Comorbidities of Obesity in a Rural African Population Residing in Limpopo Province, South Africa: A Comparison between General and Central Obesity

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This research article by Ntimana CB et al examines the Comorbidities of Obesity in a rural African population residing in Limpopo Province, South Africa with comparison of central vs general obesity.

My main question is whether the borderline mean BMI for obesity (mean value 28 in the population studied) is sufficient to show differences concerning general obesity vs central obesity.

Also the BMI of the female population is only borderline positive for obesity (30.81).

In this context I understand that the findings may not really be strong enough to let the authors draw conclusions about differences between central and general obesity.

Other points to be clarified are the following: 

1. Please describe the method used for measuring subcutaneous vs visceral fat.

2. I would like to see smoking status and alcohol consumption in table 1.

3. Explain the additive significance of using bivariate vs partial correlations as well as multivariable logistics regression analysis also in the clinical setting. Why do you think some statistical significancies using the one method are not proven with the other? Please add this in the study limitations.

4. Please explain the clinical information that is aqcuired by high TC/HDLc ratios as well as LDLc/HDLc ratios.

 

Comments on the Quality of English Language

Please correct LDH in line 191, Page 7.

Correct hypertensions line 251, Page 9

Correct DHL line 343, page 10.

Correct increase, line 279, page 9

Line 240, page 8.

Line 170, page 8.

Author Response

Please see attached 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

1.       Why diabetes was diagnosed using only 1 diagnostic criterion - glucose level?  Was it fasting glucose level?  What about other diagnostic criteria of diabetes? Not using of all diagnostic criteria of diabetes could led to results, which are different from real incidence of diabetes in these patients. This is recommended to be noted in the limitations of the study.

2  2.     Some abbreviations are not deciphered

    3.     Add units of measurement (for example, cm, %) in the text and in Table 1, where they are missing

          4. Lines 240, 279 - need to take out the extra words

     5.       Figures, illustrating the main results, could help to make results more demonstrative. If it is possible, add figures.

 

Comments on the Quality of English Language

There are grammatical and punctuation errors in the text.

For example, grammatical mistakes

Centrally obese participants were more likely to be diabetic, hypertensive, dyslipidaemia, and have reduced kidney function.

 These results suggests that fat deposition is more common among women compared to men.

 Punctuation mistakes:

In the present, study obese participants were more likely to be hypertensive, and have increased LDL-C/HDL-C, and it is not associated with diabetes, and kidney diseases.

Author Response

please see the attached 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Reviewing the revised manuscript of Ntimana CB et al:

In the Discussion session the differences in cardiovascular demographics between Africans and Caucasians should be highlighted, e.g. hypertension, DM and cad prevalences, as these differences may play a role in the consequences of obesity in this certain geographical area.

The population, as previously commented, has only borderline BMIs and central obesity measurements. Citing the article of X Jin et al (2023-Normal-weight central obesity: implications for diabetes mellitus), could you please refer, how many of the participants were normal weight, but still had central obesity?  

Comments on the Quality of English Language

Minor editing is required. 

Not all corrections have been made from the last revision.

Author Response

please find the attached

Author Response File: Author Response.pdf