Reviewer's report
Title:A simple index of lipid overaccumulation is a good marker of liver steatosis
Version: 2Date:13 July 2010
Reviewer: luigi adinolfi
Reviewer's report:
General comments
The authors performed this study to evaluated the ability of LAP index to identify
liver steatosis. They used the same study population from Northen Italian town
where FLI was developed. 588 subjects were included in the study. Liver
steatosis was evaluated by ultrasonography. A complicated statistical analysis
was used. In particular, an ordinal proportional-odds logistic regression model.
The OR of levels of different steatosis considered increased with the increasing
values of lnLAP. The authors conclusion was that LAP is an accurate approach
to individuate subjects with steatosis, expecially among male.
The study is of interest and may have some clinical application. However, some
points should be better clarify and the limitation should be better underlined.
Major Compulsory Revisions:
- LAP was originally developed as a marker of cardiometabolic risk. The authors
should better explain why they hypothesized that LAP could also individuate
subjects with steatosis and if they believed that LAP index is better/simpler than
FLI in individuate steatotic patients
- The data presented seem to indicate that LAP individuate very well subjects
with severe steatosis but do not discriminate between subjects with intermediate
steatosis and normal subjects. This point should be better clarify, also in
consideration of the low sensitivity of ultrasonographic in detecting liver steatosis
below 30%.
- The authors should clarify, in their experience, what means intermediate and
severe steatosis and if the two conditions are associated at different clinical
meaning.
Discretional revisions
- The authors should compared the accuracy of LAP and of FLI in predicting
ultrasonographic liver steatosis to individuate the best test to use in clinical
practice/epidemiologic studies.
- The sensitivity and specificity of LAP to individuate intermediate and severe
steatosis should be performed. A ROC analysis should be done. Cut off of LAP
to discriminate subjects with and without steatosis shoud be calculated
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Reviewer's report
Title:A simple index of lipid overaccumulation is a good marker of liver steatosis
Version: 2Date:13 July 2010
Reviewer: luigi adinolfi
Reviewer's report:
General comments
The authors performed this study to evaluated the ability of LAP index to identify
liver steatosis. They used the same study population from Northen Italian town
where FLI was developed. 588 subjects were included in the study. Liver
steatosis was evaluated by ultrasonography. A complicated statistical analysis
was used. In particular, an ordinal proportional-odds logistic regression model.
The OR of levels of different steatosis considered increased with the increasing
values of lnLAP. The authors conclusion was that LAP is an accurate approach
to individuate subjects with steatosis, expecially among male.
The study is of interest and may have some clinical application. However, some
points should be better clarify and the limitation should be better underlined.
Major Compulsory Revisions:
- LAP was originally developed as a marker of cardiometabolic risk. The authors
should better explain why they hypothesized that LAP could also individuate
subjects with steatosis and if they believed that LAP index is better/simpler than
FLI in individuate steatotic patients
- The data presented seem to indicate that LAP individuate very well subjects
with severe steatosis but do not discriminate between subjects with intermediate
steatosis and normal subjects. This point should be better clarify, also in
consideration of the low sensitivity of ultrasonographic in detecting liver steatosis
below 30%.
- The authors should clarify, in their experience, what means intermediate and
severe steatosis and if the two conditions are associated at different clinical
meaning.
Discretional revisions
- The authors should compared the accuracy of LAP and of FLI in predicting
ultrasonographic liver steatosis to individuate the best test to use in clinical
practice/epidemiologic studies.
- The sensitivity and specificity of LAP to individuate intermediate and severe
steatosis should be performed. A ROC analysis should be done. Cut off of LAP
to discriminate subjects with and without steatosis shoud be calculated
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Please review this paper.
user
Reviewer's report
Title:A simple index of lipid overaccumulation is a good marker of liver steatosis
Version: 2Date:13 July 2010
Reviewer: luigi adinolfi
Reviewer's report:
General comments
The authors performed this study to evaluated the ability of LAP index to identify
liver steatosis. They used the same study population from Northen Italian town
where FLI was developed. 588 subjects were included in the study. Liver
steatosis was evaluated by ultrasonography. A complicated statistical analysis
was used. In particular, an ordinal proportional-odds logistic regression model.
The OR of levels of different steatosis considered increased with the increasing
values of lnLAP. The authors conclusion was that LAP is an accurate approach
to individuate subjects with steatosis, expecially among male.
The study is of interest and may have some clinical application. However, some
points should be better clarify and the limitation should be better underlined.
Major Compulsory Revisions:
- LAP was originally developed as a marker of cardiometabolic risk. The authors
should better explain why they hypothesized that LAP could also individuate
subjects with steatosis and if they believed that LAP index is better/simpler than
FLI in individuate steatotic patients
- The data presented seem to indicate that LAP individuate very well subjects
with severe steatosis but do not discriminate between subjects with intermediate
steatosis and normal subjects. This point should be better clarify, also in
consideration of the low sensitivity of ultrasonographic in detecting liver steatosis
below 30%.
- The authors should clarify, in their experience, what means intermediate and
severe steatosis and if the two conditions are associated at different clinical
meaning.
Discretional revisions
- The authors should compared the accuracy of LAP and of FLI in predicting
ultrasonographic liver steatosis to individuate the best test to use in clinical
practice/epidemiologic studies.
- The sensitivity and specificity of LAP to individuate intermediate and severe
steatosis should be performed. A ROC analysis should be done. Cut off of LAP
to discriminate subjects with and without steatosis shoud be calculated
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
assistant