Reviewer's report
Title:A simple index of lipid overaccumulation is a good marker of liver steatosis
Version: 2Date:9 July 2010
Reviewer: Elisabetta E Bugianesi
Reviewer's report:
The manuscript by Bedogni et al is aimed at evaluating the effectiveness of LAP
(lipid accumulation product), an index of cardiometabolic risk factors, in
predicting liver steatosis.
The rationale of the study is based on the observation that the variables upon
which LAP is built (waist circumference and triglycerides levels) are also shared
by FLI, a validated index of fatty liver. LAP has been calculated in 588
participants of the Dionysos study, 305 cases with suspected liver disease (SLD)
and 283 age and sex-matched controls, and models have been built to predict
absence/intermediate/severe liver steatosis according to US.
The authors conclude that a model consisting of lnLAP and sex is able to detect
the presence and the severity of steatosis.
The current wide search of indices to predict fatty liver is motivated by the lack of
a serum marker that can easily identify it based on readily available
clinical/anthropometric measures.
This study further adds to this relevant topic, with the peculiar observation that
markers of cardiometabolic risk and of fatty liver are based on similar
parameters, thus supporting the hypothesis that steatosis and cardiovascular risk
share a common pathway.
Major comments:
1. The rationale of the study is mainly supported by the observation of coincident
parameters between FLIP and LAP, but it should be more clearly motivated in
terms of pathophysiological mechanisms of fatty liver and related metabolic
abnormalities. Waist circumference per se is able to identify a large percentage
of fatty liver, since both hepatic and visceral fat belong to the same “axis” of
central obesity
2. Limitations are clearly stated by the authors, however a cost-effectiveness
analysis of this index vs the US screening would be of interest.
3. Background, Page 6, lines 11-12: what do the authors mean by “because the
simple dichotomization of liver steatosis into fatty liver…”?
4. Why is dietary assessment mentioned? Was it used just for ethanol
consumption?
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:A simple index of lipid overaccumulation is a good marker of liver steatosis
Version: 2Date:9 July 2010
Reviewer: Elisabetta E Bugianesi
Reviewer's report:
The manuscript by Bedogni et al is aimed at evaluating the effectiveness of LAP
(lipid accumulation product), an index of cardiometabolic risk factors, in
predicting liver steatosis.
The rationale of the study is based on the observation that the variables upon
which LAP is built (waist circumference and triglycerides levels) are also shared
by FLI, a validated index of fatty liver. LAP has been calculated in 588
participants of the Dionysos study, 305 cases with suspected liver disease (SLD)
and 283 age and sex-matched controls, and models have been built to predict
absence/intermediate/severe liver steatosis according to US.
The authors conclude that a model consisting of lnLAP and sex is able to detect
the presence and the severity of steatosis.
The current wide search of indices to predict fatty liver is motivated by the lack of
a serum marker that can easily identify it based on readily available
clinical/anthropometric measures.
This study further adds to this relevant topic, with the peculiar observation that
markers of cardiometabolic risk and of fatty liver are based on similar
parameters, thus supporting the hypothesis that steatosis and cardiovascular risk
share a common pathway.
Major comments:
1. The rationale of the study is mainly supported by the observation of coincident
parameters between FLIP and LAP, but it should be more clearly motivated in
terms of pathophysiological mechanisms of fatty liver and related metabolic
abnormalities. Waist circumference per se is able to identify a large percentage
of fatty liver, since both hepatic and visceral fat belong to the same “axis” of
central obesity
2. Limitations are clearly stated by the authors, however a cost-effectiveness
analysis of this index vs the US screening would be of interest.
3. Background, Page 6, lines 11-12: what do the authors mean by “because the
simple dichotomization of liver steatosis into fatty liver…”?
4. Why is dietary assessment mentioned? Was it used just for ethanol
consumption?
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:A simple index of lipid overaccumulation is a good marker of liver steatosis
Version: 2Date:9 July 2010
Reviewer: Elisabetta E Bugianesi
Reviewer's report:
The manuscript by Bedogni et al is aimed at evaluating the effectiveness of LAP
(lipid accumulation product), an index of cardiometabolic risk factors, in
predicting liver steatosis.
The rationale of the study is based on the observation that the variables upon
which LAP is built (waist circumference and triglycerides levels) are also shared
by FLI, a validated index of fatty liver. LAP has been calculated in 588
participants of the Dionysos study, 305 cases with suspected liver disease (SLD)
and 283 age and sex-matched controls, and models have been built to predict
absence/intermediate/severe liver steatosis according to US.
The authors conclude that a model consisting of lnLAP and sex is able to detect
the presence and the severity of steatosis.
The current wide search of indices to predict fatty liver is motivated by the lack of
a serum marker that can easily identify it based on readily available
clinical/anthropometric measures.
This study further adds to this relevant topic, with the peculiar observation that
markers of cardiometabolic risk and of fatty liver are based on similar
parameters, thus supporting the hypothesis that steatosis and cardiovascular risk
share a common pathway.
Major comments:
1. The rationale of the study is mainly supported by the observation of coincident
parameters between FLIP and LAP, but it should be more clearly motivated in
terms of pathophysiological mechanisms of fatty liver and related metabolic
abnormalities. Waist circumference per se is able to identify a large percentage
of fatty liver, since both hepatic and visceral fat belong to the same “axis” of
central obesity
2. Limitations are clearly stated by the authors, however a cost-effectiveness
analysis of this index vs the US screening would be of interest.
3. Background, Page 6, lines 11-12: what do the authors mean by “because the
simple dichotomization of liver steatosis into fatty liver…”?
4. Why is dietary assessment mentioned? Was it used just for ethanol
consumption?
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
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