Reviewer ’s report  
 
Title: PREVALENCE OF AND RISK FACTORS FOR FATTY LIVER IN THE GENERAL 
POPULATION OF NORTHERN ITALY: THE BAGNACAVALLO STUDY  
 
Version: 1 Date: 07 May 2 018 
 
Reviewer: Alfredo Di Leo  
 
Reviewer's report:  
 
Foschi et al performed a large cohort study on about 4000 Italian patients in a single city, with 
the aim of estimating the global prevalence of fatty liver disease (FLD) and associated factors.  
The most important flaw of this manuscript is that the logistic regression in table 2 was 
performed in both patients with AFLD and NAFLD, which are two diseases with different 
etiologies and different na tural history. The fact that alcoholic intake was kept into account in 
some models does not counterpoise this drawback. Therefore, that analysis should be performed 
separately for AFLD and NAFLD.  
 
Other comments:  
There are too many abbreviations. I suggest to use full spelling for some of these such as SLD, 
DN&L and BCV.  
In ALE+ and ALE - population, the presence of HBV or HCV was 4.1% and 1.1% respectively. 
Was this difference statistically significant?  
Table 1: the sum of patients according to fatty liver d egree is inferior to the total number of 
patients with FL: does this mean that in some cases it was not possible to establish the degree of 
FL severity? An explanation is necessary.  
Page 14 lines 46 -56: please report the p value of the comparison 74% vs 35 % (this detail has 
been reported in table 1, but should be enclosed as well in the main text).  
Supplementary figures 1 and 2 are very important and should be embedded in the main text. 
They could be unified in a single figure with two panels (a and b).  
Are the methods appropriate and well described?  
If not, please s pecify what is required in your comments to the authors.  
 
Yes 
  
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data sh own?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspect s require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declarati on of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If you r reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/ licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: PREVALENCE OF AND RISK FACTORS FOR FATTY LIVER IN THE GENERAL 
POPULATION OF NORTHERN ITALY: THE BAGNACAVALLO STUDY  
 
Version: 1 Date: 07 May 2 018 
 
Reviewer: Alfredo Di Leo  
 
Reviewer's report:  
 
Foschi et al performed a large cohort study on about 4000 Italian patients in a single city, with 
the aim of estimating the global prevalence of fatty liver disease (FLD) and associated factors.  
The most important flaw of this manuscript is that the logistic regression in table 2 was 
performed in both patients with AFLD and NAFLD, which are two diseases with different 
etiologies and different na tural history. The fact that alcoholic intake was kept into account in 
some models does not counterpoise this drawback. Therefore, that analysis should be performed 
separately for AFLD and NAFLD.  
 
Other comments:  
There are too many abbreviations. I suggest to use full spelling for some of these such as SLD, 
DN&L and BCV.  
In ALE+ and ALE - population, the presence of HBV or HCV was 4.1% and 1.1% respectively. 
Was this difference statistically significant?  
Table 1: the sum of patients according to fatty liver d egree is inferior to the total number of 
patients with FL: does this mean that in some cases it was not possible to establish the degree of 
FL severity? An explanation is necessary.  
Page 14 lines 46 -56: please report the p value of the comparison 74% vs 35 % (this detail has 
been reported in table 1, but should be enclosed as well in the main text).  
Supplementary figures 1 and 2 are very important and should be embedded in the main text. 
They could be unified in a single figure with two panels (a and b).  
Are the methods appropriate and well described?  
If not, please s pecify what is required in your comments to the authors.  
 
Yes 
  
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data sh own?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspect s require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declarati on of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If you r reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/ licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: PREVALENCE OF AND RISK FACTORS FOR FATTY LIVER IN THE GENERAL 
POPULATION OF NORTHERN ITALY: THE BAGNACAVALLO STUDY  
 
Version: 1 Date: 07 May 2 018 
 
Reviewer: Alfredo Di Leo  
 
Reviewer's report:  
 
Foschi et al performed a large cohort study on about 4000 Italian patients in a single city, with 
the aim of estimating the global prevalence of fatty liver disease (FLD) and associated factors.  
The most important flaw of this manuscript is that the logistic regression in table 2 was 
performed in both patients with AFLD and NAFLD, which are two diseases with different 
etiologies and different na tural history. The fact that alcoholic intake was kept into account in 
some models does not counterpoise this drawback. Therefore, that analysis should be performed 
separately for AFLD and NAFLD.  
 
Other comments:  
There are too many abbreviations. I suggest to use full spelling for some of these such as SLD, 
DN&L and BCV.  
In ALE+ and ALE - population, the presence of HBV or HCV was 4.1% and 1.1% respectively. 
Was this difference statistically significant?  
Table 1: the sum of patients according to fatty liver d egree is inferior to the total number of 
patients with FL: does this mean that in some cases it was not possible to establish the degree of 
FL severity? An explanation is necessary.  
Page 14 lines 46 -56: please report the p value of the comparison 74% vs 35 % (this detail has 
been reported in table 1, but should be enclosed as well in the main text).  
Supplementary figures 1 and 2 are very important and should be embedded in the main text. 
They could be unified in a single figure with two panels (a and b).  
Are the methods appropriate and well described?  
If not, please s pecify what is required in your comments to the authors.  
 
Yes 
  
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data sh own?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspect s require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declarati on of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If you r reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/ licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant