Reviewer's report
Title:Nine-year incident diabetes is predicted by fatty liver indices: The French
D.E.S.I.R. study
Version: 1Date:26 February 2010
Reviewer: Llorenç Caballeria
Reviewer's report:
Overall this is a good article especially because of the size of the sample studied,
the years of follow up and the invasive approach of predicting diabetes and the
progression of fatty liver used.
There are, however, several considerations which should be addressed.
Major Compulsory Revisions
The authors conclude that the two indexes studied predict the incidence of
diabetes. However, I have doubts with respect to the utility of the HAFLD-FLS
index. The authors should clarify this aspect since the utility of this index is
limited by the inclusion of diabetes and fasting insulin in its definition. I do not
understand how the presence of diabetes can be predicted if being diabetic is
included in the definition.
In the limitations the authors recognize the absence of imaging tests for the
follow up of fatty liver. The doubts presented are: Is the determination of these
indexes sufficient to suspect the progression of fatty liver?
Perhaps it would be interesting to at least do abdominal echogaphies to confirm
the progression of fatty liver at the same time as performing the indexes to
thereby support the importance of these indexes.
It is strange that the authors did not consider the use of abdominal echography
which is very usual, inexpensive and non invasive. The authors should address
these questions.
Discretionary Revisions
The authors show the incidence of diabetes at the end of the nine years of follow
up. Since the patients were examined every three years, I believe that it would
enrich the manuscript if the authors were to report the incidence of diabetes at
each visit.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Reviewer's report
Title:Nine-year incident diabetes is predicted by fatty liver indices: The French
D.E.S.I.R. study
Version: 1Date:26 February 2010
Reviewer: Llorenç Caballeria
Reviewer's report:
Overall this is a good article especially because of the size of the sample studied,
the years of follow up and the invasive approach of predicting diabetes and the
progression of fatty liver used.
There are, however, several considerations which should be addressed.
Major Compulsory Revisions
The authors conclude that the two indexes studied predict the incidence of
diabetes. However, I have doubts with respect to the utility of the HAFLD-FLS
index. The authors should clarify this aspect since the utility of this index is
limited by the inclusion of diabetes and fasting insulin in its definition. I do not
understand how the presence of diabetes can be predicted if being diabetic is
included in the definition.
In the limitations the authors recognize the absence of imaging tests for the
follow up of fatty liver. The doubts presented are: Is the determination of these
indexes sufficient to suspect the progression of fatty liver?
Perhaps it would be interesting to at least do abdominal echogaphies to confirm
the progression of fatty liver at the same time as performing the indexes to
thereby support the importance of these indexes.
It is strange that the authors did not consider the use of abdominal echography
which is very usual, inexpensive and non invasive. The authors should address
these questions.
Discretionary Revisions
The authors show the incidence of diabetes at the end of the nine years of follow
up. Since the patients were examined every three years, I believe that it would
enrich the manuscript if the authors were to report the incidence of diabetes at
each visit.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Please review this paper.
user
Reviewer's report
Title:Nine-year incident diabetes is predicted by fatty liver indices: The French
D.E.S.I.R. study
Version: 1Date:26 February 2010
Reviewer: Llorenç Caballeria
Reviewer's report:
Overall this is a good article especially because of the size of the sample studied,
the years of follow up and the invasive approach of predicting diabetes and the
progression of fatty liver used.
There are, however, several considerations which should be addressed.
Major Compulsory Revisions
The authors conclude that the two indexes studied predict the incidence of
diabetes. However, I have doubts with respect to the utility of the HAFLD-FLS
index. The authors should clarify this aspect since the utility of this index is
limited by the inclusion of diabetes and fasting insulin in its definition. I do not
understand how the presence of diabetes can be predicted if being diabetic is
included in the definition.
In the limitations the authors recognize the absence of imaging tests for the
follow up of fatty liver. The doubts presented are: Is the determination of these
indexes sufficient to suspect the progression of fatty liver?
Perhaps it would be interesting to at least do abdominal echogaphies to confirm
the progression of fatty liver at the same time as performing the indexes to
thereby support the importance of these indexes.
It is strange that the authors did not consider the use of abdominal echography
which is very usual, inexpensive and non invasive. The authors should address
these questions.
Discretionary Revisions
The authors show the incidence of diabetes at the end of the nine years of follow
up. Since the patients were examined every three years, I believe that it would
enrich the manuscript if the authors were to report the incidence of diabetes at
each visit.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
assistant