Title: Relation between triglycerides and the severity of acute pancreatitis combined with
nonalcoholic fatty liver disease: a retrospective study
Version: 1 Date: 14 May 2023
Reviewer's report:
I am pleased to review the manuscript entitled " Effect of triglycerides on the severity of
acute pancreatitis combined with nonalcoholic fatty liver disease: a retrospective study" by Lei
Zhu et al. The investigation regarding the relationship between high triglycerides and acute
pancreatitis within the context of non-alcoholic fatty liver disease (NAFLD) is both intriguing
and of significant importance. Nevertheless, several concerns surround the analysis in this paper,
warranting substantial revisions to its content.
Major
1. The presence of eight individuals with alcohol in Table 1 raises questions regarding the
premise of this cohort being solely based on NAFLD. This assumption appears to be incorrect,
and thus, it is necessary to exclude these eight individuals from the analysis and reevaluate the
data accordingly.
2. In Table 1, it appears that there are two cases of hypertriglyceridemia (HTG) included in the
non-hypertriglyceridemia (NHTG) group. This raises concern as, by definition, individuals with
HTG should be excluded from the NHTG group. It is imperative to perform a revised analysis
to ensure accurate results and proper grouping of patients.
Minor
1. In 3.2, “ 2012 revision of Atlanta” should be “2012 revision of the Atlanta Classification of
AP” and please add the reference. (Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD,
Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group. Classification
of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international
consensus. Gut. 2013 ;62:102-11. doi: 10.1136/gutjnl-2012-302779.)
2. MAP, MSAP, and SAP should be spelled out.
3. Why did the authors classify AP severity into 3 groups (MAP, MSAP, and SAP) but only
compare MSAP and SAP? Wu et al. [4]reported that the incidence of mild AP, moderately severe
AP, and severe AP was 77.30%, 18.3%, and 4.3% in the non-NAFLD group and 58.2%, 33.9%,
and 7.9% in the NAFLD group, respectively. In this manuscript, MSAP was higher than their
cohort. What do authors think about it? Please discuss it.
4. The authors should discuss the related articles as follows: “Xu C., Qiao Z., Lu Y., et al.
Influence of fatty liver on the severity and clinical outcome in acute pancreatitis. PLoS ONE.
2015;10(11)” and “Qi X., Hou Y., Guo X. Severe fatty liver disease and acute pancreatitis: is
there a correlation between them. Clinical and Experimental Hepatology. 2016;1(4):127–130.”
5. In Figure 1, in addition to mentioning "compare," please add boxes for each comparison and
add the number of the selected case to each box.
6. In Table 1, comparisons should be performed between each etiology.
Title: Relation between triglycerides and the severity of acute pancreatitis combined with
nonalcoholic fatty liver disease: a retrospective study
Version: 1 Date: 14 May 2023
Reviewer's report:
I am pleased to review the manuscript entitled " Effect of triglycerides on the severity of
acute pancreatitis combined with nonalcoholic fatty liver disease: a retrospective study" by Lei
Zhu et al. The investigation regarding the relationship between high triglycerides and acute
pancreatitis within the context of non-alcoholic fatty liver disease (NAFLD) is both intriguing
and of significant importance. Nevertheless, several concerns surround the analysis in this paper,
warranting substantial revisions to its content.
Major
1. The presence of eight individuals with alcohol in Table 1 raises questions regarding the
premise of this cohort being solely based on NAFLD. This assumption appears to be incorrect,
and thus, it is necessary to exclude these eight individuals from the analysis and reevaluate the
data accordingly.
2. In Table 1, it appears that there are two cases of hypertriglyceridemia (HTG) included in the
non-hypertriglyceridemia (NHTG) group. This raises concern as, by definition, individuals with
HTG should be excluded from the NHTG group. It is imperative to perform a revised analysis
to ensure accurate results and proper grouping of patients.
Minor
1. In 3.2, “ 2012 revision of Atlanta” should be “2012 revision of the Atlanta Classification of
AP” and please add the reference. (Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD,
Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group. Classification
of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international
consensus. Gut. 2013 ;62:102-11. doi: 10.1136/gutjnl-2012-302779.)
2. MAP, MSAP, and SAP should be spelled out.
3. Why did the authors classify AP severity into 3 groups (MAP, MSAP, and SAP) but only
compare MSAP and SAP? Wu et al. [4]reported that the incidence of mild AP, moderately severe
AP, and severe AP was 77.30%, 18.3%, and 4.3% in the non-NAFLD group and 58.2%, 33.9%,
and 7.9% in the NAFLD group, respectively. In this manuscript, MSAP was higher than their
cohort. What do authors think about it? Please discuss it.
4. The authors should discuss the related articles as follows: “Xu C., Qiao Z., Lu Y., et al.
Influence of fatty liver on the severity and clinical outcome in acute pancreatitis. PLoS ONE.
2015;10(11)” and “Qi X., Hou Y., Guo X. Severe fatty liver disease and acute pancreatitis: is
there a correlation between them. Clinical and Experimental Hepatology. 2016;1(4):127–130.”
5. In Figure 1, in addition to mentioning "compare," please add boxes for each comparison and
add the number of the selected case to each box.
6. In Table 1, comparisons should be performed between each etiology.
Please review this paper.
user
Title: Relation between triglycerides and the severity of acute pancreatitis combined with
nonalcoholic fatty liver disease: a retrospective study
Version: 1 Date: 14 May 2023
Reviewer's report:
I am pleased to review the manuscript entitled " Effect of triglycerides on the severity of
acute pancreatitis combined with nonalcoholic fatty liver disease: a retrospective study" by Lei
Zhu et al. The investigation regarding the relationship between high triglycerides and acute
pancreatitis within the context of non-alcoholic fatty liver disease (NAFLD) is both intriguing
and of significant importance. Nevertheless, several concerns surround the analysis in this paper,
warranting substantial revisions to its content.
Major
1. The presence of eight individuals with alcohol in Table 1 raises questions regarding the
premise of this cohort being solely based on NAFLD. This assumption appears to be incorrect,
and thus, it is necessary to exclude these eight individuals from the analysis and reevaluate the
data accordingly.
2. In Table 1, it appears that there are two cases of hypertriglyceridemia (HTG) included in the
non-hypertriglyceridemia (NHTG) group. This raises concern as, by definition, individuals with
HTG should be excluded from the NHTG group. It is imperative to perform a revised analysis
to ensure accurate results and proper grouping of patients.
Minor
1. In 3.2, “ 2012 revision of Atlanta” should be “2012 revision of the Atlanta Classification of
AP” and please add the reference. (Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD,
Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group. Classification
of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international
consensus. Gut. 2013 ;62:102-11. doi: 10.1136/gutjnl-2012-302779.)
2. MAP, MSAP, and SAP should be spelled out.
3. Why did the authors classify AP severity into 3 groups (MAP, MSAP, and SAP) but only
compare MSAP and SAP? Wu et al. [4]reported that the incidence of mild AP, moderately severe
AP, and severe AP was 77.30%, 18.3%, and 4.3% in the non-NAFLD group and 58.2%, 33.9%,
and 7.9% in the NAFLD group, respectively. In this manuscript, MSAP was higher than their
cohort. What do authors think about it? Please discuss it.
4. The authors should discuss the related articles as follows: “Xu C., Qiao Z., Lu Y., et al.
Influence of fatty liver on the severity and clinical outcome in acute pancreatitis. PLoS ONE.
2015;10(11)” and “Qi X., Hou Y., Guo X. Severe fatty liver disease and acute pancreatitis: is
there a correlation between them. Clinical and Experimental Hepatology. 2016;1(4):127–130.”
5. In Figure 1, in addition to mentioning "compare," please add boxes for each comparison and
add the number of the selected case to each box.
6. In Table 1, comparisons should be performed between each etiology.
assistant