Title: Clinical Risk Factors for Sarcopenia in Acute and Chronic Pancreatitis
Version: 3 Date: 02 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
The manuscript addresses an important and underexplored clinical topic—sarcopenia in
acute and chronic pancreatitis—with significant implications for patient management. Its
robust methodology, utilizing CT imaging for skeletal muscle index (SMI) quantification
and multivariate logistic regression analysis, ensures scientific rigor. The data are presented
clearly through well-organized tables and figures, effectively illustrating key findings such as
sarcopenia prevalence differences between AP and CP. Additionally, the discussion thoughtfully
contextualizes results within the broader literature and identifies critical areas for future research,
particularly regarding mechanisms and potential interventions for sarcopenia in pancreatitis.
The authors tried to contribute to this field of research with new findings; nevertheless, some
observations require sufficient justification.
1. With only 103 subjects, the sample size may reduce the power of some subgroup analyses,
particularly within the CP-only cohort.
2. The limitations note that reliance on muscle mass without functional measures may
overestimate the prevalence of sarcopenia.
3. The cross-sectional design limits insights into causal relationships and temporal changes in
sarcopenia.
4. Critical confounders like dietary intake and activity levels are missing, which may affect the
interpretation of sarcopenia’s determinants.
5. Provide more detail about the methodology, including the criteria used for selecting subjects
and how imaging quality was evaluated. Additionally, explain the steps taken to minimize
variability between reviewers during CT analysis.
6. Suggest incorporating functional assessments like grip strength or gait speed in future studies
to align more closely with contemporary definitions of sarcopenia.
7. Address whether the study population reflects the broader pancreatitis demographic,
particularly in terms of racial and socioeconomic diversity.
8. Consider discussing practical interventions informed by the study’s findings, such as tailored
nutritional plans or exercise programs, to improve clinical outcomes.
9. Offer a more detailed explanation of the statistical approach, particularly the rationale behind
using logistic regression and the forward selection method.
10. Propose specific areas for future research, such as examining the role of cytokines in the
development of sarcopenia or tracking body composition changes over time in pancreatitis
patients.
Title: Clinical Risk Factors for Sarcopenia in Acute and Chronic Pancreatitis
Version: 3 Date: 02 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
The manuscript addresses an important and underexplored clinical topic—sarcopenia in
acute and chronic pancreatitis—with significant implications for patient management. Its
robust methodology, utilizing CT imaging for skeletal muscle index (SMI) quantification
and multivariate logistic regression analysis, ensures scientific rigor. The data are presented
clearly through well-organized tables and figures, effectively illustrating key findings such as
sarcopenia prevalence differences between AP and CP. Additionally, the discussion thoughtfully
contextualizes results within the broader literature and identifies critical areas for future research,
particularly regarding mechanisms and potential interventions for sarcopenia in pancreatitis.
The authors tried to contribute to this field of research with new findings; nevertheless, some
observations require sufficient justification.
1. With only 103 subjects, the sample size may reduce the power of some subgroup analyses,
particularly within the CP-only cohort.
2. The limitations note that reliance on muscle mass without functional measures may
overestimate the prevalence of sarcopenia.
3. The cross-sectional design limits insights into causal relationships and temporal changes in
sarcopenia.
4. Critical confounders like dietary intake and activity levels are missing, which may affect the
interpretation of sarcopenia’s determinants.
5. Provide more detail about the methodology, including the criteria used for selecting subjects
and how imaging quality was evaluated. Additionally, explain the steps taken to minimize
variability between reviewers during CT analysis.
6. Suggest incorporating functional assessments like grip strength or gait speed in future studies
to align more closely with contemporary definitions of sarcopenia.
7. Address whether the study population reflects the broader pancreatitis demographic,
particularly in terms of racial and socioeconomic diversity.
8. Consider discussing practical interventions informed by the study’s findings, such as tailored
nutritional plans or exercise programs, to improve clinical outcomes.
9. Offer a more detailed explanation of the statistical approach, particularly the rationale behind
using logistic regression and the forward selection method.
10. Propose specific areas for future research, such as examining the role of cytokines in the
development of sarcopenia or tracking body composition changes over time in pancreatitis
patients.
Please review this paper.
user
Title: Clinical Risk Factors for Sarcopenia in Acute and Chronic Pancreatitis
Version: 3 Date: 02 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
The manuscript addresses an important and underexplored clinical topic—sarcopenia in
acute and chronic pancreatitis—with significant implications for patient management. Its
robust methodology, utilizing CT imaging for skeletal muscle index (SMI) quantification
and multivariate logistic regression analysis, ensures scientific rigor. The data are presented
clearly through well-organized tables and figures, effectively illustrating key findings such as
sarcopenia prevalence differences between AP and CP. Additionally, the discussion thoughtfully
contextualizes results within the broader literature and identifies critical areas for future research,
particularly regarding mechanisms and potential interventions for sarcopenia in pancreatitis.
The authors tried to contribute to this field of research with new findings; nevertheless, some
observations require sufficient justification.
1. With only 103 subjects, the sample size may reduce the power of some subgroup analyses,
particularly within the CP-only cohort.
2. The limitations note that reliance on muscle mass without functional measures may
overestimate the prevalence of sarcopenia.
3. The cross-sectional design limits insights into causal relationships and temporal changes in
sarcopenia.
4. Critical confounders like dietary intake and activity levels are missing, which may affect the
interpretation of sarcopenia’s determinants.
5. Provide more detail about the methodology, including the criteria used for selecting subjects
and how imaging quality was evaluated. Additionally, explain the steps taken to minimize
variability between reviewers during CT analysis.
6. Suggest incorporating functional assessments like grip strength or gait speed in future studies
to align more closely with contemporary definitions of sarcopenia.
7. Address whether the study population reflects the broader pancreatitis demographic,
particularly in terms of racial and socioeconomic diversity.
8. Consider discussing practical interventions informed by the study’s findings, such as tailored
nutritional plans or exercise programs, to improve clinical outcomes.
9. Offer a more detailed explanation of the statistical approach, particularly the rationale behind
using logistic regression and the forward selection method.
10. Propose specific areas for future research, such as examining the role of cytokines in the
development of sarcopenia or tracking body composition changes over time in pancreatitis
patients.
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