Title: Association between non-insulin-based insulin resistance surrogate makers and
Helicobacter pylori infection: a population-based study
Version: 0 Date: 01 Dec 2024
Reviewer's report:
In this study, Jiayu Qiu et al reported the associations between three non-insulin-based markers
(TG glucose index, TG/HDL ratio, MetS-IR) and H pylori infection. They used the National
Health and Nutrition Examination Survey (NHANES) 1999-2000 data and logistic regression
model, restricted cubic spline (RCS) curve and subgroup analysis to perform the analyses. They
found all the three non-insulin-based IR surrogate markers were all positively associated with H.
pylori infection in US populations. This is an interesting study. However, I have some questions:
1. The associations between H pylori infection and insulin resistance (IR), cardiovascular
diseases have been reported in many previous studies. The current study found the same
association between IR and H pylori infection by using the non-insulin-based surrogate markers.
The novelty or clinical significance is not high.
2. As the authors mentioned in the limitation section, patients with a positive finding of serum
antibody IgG of H pylori may have current or past infections of H pylori infection. Some of the
patients might receive H pylori eradication therapy. The association between IR and H pylori
infection effects is unsure (from current or past inflammation or immune status ? )
3. This cross-section study used data form NHANES 1999-2000. The authors used good
statistical methods to perform the analyses. But the data was from 24 years ago. For such a
long period, a longitudinal follow up could find the incidence or prevalence of IR, DM or
cardiovascular events in those with or without H pylori infection.
4. Serum fasting insulin and glucose values were available in this study (table 1). Could authors
give the correlations between HOMA-IR and these three non-insulin-based surrogate markers?
5. In discussion section, after the reference 48, authors reported “ In our study, we found the
high level of IR surrogate markers might be significantly induce an increased risk of H. pylori
infection based on large sample of US populations, which firstly contribute to provide evidence
for the effects of IR on H. pylori infection.” Do authors mean a higher level of IR surrogate
markers induce an increased risk of H. pylori infection? In fact, most patients got H. pylori
infection before young adult (teenage period) and kept the infection status for a long time.
Patients with higher non-insulin-based markers may have a lower immunity and be easy to get
infections, such as H pylori. But the current study could not give solid evidence for “higher non-
insulin-based surrogate markers increase a risk of H pylori infection”.
Title: Association between non-insulin-based insulin resistance surrogate makers and
Helicobacter pylori infection: a population-based study
Version: 0 Date: 01 Dec 2024
Reviewer's report:
In this study, Jiayu Qiu et al reported the associations between three non-insulin-based markers
(TG glucose index, TG/HDL ratio, MetS-IR) and H pylori infection. They used the National
Health and Nutrition Examination Survey (NHANES) 1999-2000 data and logistic regression
model, restricted cubic spline (RCS) curve and subgroup analysis to perform the analyses. They
found all the three non-insulin-based IR surrogate markers were all positively associated with H.
pylori infection in US populations. This is an interesting study. However, I have some questions:
1. The associations between H pylori infection and insulin resistance (IR), cardiovascular
diseases have been reported in many previous studies. The current study found the same
association between IR and H pylori infection by using the non-insulin-based surrogate markers.
The novelty or clinical significance is not high.
2. As the authors mentioned in the limitation section, patients with a positive finding of serum
antibody IgG of H pylori may have current or past infections of H pylori infection. Some of the
patients might receive H pylori eradication therapy. The association between IR and H pylori
infection effects is unsure (from current or past inflammation or immune status ? )
3. This cross-section study used data form NHANES 1999-2000. The authors used good
statistical methods to perform the analyses. But the data was from 24 years ago. For such a
long period, a longitudinal follow up could find the incidence or prevalence of IR, DM or
cardiovascular events in those with or without H pylori infection.
4. Serum fasting insulin and glucose values were available in this study (table 1). Could authors
give the correlations between HOMA-IR and these three non-insulin-based surrogate markers?
5. In discussion section, after the reference 48, authors reported “ In our study, we found the
high level of IR surrogate markers might be significantly induce an increased risk of H. pylori
infection based on large sample of US populations, which firstly contribute to provide evidence
for the effects of IR on H. pylori infection.” Do authors mean a higher level of IR surrogate
markers induce an increased risk of H. pylori infection? In fact, most patients got H. pylori
infection before young adult (teenage period) and kept the infection status for a long time.
Patients with higher non-insulin-based markers may have a lower immunity and be easy to get
infections, such as H pylori. But the current study could not give solid evidence for “higher non-
insulin-based surrogate markers increase a risk of H pylori infection”.
Please review this paper.
user
Title: Association between non-insulin-based insulin resistance surrogate makers and
Helicobacter pylori infection: a population-based study
Version: 0 Date: 01 Dec 2024
Reviewer's report:
In this study, Jiayu Qiu et al reported the associations between three non-insulin-based markers
(TG glucose index, TG/HDL ratio, MetS-IR) and H pylori infection. They used the National
Health and Nutrition Examination Survey (NHANES) 1999-2000 data and logistic regression
model, restricted cubic spline (RCS) curve and subgroup analysis to perform the analyses. They
found all the three non-insulin-based IR surrogate markers were all positively associated with H.
pylori infection in US populations. This is an interesting study. However, I have some questions:
1. The associations between H pylori infection and insulin resistance (IR), cardiovascular
diseases have been reported in many previous studies. The current study found the same
association between IR and H pylori infection by using the non-insulin-based surrogate markers.
The novelty or clinical significance is not high.
2. As the authors mentioned in the limitation section, patients with a positive finding of serum
antibody IgG of H pylori may have current or past infections of H pylori infection. Some of the
patients might receive H pylori eradication therapy. The association between IR and H pylori
infection effects is unsure (from current or past inflammation or immune status ? )
3. This cross-section study used data form NHANES 1999-2000. The authors used good
statistical methods to perform the analyses. But the data was from 24 years ago. For such a
long period, a longitudinal follow up could find the incidence or prevalence of IR, DM or
cardiovascular events in those with or without H pylori infection.
4. Serum fasting insulin and glucose values were available in this study (table 1). Could authors
give the correlations between HOMA-IR and these three non-insulin-based surrogate markers?
5. In discussion section, after the reference 48, authors reported “ In our study, we found the
high level of IR surrogate markers might be significantly induce an increased risk of H. pylori
infection based on large sample of US populations, which firstly contribute to provide evidence
for the effects of IR on H. pylori infection.” Do authors mean a higher level of IR surrogate
markers induce an increased risk of H. pylori infection? In fact, most patients got H. pylori
infection before young adult (teenage period) and kept the infection status for a long time.
Patients with higher non-insulin-based markers may have a lower immunity and be easy to get
infections, such as H pylori. But the current study could not give solid evidence for “higher non-
insulin-based surrogate markers increase a risk of H pylori infection”.
assistant