Serum Lipid Levels and Suicidal Ideation of Adults: A Cross-Sectional Study Using the Korea National Health and Nutrition Examination Survey

Round 1

Reviewer 1 Report

The topic of the study is particularly interesting and well exemplified. I would suggest an improvement of the introduction if the authors accept in the sense of a presentation and the impact of the cultural environment on behavioural deviations, not only the changes produced by food. After all, the nature of the food has great influences from traditional regional and family gastronomy. I would also suggest a development of the conclusions with an emphasis on the plus brought by the present study compared to other similar studies.

Author Response

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Reviewer 2 Report

Study Design: The study appropriately utilized a cross-sectional design and a large sample size from the Korea National Health and Nutrition Examination Survey (KNHANES). However, the study design limits the ability to draw causal relationships and does not account for potential confounding variables such as diet and mental health history.

Results Elaboration:

The findings of lower LDL-C levels being associated with an increased risk of suicidal ideation among Korean men aged 19 years or older are intriguing. However, an in-depth discussion on why these differences might exist between men and women would enhance the paper. It might be valuable to explore potential therapeutic interventions for this population. In this regard, the study by Cuomo et al. (2019 Jan 23;9:784doi: 10.3389/fpsyt.2018.00784.) on the "Feasibility, Adherence and Efficacy of Liraglutide Treatment in a Sample of Individuals with Mood Disorders and Obesity" could provide valuable insights.

Future Strategies: Future research should explore the potential mechanisms linking LDL-C levels and suicidal ideation and consider the potential influence of lifestyle or psychological variables. It would be beneficial to replicate this study in different cultural or geographical contexts to confirm the findings' generalizability. A longitudinal study design could help establish a causal relationship between LDL-C levels and suicidal ideation.

Overall, the English language used in your manuscript is clear and generally well-written. However, there are minor suggestions that can improve its readability and clarity:

1. Please pay attention to the consistent use of tenses. Make sure the tense usage is correct and consistent throughout the paper.

2. Please ensure that abbreviations are defined upon first usage. For example, LDL-C and TC should be defined before being used in the text.

3. Some sentences could be simplified for better comprehension. For instance, avoid long, complex sentences when a few shorter sentences can convey the same information more clearly.

4. Lastly, consider having a native English speaker or professional language editing service review the manuscript to refine grammar and syntax further, ensuring the research is communicated effectively.

Author Response

Please see the attachment

Author Response File: Author Response.docx