PONE-D-20-14422

Association of sleep quality and sleep duration with serum uric acid level in adults

PLOS ONE

Dear Dr Chang

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Xianwu Cheng, M.D., Ph.D., FAHA

Academic Editor

PLOS ONE

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Additional Editor Comments (if provided):

Although the topic is interesting, as you will gather from the reviews, the referees identified substantive methodological problems, statistical analysis, and data presentation as well as the recruitment of all subjects. The editorial broad member also concurs. You may resubmit a revised version but it will be re-reviewed and there exists no guarantee that even with revision it will necessarily be accepted.

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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?

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 #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 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 #2: Yes

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4. 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 #2: 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: In this manuscript, the authors investigate the relationship between uric acid levels and both sleep duration and sleep quality, using data from the PSQI. They found that decreases in sleep duration are associated with a higher UA level while poor sleep quality was associated with a lower UA.

While the paper is well-written and the statistics appear appropriate, I am unsure of the clinical significance of the statistical finding. In particular, if you look at Table 1, the UA difference is only 0.1 mg/dL between the two groups. This is statistically difference but not sure it is clinically significant, since both levels are likely in normal range. Then, if you look at Table 3, it would appear that the differences in UA between the two groups, after various corrections, remains quite small. Thus, it is not clear to me that the statistical difference in UA has any clinical outcomes that are important.

Therefore, the paper would be greatly enhanced if the authors had any outcome data related to UA that showed that the small differences make a clinical difference.

Reviewer #2: This article is a report of regression on a large dataset exploring the replationship between uric acid levels and duration of sleep. This article will contribute meaningful evidence to the scientific literature. It appears to be scieintifically developed and a good discussion of the reasons for the relatinship are discussed.

I am recommending that the authors consider adding one variable to their dataset that could be a mediator to the relationship. The authors will also need to edit the grammar and sentence structure in below mentioned sections of the paper.

Introduction:

Line 45: typo “lover”

Line 47: poor grammar/sentence structure

There is no mention of the possible physiological relationship between sleep duration and uric acid levels. This must be delineated to substantiate the scientific underpinnings of the study.

Study Population:

Poor grammar and sentence structure.

Why did you exclude medications? Again, poor writing.

Clinical measurements:

There is no mention of the validity and reliability of the PSQI sleep duration question. What construct is the sleep duration question really accessing? Is subjective report of sleep a valid measure? This must be substantiated.

Validation and measurement specifications and moderators of the uric acid test are not discussed. For example, does diet the day of the test have an impact on the uric acid level? How about time of day the blood was drawn? Was there only one data point for the uric acid level?

Results and Analysis:

Ok, although the PSQI is a valid screen for obstructive sleep apnea. Why didn’t you look at the relationship between OSA and uric acid levels? Do you have any measures of inflammation in your dataset? If so, you might want to look at that relationship.

Discussion:

Really nice review of the literature and discussion, but I think you are missing the point about OSA/obesity/uric acid levels.

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Reviewer #1: Yes: James A Rowley, MD

Reviewer #2: Yes: Carla R. Jungquist

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Association of Sleep Quality and Sleep Duration with Serum Uric Acid Levels in Adults

PONE-D-20-14422R1

Dear Dr Chang

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,

Xianwu Cheng, M.D., Ph.D., FAHA

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Although the original reviewer#2 has delined to review second peer review process (minor revision), all original concerns have been addressed by the authors.

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

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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

**********

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

Reviewer #1: 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

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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

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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: (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