Title:  The role of vitamin D in treated and refractory ulcerative colitis patients: a case-control
study
Version: 4 Date: 01 Aug 2024
Reviewer's report:
Authors did not answer the former comment "Authors should state the definition of 'respond to
treatment methods' ".
They now stated the treatment methods with sentences “three stages of treatment were
performed. Patients who responded to each of these three stages were selected as treated
individuals (group 1), but those who did not respond to all three stages were selected as
treatment-resistant individuals (group 3). The treatment steps of the patients were as follows:
The first stage of treatment was 5-aminosalicylic acid (5-ASA) treatment. The second stage of
treatment was treatment with glucocorticoids and azathioprine. The third stage of treatment was
a biological treatment that includes anti-TNF-# which includes Infliximab and Adalimumab.
Inclusion of the study: In the treated group (group 1), all those who responded to each of the
three treatment steps were included in the study, and the treatment-resistant group (group 3), all
those who did not respond to all three treatment steps were included in the study.”
However, they still did not state how to define a response. Is it a mucosal healing?
“This study was a case-control type and 4 groups of people were included in this study. Given
an 80% power and the type I error of 0.05, and considering an effect size of 0.80 according to
the study of Lamb et al (18), the calculated sample size using GPower was equal to 23 persons
for each group.”
Authors now wrote the above sentences in the Material and Methods. I suggested go for a
statistician to make certain that the number of patients is sufficient to make a conclusion, as
authors cited a reference published 22 years ago (2002) and many things might have changed.
More work is needed for an understandable presentation, and I failed to understand many
sentences, for example:
1. The results of Vitamin D; Mean (Std. dev.) analysis with demographic variables and other
blood factors show that in the group 1 UC patients and group 2, people whose BMI is <18.5 have
the highest Vitamin D; Mean (Std. dev.), which include 27 (12.11) and 28 (8.19) respectively.
2. However, the point of interest in this study is that in patients who are resistant to treatment
and their first-degree relatives who had a BMI less than 18, the level of vitamin D was lower
than that of treated people and even their relatives.
3.In a retrospective study, the average level of vitamin D in people with ulcerative colitis was
17.1±9.7 and in healthy people was 20.4±7.0 (24), although the average level of vitamin D in
this study was lower than our study, in this study, similar to our study, there is a significant
relationship with ulcerative colitis.
…
Title:  The role of vitamin D in treated and refractory ulcerative colitis patients: a case-control
study
Version: 4 Date: 01 Aug 2024
Reviewer's report:
Authors did not answer the former comment "Authors should state the definition of 'respond to
treatment methods' ".
They now stated the treatment methods with sentences “three stages of treatment were
performed. Patients who responded to each of these three stages were selected as treated
individuals (group 1), but those who did not respond to all three stages were selected as
treatment-resistant individuals (group 3). The treatment steps of the patients were as follows:
The first stage of treatment was 5-aminosalicylic acid (5-ASA) treatment. The second stage of
treatment was treatment with glucocorticoids and azathioprine. The third stage of treatment was
a biological treatment that includes anti-TNF-# which includes Infliximab and Adalimumab.
Inclusion of the study: In the treated group (group 1), all those who responded to each of the
three treatment steps were included in the study, and the treatment-resistant group (group 3), all
those who did not respond to all three treatment steps were included in the study.”
However, they still did not state how to define a response. Is it a mucosal healing?
“This study was a case-control type and 4 groups of people were included in this study. Given
an 80% power and the type I error of 0.05, and considering an effect size of 0.80 according to
the study of Lamb et al (18), the calculated sample size using GPower was equal to 23 persons
for each group.”
Authors now wrote the above sentences in the Material and Methods. I suggested go for a
statistician to make certain that the number of patients is sufficient to make a conclusion, as
authors cited a reference published 22 years ago (2002) and many things might have changed.
More work is needed for an understandable presentation, and I failed to understand many
sentences, for example:
1. The results of Vitamin D; Mean (Std. dev.) analysis with demographic variables and other
blood factors show that in the group 1 UC patients and group 2, people whose BMI is <18.5 have
the highest Vitamin D; Mean (Std. dev.), which include 27 (12.11) and 28 (8.19) respectively.
2. However, the point of interest in this study is that in patients who are resistant to treatment
and their first-degree relatives who had a BMI less than 18, the level of vitamin D was lower
than that of treated people and even their relatives.
3.In a retrospective study, the average level of vitamin D in people with ulcerative colitis was
17.1±9.7 and in healthy people was 20.4±7.0 (24), although the average level of vitamin D in
this study was lower than our study, in this study, similar to our study, there is a significant
relationship with ulcerative colitis.
…
Please review this paper.
user
Title:  The role of vitamin D in treated and refractory ulcerative colitis patients: a case-control
study
Version: 4 Date: 01 Aug 2024
Reviewer's report:
Authors did not answer the former comment "Authors should state the definition of 'respond to
treatment methods' ".
They now stated the treatment methods with sentences “three stages of treatment were
performed. Patients who responded to each of these three stages were selected as treated
individuals (group 1), but those who did not respond to all three stages were selected as
treatment-resistant individuals (group 3). The treatment steps of the patients were as follows:
The first stage of treatment was 5-aminosalicylic acid (5-ASA) treatment. The second stage of
treatment was treatment with glucocorticoids and azathioprine. The third stage of treatment was
a biological treatment that includes anti-TNF-# which includes Infliximab and Adalimumab.
Inclusion of the study: In the treated group (group 1), all those who responded to each of the
three treatment steps were included in the study, and the treatment-resistant group (group 3), all
those who did not respond to all three treatment steps were included in the study.”
However, they still did not state how to define a response. Is it a mucosal healing?
“This study was a case-control type and 4 groups of people were included in this study. Given
an 80% power and the type I error of 0.05, and considering an effect size of 0.80 according to
the study of Lamb et al (18), the calculated sample size using GPower was equal to 23 persons
for each group.”
Authors now wrote the above sentences in the Material and Methods. I suggested go for a
statistician to make certain that the number of patients is sufficient to make a conclusion, as
authors cited a reference published 22 years ago (2002) and many things might have changed.
More work is needed for an understandable presentation, and I failed to understand many
sentences, for example:
1. The results of Vitamin D; Mean (Std. dev.) analysis with demographic variables and other
blood factors show that in the group 1 UC patients and group 2, people whose BMI is <18.5 have
the highest Vitamin D; Mean (Std. dev.), which include 27 (12.11) and 28 (8.19) respectively.
2. However, the point of interest in this study is that in patients who are resistant to treatment
and their first-degree relatives who had a BMI less than 18, the level of vitamin D was lower
than that of treated people and even their relatives.
3.In a retrospective study, the average level of vitamin D in people with ulcerative colitis was
17.1±9.7 and in healthy people was 20.4±7.0 (24), although the average level of vitamin D in
this study was lower than our study, in this study, similar to our study, there is a significant
relationship with ulcerative colitis.
…
assistant