Reviewer's report
Title:Visceral Obesity and the Risk of Barrett's Esophagus in Japanese Patients
with Non-alcoholic Fatty Liver Disease
Version: 1Date:3 May 2009
Reviewer: Yoshihisa URITA
Reviewer's report:
Dear Dr. Akiyama,
Your manuscript entitled “Visceral obesity and the risk of Barrett’s esophagus in
Japanese patients with non-alcoholic liver disease” has been reviewed. The
authors conclude that the existence of a significant association between visceral
obesity, as measured on abdominal CT images, and the risk of BE in a Japanese
population with NAFLD. However, I don not accept that their conclusions are
valid although this manuscript provides some interesting results. This paper has
some problems revised.
1. 172 consecutive NAFLD patients (86 men and 86 women) who underwent
both endoscopy and abdominal CT were recruited in this study. BMI ranged from
16.7 to 43.6. A patient with a BMI of 16.7 is considered as skinny, and might
have a different mechanism of developing fatty liver disease from an obese
patient. The author should analyze after separating skinny patients from obese
ones.
2. The author should describe the patients taking drugs that have the possibility
of modification to LES pressure as a consequence of medication such as Ca
channel blockers. Patients with metabolic syndrome are frequently suffering from
hypertension.
3. Why was NAFLD diagnosed according to the ultrasonographic findings? It is
because all patients underwent abdominal CT. We sometimes experienced the
NAFLD patient with different diagnosis by the method using US and CT. I think
that abdominal CT is superior to the diagnostic ability compared to US.
4. On the result section, it was described that VAT (OR, 1.007; 95% CI,
1.000-1.015) showed an independently significant association with the risk of BE.
Is this a true? When OR was 1.007, this value may not be considered as
statistically significant.
5. Do the author think whether the same conclusions may be drawn after patients
with ALD are included? Or, is a significant association between visceral obesity
and the risk of BE limited to NAFLD? The author should describe this point on
the Discussion section.
I believe that you can modify your paper by considering the above-mentioned
comments to make this paper into better form. Major Compulsory Revisions are
required.
Yours sincerely,
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Reviewer's report
Title:Visceral Obesity and the Risk of Barrett's Esophagus in Japanese Patients
with Non-alcoholic Fatty Liver Disease
Version: 1Date:3 May 2009
Reviewer: Yoshihisa URITA
Reviewer's report:
Dear Dr. Akiyama,
Your manuscript entitled “Visceral obesity and the risk of Barrett’s esophagus in
Japanese patients with non-alcoholic liver disease” has been reviewed. The
authors conclude that the existence of a significant association between visceral
obesity, as measured on abdominal CT images, and the risk of BE in a Japanese
population with NAFLD. However, I don not accept that their conclusions are
valid although this manuscript provides some interesting results. This paper has
some problems revised.
1. 172 consecutive NAFLD patients (86 men and 86 women) who underwent
both endoscopy and abdominal CT were recruited in this study. BMI ranged from
16.7 to 43.6. A patient with a BMI of 16.7 is considered as skinny, and might
have a different mechanism of developing fatty liver disease from an obese
patient. The author should analyze after separating skinny patients from obese
ones.
2. The author should describe the patients taking drugs that have the possibility
of modification to LES pressure as a consequence of medication such as Ca
channel blockers. Patients with metabolic syndrome are frequently suffering from
hypertension.
3. Why was NAFLD diagnosed according to the ultrasonographic findings? It is
because all patients underwent abdominal CT. We sometimes experienced the
NAFLD patient with different diagnosis by the method using US and CT. I think
that abdominal CT is superior to the diagnostic ability compared to US.
4. On the result section, it was described that VAT (OR, 1.007; 95% CI,
1.000-1.015) showed an independently significant association with the risk of BE.
Is this a true? When OR was 1.007, this value may not be considered as
statistically significant.
5. Do the author think whether the same conclusions may be drawn after patients
with ALD are included? Or, is a significant association between visceral obesity
and the risk of BE limited to NAFLD? The author should describe this point on
the Discussion section.
I believe that you can modify your paper by considering the above-mentioned
comments to make this paper into better form. Major Compulsory Revisions are
required.
Yours sincerely,
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Please review this paper.
user
Reviewer's report
Title:Visceral Obesity and the Risk of Barrett's Esophagus in Japanese Patients
with Non-alcoholic Fatty Liver Disease
Version: 1Date:3 May 2009
Reviewer: Yoshihisa URITA
Reviewer's report:
Dear Dr. Akiyama,
Your manuscript entitled “Visceral obesity and the risk of Barrett’s esophagus in
Japanese patients with non-alcoholic liver disease” has been reviewed. The
authors conclude that the existence of a significant association between visceral
obesity, as measured on abdominal CT images, and the risk of BE in a Japanese
population with NAFLD. However, I don not accept that their conclusions are
valid although this manuscript provides some interesting results. This paper has
some problems revised.
1. 172 consecutive NAFLD patients (86 men and 86 women) who underwent
both endoscopy and abdominal CT were recruited in this study. BMI ranged from
16.7 to 43.6. A patient with a BMI of 16.7 is considered as skinny, and might
have a different mechanism of developing fatty liver disease from an obese
patient. The author should analyze after separating skinny patients from obese
ones.
2. The author should describe the patients taking drugs that have the possibility
of modification to LES pressure as a consequence of medication such as Ca
channel blockers. Patients with metabolic syndrome are frequently suffering from
hypertension.
3. Why was NAFLD diagnosed according to the ultrasonographic findings? It is
because all patients underwent abdominal CT. We sometimes experienced the
NAFLD patient with different diagnosis by the method using US and CT. I think
that abdominal CT is superior to the diagnostic ability compared to US.
4. On the result section, it was described that VAT (OR, 1.007; 95% CI,
1.000-1.015) showed an independently significant association with the risk of BE.
Is this a true? When OR was 1.007, this value may not be considered as
statistically significant.
5. Do the author think whether the same conclusions may be drawn after patients
with ALD are included? Or, is a significant association between visceral obesity
and the risk of BE limited to NAFLD? The author should describe this point on
the Discussion section.
I believe that you can modify your paper by considering the above-mentioned
comments to make this paper into better form. Major Compulsory Revisions are
required.
Yours sincerely,
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
assistant