PONE-D-24-50053Predictive Value of Uric Acid to Albumin Ratio for Carotid Atherosclerosis in Type 2 Diabetes Mellitus: A retrospective studyPredictive Value of Uric Acid to Albumin Ratio for Carotid Atherosclerosis in Type 2 Diabetes MellitusPLOS ONE

Dear Dr. Jin,

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: 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: I have reviewed the manuscript entitled 'Predictive Value of Uric Acid to Albumin Ratio for Carotid Atherosclerosis in Type 2 Diabetes Mellitus: A retrospective study'.

The manuscript sounds scientific and is well-presented. However several issues should be evaluated in order to provide more precise deductions.

The title was written twice please check.

In the introduction section the role of uric acid/ albumin should be mentioned with recent investigations citing 'The Association of Serum Uric Acid/Albumin Ratio with No-Reflow in Patients with ST Elevation Myocardial Infarction', 'Predictive value of uric acid/albumin ratio for the prediction of new-onset atrial fibrillation in patients with ST-Elevation myocardial infarction' and 'Association of Uric Acid Albumin Ratio with Recurrence of Atrial Fibrillation after Cryoballoon Catheter Ablation'. These articles will emphasize the concomitancy of inflammation and uric acid/ albumin.

Please explain the inclusion and exclusion criteria more in detail.

Please emphasize the hypothesis of the study.

The role of albumin should also be mentioned since it has several predictive effects in addition to other parameters such as in Naples score, PNI and others. Please mention the importance of albumin citing 'Overlap Between Nutritional Indices in Patients with Acute Coronary Syndrome: A Focus on Albumin' and 'Evaluation of Naples Score for Long-Term Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention'.

Reviewer #2: 1. The authors should consistently use either sex or Gender in every places.

2. In the table, "n" should be used instead of "N". “N” denotes population.

3. Kindly provide a more detailed description of Figures 1, 2 and 3.

4. The authors have not addressed the topic of women patients, and they have not even mentioned it in the limitations section.

Reviewer #3: After reviewing the manuscript, I would like to highlight several points as drawbacks

*The study’s sample size may limit the generalizability of its findings, as it is confined to a particular demographic.

*The retrospective nature of the study introduces potential biases and limits the capacity to infer causality.

As recommendations, details on how carotid IMT and plaques were measured could be clarified to ensure reproducibility. Additionally, addressing potential confounding variables in analyses would strengthen the conclusions drawn.

However, The study investigates the uric acid to albumin ratio (UAR) as a predictive biomarker for carotid atherosclerosis specifically in patients with type 2 diabetes mellitus (T2DM). This offers new insights, particularly since UAR combines elements of both nutritional status and inflammatory response.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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Submitted filename: Review comment PLOS.docx

Predictive Value of Uric Acid to Albumin Ratio for Carotid Atherosclerosis in Type 2 Diabetes Mellitus: A Retrospective Study

PONE-D-24-50053R1

Dear Dr. Jin,

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,

Aleksandra Klisic

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 #3: 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 #3: Yes

**********

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

Reviewer #1: Yes

Reviewer #3: 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: Yes

Reviewer #3: 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 #3: 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: I have reviewed the manuscript entitled ' Predictive Value of Uric Acid to Albumin Ratio for Carotid Atherosclerosis in Type 2 Diabetes Mellitus: A Retrospective Study'. The manuscript is acceptable after the revisions.

Reviewer #3: (No Response)

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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: No

Reviewer #3: No

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