Associations between Rest–Activity Rhythms and Liver Function Tests: The US National Health and Nutrition Examination Survey, 2011–2014

Round 1

Reviewer 1 Report

The manuscript discusses an intriguing relationship between rest-activity rhythms and liver function using data from the National Health and Nutrition Examination Survey between 2011 and 2014. The study's main objective is to evaluate the association between rest-activity rhythm characteristics and abnormal levels of various biomarkers related to liver function.

The manuscript clearly defines the study's objectives and provides a brief background. The methodology used to collect and analyze the data involves using seven rest-activity rhythm parameters derived from actigraphy data. The results clearly and concisely show a strong correlation between weakened rest-activity rhythms and impaired liver function. The results are supported by statistical analysis and adjustment for potential confounders, increasing the reliability of the study's conclusions. The manuscript suggests a possible link between circadian rhythms and liver health and represents a valuable contribution to this topic.

The text is written in a scientific and technical style appropriate to the subject.

Author Response

Thank you for your comments.

Reviewer 2 Report

I thank the editor for the opportunity to review this manuscript. Please find below my recommendations:

Minor:

1.       Introduction: Please define a weakened circadian rhythm

2.       Methodology: Please justify the markers choice to asses the liver dysfunction

3.       Methodology: Please specify the time frames/check points, when the liver enzymes were assessed.

4.       Methodology: Please provide a justification for the social confounders (i.e. marital status, incomes etc) you choose

Author Response

Thank you. Please see the attachment.

Author Response File: Author Response.pdf