Reviewer's report 
 Serum leptin concentrations in chronic viral hepatitis: A clinical approach Title: 
 1  26 February 2007 Version: Date: 
 Manuel Romero-Gómez Reviewer: 
Reviewer's report: 
General Comments: 
This study attempts to analyze the relationship between serum leptin levels and fibrosis progression 
together with its impact on antiviral response. I have got several concerns: 
1.- The main weakness in this study is the low number of patients included. The authors must be 
encouraged to include a large cohort of chronic hepatitis B patients. 2.- As stated by authors, leptin level shows a gender based difference. Indeed, the relationship between leptin concentration and lamivudine response needs to be corrected by sex. 
3.- Although the authors tried to analyze separately both cohorts, some of the statistical analysis taking 
patients all together is not recommendable. In my opinion, the impact of leptin concentration on fibrosis and 
antiviral response needs to be addressed separately in each cohort. 
4.- I miss a reference to a previously reported paper about the impact of insulin resistance on sustained 
response in chronic hepatitis C (Romero-Gomez et al. Gastroenterology 2005). This article must be added 
and discussed. 
5.- Control group showed an average age older than patients group (62.5 vs. 45.5 in males and 53 vs. 38 in 
females). This bias could explain the lack of differences in insulin resistance between groups, owing to the 
fact that HOMA-IR increases with age. 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 Yes, and I have assessed the statistics in my report. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
Reviewer's report 
 Serum leptin concentrations in chronic viral hepatitis: A clinical approach Title: 
 1  26 February 2007 Version: Date: 
 Manuel Romero-Gómez Reviewer: 
Reviewer's report: 
General Comments: 
This study attempts to analyze the relationship between serum leptin levels and fibrosis progression 
together with its impact on antiviral response. I have got several concerns: 
1.- The main weakness in this study is the low number of patients included. The authors must be 
encouraged to include a large cohort of chronic hepatitis B patients. 2.- As stated by authors, leptin level shows a gender based difference. Indeed, the relationship between leptin concentration and lamivudine response needs to be corrected by sex. 
3.- Although the authors tried to analyze separately both cohorts, some of the statistical analysis taking 
patients all together is not recommendable. In my opinion, the impact of leptin concentration on fibrosis and 
antiviral response needs to be addressed separately in each cohort. 
4.- I miss a reference to a previously reported paper about the impact of insulin resistance on sustained 
response in chronic hepatitis C (Romero-Gomez et al. Gastroenterology 2005). This article must be added 
and discussed. 
5.- Control group showed an average age older than patients group (62.5 vs. 45.5 in males and 53 vs. 38 in 
females). This bias could explain the lack of differences in insulin resistance between groups, owing to the 
fact that HOMA-IR increases with age. 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 Yes, and I have assessed the statistics in my report. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
Please review this paper.
user
Reviewer's report 
 Serum leptin concentrations in chronic viral hepatitis: A clinical approach Title: 
 1  26 February 2007 Version: Date: 
 Manuel Romero-Gómez Reviewer: 
Reviewer's report: 
General Comments: 
This study attempts to analyze the relationship between serum leptin levels and fibrosis progression 
together with its impact on antiviral response. I have got several concerns: 
1.- The main weakness in this study is the low number of patients included. The authors must be 
encouraged to include a large cohort of chronic hepatitis B patients. 2.- As stated by authors, leptin level shows a gender based difference. Indeed, the relationship between leptin concentration and lamivudine response needs to be corrected by sex. 
3.- Although the authors tried to analyze separately both cohorts, some of the statistical analysis taking 
patients all together is not recommendable. In my opinion, the impact of leptin concentration on fibrosis and 
antiviral response needs to be addressed separately in each cohort. 
4.- I miss a reference to a previously reported paper about the impact of insulin resistance on sustained 
response in chronic hepatitis C (Romero-Gomez et al. Gastroenterology 2005). This article must be added 
and discussed. 
5.- Control group showed an average age older than patients group (62.5 vs. 45.5 in males and 53 vs. 38 in 
females). This bias could explain the lack of differences in insulin resistance between groups, owing to the 
fact that HOMA-IR increases with age. 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 Yes, and I have assessed the statistics in my report. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
assistant