Reviewer ’s report  
 
Title: Significantly different clinical features between hypertriglyceridemia and biliary acute 
pancreatitis: A Retrospective Study of 730 Patients from A Tertiary  
 
Version: 0 Date: 09 Nov 2017  
 
Reviewer: Vinaya Gaduputi  
 
Reviewer's report:  
 
This is a well written, comprehensive retrospective study. However, few points that need 
addressing:   
1. It is very unusual that the incidence of hypertriglyceridemia induced AP (30%) is almost 6 
times that of alcohol induced pancreatitis (5%). It needs to be mentioned if any of these 
HTG -AP patients also had Alcohol intake as even small amounts of alco hol can raise 
triglyceride levels.  There could be some referral center bias that preferentially higher 
proportion of HTG -AP patients were referred for possible Insulin/ apheresis therapy.  
 
2. Did all patients with AP get Ultrasound scan to rule out gallst ones at the time of admission?  
 
3. Please explain the definition of 'significant fat diet rate' found in HTG -AP 
 
4. Authors also need mention if they have the data with regards the mean duration of 
symptoms of AP/ average time taken for the patient to presen t to the hospital after onset of 
symptoms - as this is a significant confounding factor which could determine the occurrence 
of local and systemic complications.   
 
5. There was no mention of treatment strategies employed for either of the study groups. 
Auth ors should also mention how these groups were treated: time to initiation of hydration, 
rate of hydration, which kind of solution was used. These factors obviously influence the 
course of AP and incidence of complications. Authors should mention what propo rtion of 
patients with HTG -AP received Insulin therapy/ apheresis  
 
6. Complications such as  Walled -off pancreatic necrosis (mentioned in Table -4) are late 
complications of acute pancreatitis: were the patients followed up in clinic after discharge or 
were they hospitalized for the whole duration?   
Given the retrospective nature of the study: if there is paucity of data for answering any of the 
above mentioned questions - authors could mention it among drawbacks of the study for the 
benefit of readers.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary c ontrols?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 statist ics in the manuscript 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 written 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 qu estions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that 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 received 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 com peting 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.  
 
I declare that I have no competing interests  
 
I agree t o the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for 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 comments 
to the  editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Significantly different clinical features between hypertriglyceridemia and biliary acute 
pancreatitis: A Retrospective Study of 730 Patients from A Tertiary  
 
Version: 0 Date: 09 Nov 2017  
 
Reviewer: Vinaya Gaduputi  
 
Reviewer's report:  
 
This is a well written, comprehensive retrospective study. However, few points that need 
addressing:   
1. It is very unusual that the incidence of hypertriglyceridemia induced AP (30%) is almost 6 
times that of alcohol induced pancreatitis (5%). It needs to be mentioned if any of these 
HTG -AP patients also had Alcohol intake as even small amounts of alco hol can raise 
triglyceride levels.  There could be some referral center bias that preferentially higher 
proportion of HTG -AP patients were referred for possible Insulin/ apheresis therapy.  
 
2. Did all patients with AP get Ultrasound scan to rule out gallst ones at the time of admission?  
 
3. Please explain the definition of 'significant fat diet rate' found in HTG -AP 
 
4. Authors also need mention if they have the data with regards the mean duration of 
symptoms of AP/ average time taken for the patient to presen t to the hospital after onset of 
symptoms - as this is a significant confounding factor which could determine the occurrence 
of local and systemic complications.   
 
5. There was no mention of treatment strategies employed for either of the study groups. 
Auth ors should also mention how these groups were treated: time to initiation of hydration, 
rate of hydration, which kind of solution was used. These factors obviously influence the 
course of AP and incidence of complications. Authors should mention what propo rtion of 
patients with HTG -AP received Insulin therapy/ apheresis  
 
6. Complications such as  Walled -off pancreatic necrosis (mentioned in Table -4) are late 
complications of acute pancreatitis: were the patients followed up in clinic after discharge or 
were they hospitalized for the whole duration?   
Given the retrospective nature of the study: if there is paucity of data for answering any of the 
above mentioned questions - authors could mention it among drawbacks of the study for the 
benefit of readers.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary c ontrols?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 statist ics in the manuscript 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 written 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 qu estions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that 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 received 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 com peting 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.  
 
I declare that I have no competing interests  
 
I agree t o the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for 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 comments 
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: Significantly different clinical features between hypertriglyceridemia and biliary acute 
pancreatitis: A Retrospective Study of 730 Patients from A Tertiary  
 
Version: 0 Date: 09 Nov 2017  
 
Reviewer: Vinaya Gaduputi  
 
Reviewer's report:  
 
This is a well written, comprehensive retrospective study. However, few points that need 
addressing:   
1. It is very unusual that the incidence of hypertriglyceridemia induced AP (30%) is almost 6 
times that of alcohol induced pancreatitis (5%). It needs to be mentioned if any of these 
HTG -AP patients also had Alcohol intake as even small amounts of alco hol can raise 
triglyceride levels.  There could be some referral center bias that preferentially higher 
proportion of HTG -AP patients were referred for possible Insulin/ apheresis therapy.  
 
2. Did all patients with AP get Ultrasound scan to rule out gallst ones at the time of admission?  
 
3. Please explain the definition of 'significant fat diet rate' found in HTG -AP 
 
4. Authors also need mention if they have the data with regards the mean duration of 
symptoms of AP/ average time taken for the patient to presen t to the hospital after onset of 
symptoms - as this is a significant confounding factor which could determine the occurrence 
of local and systemic complications.   
 
5. There was no mention of treatment strategies employed for either of the study groups. 
Auth ors should also mention how these groups were treated: time to initiation of hydration, 
rate of hydration, which kind of solution was used. These factors obviously influence the 
course of AP and incidence of complications. Authors should mention what propo rtion of 
patients with HTG -AP received Insulin therapy/ apheresis  
 
6. Complications such as  Walled -off pancreatic necrosis (mentioned in Table -4) are late 
complications of acute pancreatitis: were the patients followed up in clinic after discharge or 
were they hospitalized for the whole duration?   
Given the retrospective nature of the study: if there is paucity of data for answering any of the 
above mentioned questions - authors could mention it among drawbacks of the study for the 
benefit of readers.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary c ontrols?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 statist ics in the manuscript 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 written 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 qu estions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that 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 received 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 com peting 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.  
 
I declare that I have no competing interests  
 
I agree t o the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for 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 comments 
to the  editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant