Title: Prevalent Osteoporosis and Fracture Risk in Patients with Hepatic Cirrhosis: A Systematic
Review and Meta-analysis
Version: 0 Date: 15 Jan 2025
Reviewer's report:
This is an interesting study showing that cirrhotic patients have an increased risk of osteoporosis
and fractures. However, it needs a clear definition of the research question and methodological
clarifications.
1 - The authors claim to have demonstrated an increased risk of osteoporosis. Does this mean
a higher prevalence or incidence of osteoporosis? Please note that if you want to evaluate
incidence, you only need to evaluate data from longitudinal studies. If you want to evaluate
prevalence data, it is possible to include other observational studies (cross-sectional and case-
control).
2 - The authors claim to have found a higher incidence of fractures in patients with cirrhosis.
However, non-longitudinal studies were included in this analysis, including Chen 1996 (cross-
sectional) and Zhang 2020 (case-control). These studies should be removed from the analysis.
Title: Prevalent Osteoporosis and Fracture Risk in Patients with Hepatic Cirrhosis: A Systematic
Review and Meta-analysis
Version: 0 Date: 15 Jan 2025
Reviewer's report:
This is an interesting study showing that cirrhotic patients have an increased risk of osteoporosis
and fractures. However, it needs a clear definition of the research question and methodological
clarifications.
1 - The authors claim to have demonstrated an increased risk of osteoporosis. Does this mean
a higher prevalence or incidence of osteoporosis? Please note that if you want to evaluate
incidence, you only need to evaluate data from longitudinal studies. If you want to evaluate
prevalence data, it is possible to include other observational studies (cross-sectional and case-
control).
2 - The authors claim to have found a higher incidence of fractures in patients with cirrhosis.
However, non-longitudinal studies were included in this analysis, including Chen 1996 (cross-
sectional) and Zhang 2020 (case-control). These studies should be removed from the analysis.
Please review this paper.
user
Title: Prevalent Osteoporosis and Fracture Risk in Patients with Hepatic Cirrhosis: A Systematic
Review and Meta-analysis
Version: 0 Date: 15 Jan 2025
Reviewer's report:
This is an interesting study showing that cirrhotic patients have an increased risk of osteoporosis
and fractures. However, it needs a clear definition of the research question and methodological
clarifications.
1 - The authors claim to have demonstrated an increased risk of osteoporosis. Does this mean
a higher prevalence or incidence of osteoporosis? Please note that if you want to evaluate
incidence, you only need to evaluate data from longitudinal studies. If you want to evaluate
prevalence data, it is possible to include other observational studies (cross-sectional and case-
control).
2 - The authors claim to have found a higher incidence of fractures in patients with cirrhosis.
However, non-longitudinal studies were included in this analysis, including Chen 1996 (cross-
sectional) and Zhang 2020 (case-control). These studies should be removed from the analysis.
assistant