Reviewer's report
Title:Estradiol deficiency in men with Crohn's disease is not associated with
reduced bone mineral density
Version: 1Date:6 August 2008
Reviewer: Ebbe Langholz
Reviewer's report:
From the literature it seems that low estrogen levels in men result in higher bone
turnover and greater bone loss over time.
The objective of the present study was to assess if hormonal deficiencies are
frequent among male Crohn´s disease patients and are to be considered as risk
factors for bone loss.
An altered hormone status was found but there was no clear interrelation to bone
density and turnover. However, steroid use was clearly associated with
osteoporosis and osteopenia
- Major Compulsory Revisions
1)
The question that arises when reading the manuscript is: Could the low E2 levels
be considered as a surrogate marker for steroid treatment since steroid treatment
could influence the E2 level and should the results be considered as confounding
due to steroid treatment ?.
This will need to be discussed.
I would suggest a Table comparing three different groups
Current steroid users +E2 levels
Previous steroid users + E2 levels
Never steroid user + E2 levels
2)
Another possibility could be that the disease activity could account for the low E2
levels in patients.
Have the authors considered the possibility of constructing a correlation plot
between E2 and CDAI and not only as a group comparison of values of E2 < 21
and >24 pg/ml?
- Minor Essential Revisions
All results should be given as median and range, since none of the data are
distributed according a normal distribution.
For example Age. Results are presented as median +SD and range. I think that
the SD should be omitted and results should simply be expressed as median and
interpercentile range. The use of SD is confusing.
Usually 95 % of observations can be described by mean +/- 2SD which in this
case would indicate that patients are between 10.2 years and 59.8 years, which
then is in conflict with inclusion criteria.
- Discretionary Revisions
None
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests
Reviewer's report
Title:Estradiol deficiency in men with Crohn's disease is not associated with
reduced bone mineral density
Version: 1Date:6 August 2008
Reviewer: Ebbe Langholz
Reviewer's report:
From the literature it seems that low estrogen levels in men result in higher bone
turnover and greater bone loss over time.
The objective of the present study was to assess if hormonal deficiencies are
frequent among male Crohn´s disease patients and are to be considered as risk
factors for bone loss.
An altered hormone status was found but there was no clear interrelation to bone
density and turnover. However, steroid use was clearly associated with
osteoporosis and osteopenia
- Major Compulsory Revisions
1)
The question that arises when reading the manuscript is: Could the low E2 levels
be considered as a surrogate marker for steroid treatment since steroid treatment
could influence the E2 level and should the results be considered as confounding
due to steroid treatment ?.
This will need to be discussed.
I would suggest a Table comparing three different groups
Current steroid users +E2 levels
Previous steroid users + E2 levels
Never steroid user + E2 levels
2)
Another possibility could be that the disease activity could account for the low E2
levels in patients.
Have the authors considered the possibility of constructing a correlation plot
between E2 and CDAI and not only as a group comparison of values of E2 < 21
and >24 pg/ml?
- Minor Essential Revisions
All results should be given as median and range, since none of the data are
distributed according a normal distribution.
For example Age. Results are presented as median +SD and range. I think that
the SD should be omitted and results should simply be expressed as median and
interpercentile range. The use of SD is confusing.
Usually 95 % of observations can be described by mean +/- 2SD which in this
case would indicate that patients are between 10.2 years and 59.8 years, which
then is in conflict with inclusion criteria.
- Discretionary Revisions
None
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Estradiol deficiency in men with Crohn's disease is not associated with
reduced bone mineral density
Version: 1Date:6 August 2008
Reviewer: Ebbe Langholz
Reviewer's report:
From the literature it seems that low estrogen levels in men result in higher bone
turnover and greater bone loss over time.
The objective of the present study was to assess if hormonal deficiencies are
frequent among male Crohn´s disease patients and are to be considered as risk
factors for bone loss.
An altered hormone status was found but there was no clear interrelation to bone
density and turnover. However, steroid use was clearly associated with
osteoporosis and osteopenia
- Major Compulsory Revisions
1)
The question that arises when reading the manuscript is: Could the low E2 levels
be considered as a surrogate marker for steroid treatment since steroid treatment
could influence the E2 level and should the results be considered as confounding
due to steroid treatment ?.
This will need to be discussed.
I would suggest a Table comparing three different groups
Current steroid users +E2 levels
Previous steroid users + E2 levels
Never steroid user + E2 levels
2)
Another possibility could be that the disease activity could account for the low E2
levels in patients.
Have the authors considered the possibility of constructing a correlation plot
between E2 and CDAI and not only as a group comparison of values of E2 < 21
and >24 pg/ml?
- Minor Essential Revisions
All results should be given as median and range, since none of the data are
distributed according a normal distribution.
For example Age. Results are presented as median +SD and range. I think that
the SD should be omitted and results should simply be expressed as median and
interpercentile range. The use of SD is confusing.
Usually 95 % of observations can be described by mean +/- 2SD which in this
case would indicate that patients are between 10.2 years and 59.8 years, which
then is in conflict with inclusion criteria.
- Discretionary Revisions
None
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests
assistant