Dear Dr. Kang,

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Academic Editor

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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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The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: The authors report interesting data on the effects of BF, assessed by BIA, on lung function testing in a large Korean cohort based on retrospective data.

To improve the manuscript following issues can be addressed by the authors:

1. Definition of lung function impairment. The authors must be more precise in the definitions. They used % pred for FEV1 and FVC and a standard cut-off for FEV1/FVC ratio. The authors could perform a sensitivity analysis based on LLN. Furthermore, besides flow limitation, the authors can consider the presence of restrictive spirometry.

2. Discussion. The authors formulate standard principles about the role of BF but do not bring these principles in relation to their findings. For example, BF as endocrine organ: what about the highest lung function impairment in women with lowest BF paurtile? ( line 184).

3. A major limitation of this retrospective study is the absence of lung volume measurements. The authors must address this limitation.

Reviewer #2: 1. The study is cross-sectional, but some interpretations suggest causality (e.g., “predicts pulmonary function decline”). My suggestion is to revise throughout to avoid causal language. Replace “predicts” with “is associated with” unless longitudinal data are included.

2. Discuss potential measurement error or variability and why BIA was chosen over DXA

3. Physical activity, dietary factors, and socioeconomic status could confound both adiposity and pulmonary outcomes. Acknowledge these unmeasured confounders as a limitation

4. Terms like “pulmonary function decline” imply longitudinal worsening; since this is cross-sectional, it should read “lower pulmonary function”.

5. Data collection time duration not mentioned

6. Specify whether lung function was pre- or post-bronchodilator

7. Add reference for BIA validation in Korean populations.

8. Clarify definition of “impaired pulmonary function” (thresholds used).

9. Figures are clear but could include 95% confidence intervals to improve interpretability

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Reviewer #1: No

Reviewer #2: Yes:  Dhiraj Agarwal

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Body fat percentage is independently associated with lower pulmonary function in Korean never-smokers: A cross-sectional analysis of 33,748 adults

PONE-D-25-50052R1

Dear Dr. Hae Yeon Kang,

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,

Khadija Ayed, M.D., Ph.D

Academic Editor

PLOS One