Title: The association between hemoglobin level and sarcopenia in Chinese patients with
Crohn's disease
Version: 0 Date: 17 Dec 2023
Reviewer's report:
The topic is clinically relevant; however, it lacks significant insights in a clinical context,
practical implications, and novel contributions to Crohn's disease management. Furthermore,
the retrospective design of the study, conducted at a single tertiary referral center, limits the
generalizability of the results to the total IBD population.
Firstly, the assessment of sarcopenia is incomplete. The authors should familiarize themselves
with the current recommendations within the clinical algorithm used for sarcopenia (https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6322506/), which indicates that three elements should
be assessed to diagnose sarcopenia: muscle strength, muscle quantity, and physical performance.
Without evaluating all three elements, proper diagnosis of sarcopenia is not possible. The authors
only assessed one of the required elements, so they cannot claim to have diagnosed sarcopenia
based solely on that element.
Indeed, measuring sarcopenia can be challenging, with limitations in accessibility, including
the need for specialized staff, cost, and time. Please include a comment in the discussion
on inexpensive and easily administered point-of-care tests to implement the assessment of
sarcopenia as standards of care for risk stratification in inflammatory bowel disease (Nardone
OM, 10.1016/j.dld.2023.04.014).
The authors mentioned that the exact mechanism of sarcopenia remains unknown. However,
factors such as aging, inflammation, mitochondrial dysfunction, insulin resistance, and gut
microbiota are related to sarcopenia. Please include a comment on this.
Both persistent chronic inflammation and malnutrition collaboratively predispose patients with
inflammatory bowel disease (IBD) to the development of sarcopenia. It may be important to
include data about BMI and the clinical activity of the disease (HBI clinical score).
The authors wrote about endoscopic granuloma detection. Granuloma detection is generally a
histologic feature. How can the authors assess it using endoscopy? Please clarify and explain
this point.
Unfortunately, in its current form, the manuscript is marred by several grammatical slips and
stylistically cumbersome passages.
The references should be updated. Recent data has shown the association between extra-
intestinal manifestations and sarcopenia in CD.
Title: The association between hemoglobin level and sarcopenia in Chinese patients with
Crohn's disease
Version: 0 Date: 17 Dec 2023
Reviewer's report:
The topic is clinically relevant; however, it lacks significant insights in a clinical context,
practical implications, and novel contributions to Crohn's disease management. Furthermore,
the retrospective design of the study, conducted at a single tertiary referral center, limits the
generalizability of the results to the total IBD population.
Firstly, the assessment of sarcopenia is incomplete. The authors should familiarize themselves
with the current recommendations within the clinical algorithm used for sarcopenia (https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6322506/), which indicates that three elements should
be assessed to diagnose sarcopenia: muscle strength, muscle quantity, and physical performance.
Without evaluating all three elements, proper diagnosis of sarcopenia is not possible. The authors
only assessed one of the required elements, so they cannot claim to have diagnosed sarcopenia
based solely on that element.
Indeed, measuring sarcopenia can be challenging, with limitations in accessibility, including
the need for specialized staff, cost, and time. Please include a comment in the discussion
on inexpensive and easily administered point-of-care tests to implement the assessment of
sarcopenia as standards of care for risk stratification in inflammatory bowel disease (Nardone
OM, 10.1016/j.dld.2023.04.014).
The authors mentioned that the exact mechanism of sarcopenia remains unknown. However,
factors such as aging, inflammation, mitochondrial dysfunction, insulin resistance, and gut
microbiota are related to sarcopenia. Please include a comment on this.
Both persistent chronic inflammation and malnutrition collaboratively predispose patients with
inflammatory bowel disease (IBD) to the development of sarcopenia. It may be important to
include data about BMI and the clinical activity of the disease (HBI clinical score).
The authors wrote about endoscopic granuloma detection. Granuloma detection is generally a
histologic feature. How can the authors assess it using endoscopy? Please clarify and explain
this point.
Unfortunately, in its current form, the manuscript is marred by several grammatical slips and
stylistically cumbersome passages.
The references should be updated. Recent data has shown the association between extra-
intestinal manifestations and sarcopenia in CD.
Please review this paper.
user
Title: The association between hemoglobin level and sarcopenia in Chinese patients with
Crohn's disease
Version: 0 Date: 17 Dec 2023
Reviewer's report:
The topic is clinically relevant; however, it lacks significant insights in a clinical context,
practical implications, and novel contributions to Crohn's disease management. Furthermore,
the retrospective design of the study, conducted at a single tertiary referral center, limits the
generalizability of the results to the total IBD population.
Firstly, the assessment of sarcopenia is incomplete. The authors should familiarize themselves
with the current recommendations within the clinical algorithm used for sarcopenia (https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6322506/), which indicates that three elements should
be assessed to diagnose sarcopenia: muscle strength, muscle quantity, and physical performance.
Without evaluating all three elements, proper diagnosis of sarcopenia is not possible. The authors
only assessed one of the required elements, so they cannot claim to have diagnosed sarcopenia
based solely on that element.
Indeed, measuring sarcopenia can be challenging, with limitations in accessibility, including
the need for specialized staff, cost, and time. Please include a comment in the discussion
on inexpensive and easily administered point-of-care tests to implement the assessment of
sarcopenia as standards of care for risk stratification in inflammatory bowel disease (Nardone
OM, 10.1016/j.dld.2023.04.014).
The authors mentioned that the exact mechanism of sarcopenia remains unknown. However,
factors such as aging, inflammation, mitochondrial dysfunction, insulin resistance, and gut
microbiota are related to sarcopenia. Please include a comment on this.
Both persistent chronic inflammation and malnutrition collaboratively predispose patients with
inflammatory bowel disease (IBD) to the development of sarcopenia. It may be important to
include data about BMI and the clinical activity of the disease (HBI clinical score).
The authors wrote about endoscopic granuloma detection. Granuloma detection is generally a
histologic feature. How can the authors assess it using endoscopy? Please clarify and explain
this point.
Unfortunately, in its current form, the manuscript is marred by several grammatical slips and
stylistically cumbersome passages.
The references should be updated. Recent data has shown the association between extra-
intestinal manifestations and sarcopenia in CD.
assistant