Fasting plasma glucose levels are associated with all-cause and cancer mortality: A population-based retrospective cohort study

Qing Gao; Qi Wang; Zhijuan Gan; Meng Wang; Dafeng Lu; Bingdong Zhan

doi:10.1371/journal.pone.0311150

Peer Review History

Original SubmissionJanuary 4, 2024
26 Jul 2024 Decision Letter - Mahmoud M Werfalli, Editor PONE-D-23-43491Fasting plasma glucose levels are associated with all-cause mortality and cancer death: a population-based retrospective cohort studyPLOS ONE Dear Dr. Zhan, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Sep 09 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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The following are some problems that may need to be revised 1，The 2 in the unit of BMI in line 91 should be superscripted 2，Use a unified term for fasting plasma glucose and use abbreviations FPG, in line 152 and other lines 3，Please describe the data screening process in detail and how many people were excluded 4, Please conduct subgroup analysis by sex and age Reviewer #2: #3 the data have not been made fully available, but the authors indicate "The data sets generated and/or analysed during the current study are not publicly available due individual privacy information protection but are available from the corresponding author on reasonable request." This seems reasonable to me. #4 the article is in good shape, but would benefit from English language review. I have pointed out some issues below. The authors state that “the requirement for informed consent was waived due to the retrospective design.” This does not make sense to me. If the data come from human subjects, whether prospective or retrospective, the individuals should have the opportunity to provide informed consent or to request that their data not be used. Line 46 – what does this phrase refer to? “approximately 4.2 million adults aged 20 to 79 years [7].” Lines 50-54 – in regard to the study from Korea, the study examined the relationship between glucose levels and mortality in individuals with prevalent diabetes, and it appears that the risks were highest in those with the highest glucose levels compared with 85–99 mg/dL (not compared with the lowest levels of glucose). [I did not check the results of the other papers cited.] Lines 67-69 - did this study include all residents of Quzhou City in that time period? If not, how were the individuals selected? Lines 71-73 need to be edited for clarity Line 83-84 – what about former smokers who had quit less than six months ago, how are they categorized? Line 90 – what were the “rigorous procedures” for collecting height and weight? Line 104 – “lack of information on variables” is vague. What information was considered necessary in order for the individual not to be excluded? Table 1 – I think the all-cause mortality and the cancer mortality numbers represent those who are still alive (I had assumed they represented those who had died, but the numbers don’t make sense that way.) Please clarify. ****** 6. 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. 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Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0311150.r001
Revision 1
16 Aug 2024 Author Response Reviewer 1 Thanks very much for taking your time to review this manuscript. We are very grateful to your generous comments for the manuscript. I will answer your comments one by one： Response to comment: This article is clearly structured, has some research significance, and the sample size is sufficient. The following are some problems that may need to be revised. 1.The 2 in the unit of BMI in line 91 should be superscripted Thank you for your reminder, I have corrected this error. 2.Use a unified term for fasting plasma glucose and use abbreviations FPG, in line 152 and other lines According to your suggestion, I checked the entire manuscript and standardized the terminology for fasting plasma glucose, using the abbreviation FPG throughout. I also checked the usage of other terms in the article and standardized "all-cause and cancer death" to "all-cause and cancer mortality." 3.Please describe the data screening process in detail and how many people were excluded I created a flowchart to illustrate the data screening process and the reasons and number of exclusions, making the analysis in the article clearer and more readable. 4.Please conduct subgroup analysis by sex and age Thank you very much for your suggestion. I have added this part of the analysis, conducting subgroup analysis by age (< 60 years and ≥ 60 years) and gender to explore potential modifying effects. The subgroup analysis found that in different genders, the risk of all-cause death in the IFG and DM groups and the risk of cancer death in the DM group increased to varying degrees, but the risk of death in women was slightly higher than in men. The risk of hyperglycemia on all-cause mortality and cancer mortality was more pronounced in the <60 years age group. Reviewer 2 We would like to thank the reviewers from the bottom of our hearts for carefully reviewing and guiding the paper, which has led to a great improvement in the quality of the paper. Response to comment: #3 the data have not been made fully available, but the authors indicate "The data sets generated and/or analyzed during the current study are not publicly available due individual privacy information protection but are available from the corresponding author on reasonable request." This seems reasonable to me. #4 the article is in good shape, but would benefit from English language review. I have pointed out some issues below. 1.The authors state that “the requirement for informed consent was waived due to the retrospective design.” This does not make sense to me. If the data come from human subjects, whether prospective or retrospective, the individuals should have the opportunity to provide informed consent or to request that their data not be used. This database comes from the 2015 resident health check-up data, which is part of a routine public health program. And in the retrospective analysis, we removed identifiable information, so the Quzhou CDC Ethics Review Committee waived the requirement for informed consent. 2.Line 46 – what does this phrase refer to? “approximately 4.2 million adults aged 20 to 79 years [7].” This sentence refers to the number of adults aged 20 to 79 who died from diabetes in 2019. I have revised this sentence to make the content clearer 3.Lines 50-54 – in regard to the study from Korea, the study examined the relationship between glucose levels and mortality in individuals with prevalent diabetes, and it appears that the risks were highest in those with the highest glucose levels compared with 85–99 mg/dL (not compared with the lowest levels of glucose). [I did not check the results of the other papers cited.] Thank you for your help. We apologize for our carelessness. Upon careful reading, it was found that in this prospective study in Korea, the relationship between fasting blood glucose and mortality in diabetic patients was examined. It was found that compared with 85-99 mg/dL, the multivariable adjusted risk ratio for hypoglycemia (<65 mg/dL) was 1.46. Avoiding hypoglycemia can improve the survival rate of diabetic patients. So we have revised it to "A prospective cohort study in Korea on the relationship between diabetic patients and mortality found that fasting blood glucose and all-cause mortality showed a U-shaped relationship, and hypoglycemia could increase the mortality rate of diabetic patients." 4.Lines 67-69 - did this study include all residents of Quzhou City in that time period? If not, how were the individuals selected? Thank you for your question. This study did not include all residents of Quzhou City during that time period. Instead, it included individuals who voluntarily participated in the 2015 health check-ups organized by the Quzhou City Health Bureau. These health check-ups were part of a routine public health initiative, and participation was open to all residents. Participants were not randomly selected; however, the program was widely publicized and accessible to all segments of the population, which helps to ensure a diverse and representative sample of the community. Given the large sample size and the inclusivity of the health check-up program, we believe the cohort provides a reasonably representative cross-section of the Quzhou City population. 5.Lines 71-73 need to be edited for clarity We have re-edited this content, and we want to express that the information in this database was entered into the Resident Health Check Information Database after quality control of the original data by trained professionals. This makes it easier for readers to understand the content. 6.Line 83-84 – what about former smokers who had quit less than six months ago, how are they categorized? We categorized smoking status into three groups: never smoked, former smoker, and current smoker. Individuals who had previously smoked but quit for more than six months were classified as former smokers. If they had quit for less than six months, they were judged on the basis of their past smoking habits—if they had smoked at least 100 cigarettes, they were considered current smokers; otherwise, they were classified as never smoked. To avoid ambiguity, I changed 'current smoking' to 'smoking' for clearer expression. 7.Line 90 – what were the “rigorous procedures” for collecting height and weight? We replaced the phrase "rigorous procedures" with specific content, referring to the fact that the height and weight of all participants were measured using standard instruments while they were wearing light clothing and had removed their shoes and hats. 8.Line 104 – “lack of information on variables” is vague. What information was considered necessary in order for the individual not to be excluded? The lack of variable information refers to the lack of records on smoking, drinking, and physical exercise. In the article, we have clarified this to avoid ambiguity and confusion for readers. 9.Table 1 – I think the all-cause mortality and the cancer mortality numbers represent those who are still alive (I had assumed they represented those who had died, but the numbers don’t make sense that way.) Please clarify. We apologize for the mistake. All-cause mortality and cancer mortality represent those who have died. We have corrected this part. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0311150.r002
16 Sep 2024 Decision Letter - Mahmoud M Werfalli, Editor Fasting plasma glucose levels are associated with all-cause and cancer mortality: a population-based retrospective cohort study PONE-D-23-43491R1 Dear Dr. Bingdong Zhan 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. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Mahmoud M Werfalli, PhD Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0311150.r003
Formally Accepted
18 Sep 2024 Acceptance Letter - Mahmoud M Werfalli, Editor PONE-D-23-43491R1 PLOS ONE Dear Dr. Zhan, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Mahmoud M Werfalli Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0311150.r004

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