Reviewer ’s report  
 
Title: Elevated serum triglyceride and low -density lipoprotein cho lesterol promotes the 
formation of colorectal polyps  
 
Version: 2 Date: 10 Jun 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear o bjective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
No - there are major issues  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the result s? 
 
No - there are major issues  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
No - there are issues with the statistics in the study  
 
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
 
No - there are major issues  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make  the work technically sound?  
 
Maybe - with major revisions  
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: The study needs major revision both in design and in data analysis 
and presentation.  
 
 
REQUESTED REVISIONS:  
 
First in the introduction, the TLR5 and gut microbiome parts are irrelevant to this study. The 
authors are citing only 20 references in a field where there are hundreds of directly relevant 
studies that could have enriched the paper. In the methods section, I do NOT think it is 
appropriate to includ e any patients who are taking medications to control blood lipid levels. 
Moreover, including such patients after they stop taking medications for 2 weeks before 
colonoscopy creates a non relevant patient for this study and generates bias. If blood lipids a re 
affecting colon neoplasia, and they are, this is a long term process.  In the results section, the 
statistical relevant data are NOT correctly highlighted. In Table 1, a subheading is missing for 
the columns. In Table 2 and 3 , what are the p values cor responding to, Controls vs. ALL patients 
OR Controls vs. Which subgroup of patients?  While the authors stated twice that a combination 
of the two markers might improve outcome, they should run that analysis combining both 
markers and give Area Under the C urve for that along with specificity and sensitivity for 
combined markers? Discussion can be improved. No discussion related to smoking and drinking 
was given even though it is stated in Methods.  
 
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
 
Many grammatical issues t hat need to be addressed as well.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the  manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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 receiv ed 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 your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution Lic ense 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 comme nts 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Elevated serum triglyceride and low -density lipoprotein cho lesterol promotes the 
formation of colorectal polyps  
 
Version: 2 Date: 10 Jun 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear o bjective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
No - there are major issues  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the result s? 
 
No - there are major issues  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
No - there are issues with the statistics in the study  
 
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
 
No - there are major issues  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make  the work technically sound?  
 
Maybe - with major revisions  
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: The study needs major revision both in design and in data analysis 
and presentation.  
 
 
REQUESTED REVISIONS:  
 
First in the introduction, the TLR5 and gut microbiome parts are irrelevant to this study. The 
authors are citing only 20 references in a field where there are hundreds of directly relevant 
studies that could have enriched the paper. In the methods section, I do NOT think it is 
appropriate to includ e any patients who are taking medications to control blood lipid levels. 
Moreover, including such patients after they stop taking medications for 2 weeks before 
colonoscopy creates a non relevant patient for this study and generates bias. If blood lipids a re 
affecting colon neoplasia, and they are, this is a long term process.  In the results section, the 
statistical relevant data are NOT correctly highlighted. In Table 1, a subheading is missing for 
the columns. In Table 2 and 3 , what are the p values cor responding to, Controls vs. ALL patients 
OR Controls vs. Which subgroup of patients?  While the authors stated twice that a combination 
of the two markers might improve outcome, they should run that analysis combining both 
markers and give Area Under the C urve for that along with specificity and sensitivity for 
combined markers? Discussion can be improved. No discussion related to smoking and drinking 
was given even though it is stated in Methods.  
 
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
 
Many grammatical issues t hat need to be addressed as well.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the  manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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 receiv ed 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 your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution Lic ense 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 comme nts 
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: Elevated serum triglyceride and low -density lipoprotein cho lesterol promotes the 
formation of colorectal polyps  
 
Version: 2 Date: 10 Jun 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear o bjective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
No - there are major issues  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the result s? 
 
No - there are major issues  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
No - there are issues with the statistics in the study  
 
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
 
No - there are major issues  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make  the work technically sound?  
 
Maybe - with major revisions  
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: The study needs major revision both in design and in data analysis 
and presentation.  
 
 
REQUESTED REVISIONS:  
 
First in the introduction, the TLR5 and gut microbiome parts are irrelevant to this study. The 
authors are citing only 20 references in a field where there are hundreds of directly relevant 
studies that could have enriched the paper. In the methods section, I do NOT think it is 
appropriate to includ e any patients who are taking medications to control blood lipid levels. 
Moreover, including such patients after they stop taking medications for 2 weeks before 
colonoscopy creates a non relevant patient for this study and generates bias. If blood lipids a re 
affecting colon neoplasia, and they are, this is a long term process.  In the results section, the 
statistical relevant data are NOT correctly highlighted. In Table 1, a subheading is missing for 
the columns. In Table 2 and 3 , what are the p values cor responding to, Controls vs. ALL patients 
OR Controls vs. Which subgroup of patients?  While the authors stated twice that a combination 
of the two markers might improve outcome, they should run that analysis combining both 
markers and give Area Under the C urve for that along with specificity and sensitivity for 
combined markers? Discussion can be improved. No discussion related to smoking and drinking 
was given even though it is stated in Methods.  
 
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
 
Many grammatical issues t hat need to be addressed as well.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the  manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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 receiv ed 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 your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution Lic ense 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 comme nts 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant