PONE-D-24-07867Association between degree of obesity and atopic dermatitis among adolescents: Findings from a national cross-sectional study in KoreaPLOS ONE

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Additional Editor Comment:

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#1. KCDC -> KDCA

#2. To determine the association between BMI and AD, multiple logistic regression analysis was performed after adjusting for all covariates. -> Please cite the statistical guideline (DOI: https://doi.org/10.54724/lc.2022.e3).

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Reviewers' comments:

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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: I Don't Know

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: This is a good manuscript. But I have some comments as followed.

1.The title might be revise as "Association between BMI and atopic dermatitis among adolescents: Findings from a national cross-sectional study in Korea".

2.Background part: I suggest describe the epidemical situation of atopic dermatitis at first.

3.Methods: part: Please describe the measure methods of the important variables. How to measure obesity and underweight?

4.Please add the inclusion criteria and exclusion criteria in the part of Participants.

5.Results part: Please add to the subtitle of different part.

6.Discussion part: please add to advantage of the research before the limitation of the research.

Reviewer #2: Through this manuscript, the authors have effectively demonstrated the relationship between the degree of obesity and atopic dermatitis. I appreciated how they tied this association to the clinical aspect of the disease, offering non-pharmacological interventions as a viable option. However, upon reviewing the manuscript, I encountered some conflicting points. I hope the authors will view this feedback positively.

1. In the Materials and Methods section, under the subsection "Data," the authors mentioned "sampling design method." I intend to question the appropriateness of this sampling technique.

2. Under the subheading "Variables," the study mentioned using BMI levels categorized as underweight, normal weight, and obesity. However, the World Health Organization classifies BMI into underweight, normal, overweight, and obese categories. Therefore, it would enhance the study's credibility to align with the globally accepted classification system.

3. Atopic dermatitis is a chronic skin condition. However, in this study, participants with a past history of atopic dermatitis (more than 1 year ago) were categorized into the AD "no" group. I believe this could potentially underestimate the prevalence of the disease, which might impact the subsequent analyses conducted in the study.

4.In the majority of cases, atopic dermatitis (AD) has an onset before the age of five years. However, this study targeted participants aged 12 to 18 years. This age group, coupled with the exclusion of participants with a history of AD, could have influenced the results, particularly in terms of prevalence.

5.The authors stated that "All participants signed an informed consent when they participated." However, it's worth noting that the majority of participants are minors. This raises ethical concerns regarding whether it is appropriate for a study to involve minors signing consent forms.

6.The data provided in the manuscript are publicly available on the website mentioned. However, it's important to note that all the data are in a language other than English. If feasible, it would be beneficial to have the data translated into English for wider accessibility and comprehension.

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Reviewer #1: No

Reviewer #2: No

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Association between degree of obesity and atopic dermatitis among adolescents: Findings from a national cross-sectional study in Korea

PONE-D-24-07867R1

Dear Dr. Park,

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,

Dong Keon Yon, MD, FACAAI, FAAAAI

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

This is an excellent paper.

Reviewers' comments: