewers' helpful comments.

This reviewer does not have any further comments.

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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 #2: No

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