Dear Dr. Lee,

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.

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Please modify the article in the light of comments of the reviewers. 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.

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
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We look forward to receiving your revised manuscript.

Kind regards,

Aamir Ijaz, MD, FCPS, FRCP, MCPS-HPE

Academic Editor

PLOS ONE

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When submitting your revision, we need you to address these additional requirements.

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3. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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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?

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

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: 1. The authors should correct the references. The References should be in Journal Format.

2. The authors have mentioned that this study complied with the ethical standards

of the Declaration of Helsinki and was approved by the Catholic University of Korea,

Catholic Medical Center, Eunpyeong St. Mary’s Hospital Institutional Review Board

(approval no. PC25ZISI0065). Mention the Intuitional Ethical Clearance date also.

Reviewer #2: This study explored the relationship between thyroid function and lung performance in euthyroid Korean adults. Using data from over 2,600 participants aged 40 and above, the researchers measured lung capacity and airflow with spirometry tests. They analyzed thyroid hormone levels and the presence of thyroid peroxidase antibodies (TPOAb), adjusting for lifestyle and demographic factors. The results showed that higher free thyroxine correlated with better lung function, while higher TSH related to poorer outcomes. Importantly, elevated TPOAb levels were linked to reduced lung function, independent of hormone levels. These associations were stronger in older adults and those with lower body mass index. The findings suggest that even without overt thyroid disease, thyroid autoimmunity can impair pulmonary health. The study addressed an underexplored correlation between thyroid autoimmunity and lung function. While the findings are not yet clinically applicable, they provide valuable insight and contribute to the literature, highlighting the need for further research to clarify and establish potential clinical relevance.

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what does this mean? ). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: Yes:  Jawaher Alsughayyir

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While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step.

Role of thyroid autoimmunity independent of thyroid hormone levels in pulmonary function decline: A population-based study in euthyroid adults

PONE-D-25-38118R1

Dear Dr. Lee,

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,

Aamir Ijaz, MD, FCPS, FRCP, MCPS-HPE

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: