Serum vitamin E levels and chronic inflammatory skin diseases: A systematic review and meta-analysis

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31 Aug 2021

PONE-D-21-21726

Available information of serum vitamin E levels and chronic inflammatory dermatosis: systematic review and meta-analysis

PLOS ONE

Dear Dr. Zhang,

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Reviewers’ comments:

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Comments to the Author

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Reviewer #1: No

Reviewer #2: Partly

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: No

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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: General remark

– English remains a concern, and several minor shortcomings regarding grammar and punctuation must be polished with a revised version. Remember that a flawless manuscript is the task of all co-authors, having read and approved the submission.

Abstract

– Please note the word maximum which is allowed with PLOS ONE (see Guidelines for Authors), to increase your information regarding your results, and to allow future readers to switch to your full text.

– Your aim was “To clarify the serum level of vitamin E in chronic inflammatory dermatosis, (…).” And you have concluded that “low serum Vitamin E levels increased the susceptibility risk of certain chronic inflammatory skin diseases.” This would not seem convincing. Indeed, this would even seem meaningless. With your Conclusions, please stick exclusively to your aims. Do not simply repeat your results here. Do not provide banalities (known from each and every other paper). Instead, provide a reasonable and generalizable extension of your outcome.

Intro

– “Skin disease is one of the most common human illnesses.” How can you say this? Please have a close look on caries, and on periodontitis. Again, please avoid common phrases seen with almost every paper.

– Please revise for referencing according to Journal style. “(…) pruritus, and so on[1, 2].” must read “(…) pruritus, and so on[1, 2].” First, make use of your spacebar, and revise thoroughly. Second, what do you mean when referring to “and so on”?

– Do not repeat statements. “(…) the relationship between serum vitamin E level and skin diseases is still unclear.” and “However, the existing studies produced conflicting results.” would provide comparable (or even the same) information. Please revise carefully, to facilitate reading.

– “So far, researches on level of serum vitamin E and skin diseases mainly focus on chronic inflammation skin diseases like vitiligo, psoriasis, atopic dermatitis and acne.” References missing.

– Please clarify whether there already been any “systematic reviews of literature and meta-analyses” referring to vitamin E and dermal diseases. Make clear what you will add to the literature.

– Moreover, you surely had some idea prior to starting your study. What was your null hypothesis. Remember that H0 must be deducible from the foregoing thoughts. Revise carefully.

Meths

– Heading must read “Materials and methods”. Again, you are strongly encouraged to consult the Journal’s guidelines. Additionally, double checking some recently published PLOS ONE papers will help.

– “(…) by two authors (Qi Lan and Mengxin Luo).” must read “(…) by two authors (Q.L. and M.L.). Same with “C.Z.”.

– “The literature search strategy was showed in Table. 1.” must read “The literature search strategy is given with Table 1.”. Revise carefully, to avoid any typos/delete full stops not considered necessary.

– “(version 13, StataCorp LP, College Station, TX).” must read “(Stata Statistical Software, Release 13; StataCorp LP, College Station, TX, USA).”

Results

– “In quality assessment, scores of all included case-control studies are showed in Table 3” Please clarify the quality grades with your text. Remember that only high-quality papers should be included, to avoid repetition of any “conflicting results” (which have been deemed by the Authors). Please clarify, and discuss.

– “(P < 0.00)” would seem unclear. As a general rule, please always provide p values on a 3-digit basis. Format must be “(p = 0.838)”, or “(p < 0.001)”. Note that lower case “p” would fit to the Journal style.

– High heterogeneity would seem a problem, and there must be a convincing rationale to proceed with your paper. Please discuss.

– “As a sensitivity analysis, a meta-influence plot was used to analyze the influence of individual studies on the overall effect size (Figure. 7).” This would not seem acceptable. Please remember that it is considered the task of the Authors to guide the reader. Simply referring to a Table, or to a Figure (without providing any explanations) is not deemed professional.

Disc

– Refer to H0 with the first paragraph of this section.

– “It was found that >60% of adults have vitamin E intakes below the EAR (<12 mg/d) in the United States.” Again, each and every statement calls for reference(s). Revise thoroughly throughout your text.

– “In our study, the lower serum vitamin E levels in patients of vitiligo, psoriasis, atopic dermatitis and acne compared with controls.” Please double check and revise sentence.

– This section has not been thoroughly elaborated, and there would seem room for more profound discursive aspects.

Concl

– Please see comments given above. Again, do not simply repeat your results here – these already have been presented (and should be thoroughly discussed, see comments given above). Instead, provide a reasonable and generalizable extension of your outcome.

– Same with “It might be due to the number of researches on (…).” Explanations (and even speculations) are welcome, but must be provided with the Disc section.

– Same with “The low quality and high heterogeneity of some included studies means that our results must be interpreted with caution (…).” Again, this is not considered a Conclusion. You should discuss these aspects at the right place. Why did you include those poor papers? Why did you finish such a study involving several poor papers? Please provide a sound and reasonable rationale. Moreover (and again), this is a clear limitation, and the Authors must thoroughly clarify, why PLOS ONE should proceed with this draft. At the end of the day, this only will be another paper considered “unclear”, “controversial”, or “conflicting”. Please see comments given above.

– “More studies of high-quality observational are required to confirm the association between low serum vitamin E levels and skin diseases.” Again, this is a meaningless platitude. And, moreover, this would clarify that your study did not reveal any associations, right?

Refs

– Please revise for uniform formatting. Consult some previously published PLOS ONE papers.

Reviewer #2: This systematic review focuses on the relation between vitamin E levels and chronic inflammatory dermatoses.

It is widely recognised that it would be better to study dietary patterns rather than single nutrients since nutrients and foods may interact in their biological effects.

Reverse causation is a major issue and should be clearly discussed in the study. Reverse causation can occur when people change their diet or other lifestyle habit after developing a disease or perhaps after having a close family member suffer an event like vitiligo or other immune-related conditions

Reviewer #3: This is a commendable review by the authors to understand how vitamin E can relate to various skin issues. There are a couple revisions that are needed before this article can be considered for acceptance:

1) The English is poor. I can’t detail every single grammatical error as they are numerous. Please have a native English speaker review this for grammatical accuracy.

2) The authors should not refer to vitamin E as if it is just one molecule. Please detail the subsets of vitamin E to detail what was actually measured. Was is alpha tocopherol, gamma tocopherol, tocotrienol subvariants, etc?

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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