Factors Affecting the Development of Metabolic Syndrome in Single-Person Households: A Sex-Stratified Analysis

Round 1

Reviewer 1 Report

Thank you for the opportunity to review the manuscript “Factors Affecting the Development of Metabolic Syndrome in Single-person Households: A Sex-stratified Analysis” by Jui Kim and Hyoungshim Choi.
The research was carefully designed, the manuscript is very well written, clear and easy to read. The conclusions are consistent with the results presented and they all address the main question of the research.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Thanks for this interesting paper. It is clear, well written and addresses an important issue.

I have a few minor comments that could make the paper stronger.

1. I understand that the focus of the paper is single living people. However, it would still be interesting to know how the prevalence of MetS differs between the single person household participants and others. In the introduction you have made the argument that MetS is higher in those who live alone. Is that the case in this health survey?

2. The introduction argument is not clear. I think the main focus is MetS. So you could start with the information about prevalence and risk factors for the syndrome, and then say that single living is another one of those risk factors. You have also not explained what are the potential connections between single living, a societal factor, and the more immediate risk factors such as smoking and drinking. What are the most likely avenues connecting single living and metabolic disease.

3. Line 97 – what is sufficient or insufficient dietary habit? How was this assessed?

4. Line 105 – Please provide a little information on the standard protocol for measuring height and weight? Did health staff do the measurement?

5. Line 107 – why do you combine normal and pre-obese categories? It would be more normal to either have an extra overweight category, or combine pre-obese and obese

6. Line 123 – Please tell us more about how the logistic regression models were built. What variables were included or adjusted for in the models.

7. Line 131-135 – You say there associations between age, health status, education etc between men and women. You could mention briefly the direction of these associations. That is, are men of better health status or women? The same applies to the results for Table 2 in the lines 143to 149.

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

In lines 110-112, the reference should be moved as follows: Mets was defined according to the criteria outlined by the National Cholesterol Education Program Adult Treatment Panel III [21], which was modified for the Asian population.

In the Results section, p=.000 may be replace with p<0.0001

In tables 1 and 2, it would be appropriate to apply linear trend tests for ordinal variables and show their results in a new column.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf