Reviewer's report
Title:NOX2-generated oxidative stress is associated with severity of ultrasound
liver steatosis in patients with non-alcoholic fatty liver disease
Version:3Date:20 December 2013
Reviewer: Sven Francque
Reviewer's report:
Major Compulsory Revisions
The authors report on the parameters of oxidative stress in patients with NAFLD.
The question is relevant. The paper is well written and nice to read. Methodology
is overall well-elaborated and adequate.
Some issues need to be addressed:
According to the correlation table, the urinary PGF2alpha strongly correlates with
BMI and inversely with adiponectin, but to a lesser extent with the US Hamaguchi
score. In the regression analysis looking at the dichotomous question NAFLD vs.
no NAFLD, BMI appears not to be an independent variable.
This asks for some comments:
First NAFLD is not always NASH, and in terms of inflammation and disease,
NASH is considered more dangerous than simple steatosis. The question is
whether we expect oxidative stress to be increased in a patient with mild
steatosis and without steatohepatitis. So the question remains whether we want
to oppose NAFLD vs. no NAFLD (which means that mild degrees of steatosis are
also included) or whether the relationship with the severity of the steatosis is
more relevant. So I would like to see a regression analysis assessing factors
independently related to the severity of the NAFLD, and a regression analysis
assessing factors independently related to the degree of oxidative stress as
based on the parameters used in this paper.
Furthermore non-invasive scores for the diagnosis and severity of NASH and
fibrosis. Most of these scores can be calculated with the parameters that were
recorded in these patients. I would therefore like to see an analysis in relation to
these scores, and a comparison nash vs. no nash (it can be argued that, as there
is no biopsy as golden standard, these scores can be used (with all their inherent
limitations)).
It would also be nice to include waist in the analyses, as visceral obesity seems
to be more relevant than just the BMI.
The question remains unanswered, as this is a cross-sectional analysis (this
should clearly be discussed by the authors) whether oxidative stress, caused by
obesity, contributes to the pathophysiology of NAFLD (or perhaps more NASH)
or whether the inflamed liver contributes to the oxidative stress (and hence long
term complications).
Discretionary Revisions
A minor remark: overall the paper is very well written, but some of the tables
need some correction (cytocheratin 18 e.g.).
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 declare that I have no competing interests
Reviewer's report
Title:NOX2-generated oxidative stress is associated with severity of ultrasound
liver steatosis in patients with non-alcoholic fatty liver disease
Version:3Date:20 December 2013
Reviewer: Sven Francque
Reviewer's report:
Major Compulsory Revisions
The authors report on the parameters of oxidative stress in patients with NAFLD.
The question is relevant. The paper is well written and nice to read. Methodology
is overall well-elaborated and adequate.
Some issues need to be addressed:
According to the correlation table, the urinary PGF2alpha strongly correlates with
BMI and inversely with adiponectin, but to a lesser extent with the US Hamaguchi
score. In the regression analysis looking at the dichotomous question NAFLD vs.
no NAFLD, BMI appears not to be an independent variable.
This asks for some comments:
First NAFLD is not always NASH, and in terms of inflammation and disease,
NASH is considered more dangerous than simple steatosis. The question is
whether we expect oxidative stress to be increased in a patient with mild
steatosis and without steatohepatitis. So the question remains whether we want
to oppose NAFLD vs. no NAFLD (which means that mild degrees of steatosis are
also included) or whether the relationship with the severity of the steatosis is
more relevant. So I would like to see a regression analysis assessing factors
independently related to the severity of the NAFLD, and a regression analysis
assessing factors independently related to the degree of oxidative stress as
based on the parameters used in this paper.
Furthermore non-invasive scores for the diagnosis and severity of NASH and
fibrosis. Most of these scores can be calculated with the parameters that were
recorded in these patients. I would therefore like to see an analysis in relation to
these scores, and a comparison nash vs. no nash (it can be argued that, as there
is no biopsy as golden standard, these scores can be used (with all their inherent
limitations)).
It would also be nice to include waist in the analyses, as visceral obesity seems
to be more relevant than just the BMI.
The question remains unanswered, as this is a cross-sectional analysis (this
should clearly be discussed by the authors) whether oxidative stress, caused by
obesity, contributes to the pathophysiology of NAFLD (or perhaps more NASH)
or whether the inflamed liver contributes to the oxidative stress (and hence long
term complications).
Discretionary Revisions
A minor remark: overall the paper is very well written, but some of the tables
need some correction (cytocheratin 18 e.g.).
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 declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:NOX2-generated oxidative stress is associated with severity of ultrasound
liver steatosis in patients with non-alcoholic fatty liver disease
Version:3Date:20 December 2013
Reviewer: Sven Francque
Reviewer's report:
Major Compulsory Revisions
The authors report on the parameters of oxidative stress in patients with NAFLD.
The question is relevant. The paper is well written and nice to read. Methodology
is overall well-elaborated and adequate.
Some issues need to be addressed:
According to the correlation table, the urinary PGF2alpha strongly correlates with
BMI and inversely with adiponectin, but to a lesser extent with the US Hamaguchi
score. In the regression analysis looking at the dichotomous question NAFLD vs.
no NAFLD, BMI appears not to be an independent variable.
This asks for some comments:
First NAFLD is not always NASH, and in terms of inflammation and disease,
NASH is considered more dangerous than simple steatosis. The question is
whether we expect oxidative stress to be increased in a patient with mild
steatosis and without steatohepatitis. So the question remains whether we want
to oppose NAFLD vs. no NAFLD (which means that mild degrees of steatosis are
also included) or whether the relationship with the severity of the steatosis is
more relevant. So I would like to see a regression analysis assessing factors
independently related to the severity of the NAFLD, and a regression analysis
assessing factors independently related to the degree of oxidative stress as
based on the parameters used in this paper.
Furthermore non-invasive scores for the diagnosis and severity of NASH and
fibrosis. Most of these scores can be calculated with the parameters that were
recorded in these patients. I would therefore like to see an analysis in relation to
these scores, and a comparison nash vs. no nash (it can be argued that, as there
is no biopsy as golden standard, these scores can be used (with all their inherent
limitations)).
It would also be nice to include waist in the analyses, as visceral obesity seems
to be more relevant than just the BMI.
The question remains unanswered, as this is a cross-sectional analysis (this
should clearly be discussed by the authors) whether oxidative stress, caused by
obesity, contributes to the pathophysiology of NAFLD (or perhaps more NASH)
or whether the inflamed liver contributes to the oxidative stress (and hence long
term complications).
Discretionary Revisions
A minor remark: overall the paper is very well written, but some of the tables
need some correction (cytocheratin 18 e.g.).
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 declare that I have no competing interests
assistant