Reviewer's report
Title:The Association of Serum Lipids with the Histological Pattern of
Rectosigmoid Adenoma in Taiwanese Adults
Version: 3Date:13 December 2010
Reviewer: Patricia Thompson
Reviewer's report:
Review manuscript titled "The Association of Serum Lipids with the histological
patterns of rectosigmoid adenoma in Taiwanese Adults" Sun et al.
The manuscript is very well written and focused on the relationship between
serum lipid levels and histologic features of rectosigmoid adenomas at detection
using data from 2506 otherwise healthy screened individuals. The investigators
show a strong independent association between serum triglyceride levels and
adenoma with villous histology even after accounting for obesity and diabetes
determined by fasting glucose tolerance testing. The study is well conducted and
adds knowledge to the field.
Minor Essential Revisions. The one concern that I think the authors really need to
address to make this a higher impact paper is the issue of age. Clearly, the no
adenoma group is considerably younger. Age is both a major risk factor for
adenoma and elevated serum lipids. The authors have adjusted for age as a
confounder, which is appropriate. However it would be informative to evaluate
the relationship between TG and adenoma by age strata and also by gender.
While the study may be underpowered for the more advanced histology, results
of stratified analyses, even if exploratory in nature, would be informative as it is
unclear if these relationships are present in younger individuals or restricted to
older populations. This would help to inform on when interventions targeting TGs
or other serum lipids would make sense.
Discretionary Revisions
The data suggest the primary factor of interest is TG and not 'insulin' related
features. The discussion might benefit from focus around those factors that are
mechanistically related to TGs such as increased fecal bile acid content and
effects on the colonic environment including effects on gut flora. This would also
slightly shorten a fairly long discussion text.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Reviewer's report
Title:The Association of Serum Lipids with the Histological Pattern of
Rectosigmoid Adenoma in Taiwanese Adults
Version: 3Date:13 December 2010
Reviewer: Patricia Thompson
Reviewer's report:
Review manuscript titled "The Association of Serum Lipids with the histological
patterns of rectosigmoid adenoma in Taiwanese Adults" Sun et al.
The manuscript is very well written and focused on the relationship between
serum lipid levels and histologic features of rectosigmoid adenomas at detection
using data from 2506 otherwise healthy screened individuals. The investigators
show a strong independent association between serum triglyceride levels and
adenoma with villous histology even after accounting for obesity and diabetes
determined by fasting glucose tolerance testing. The study is well conducted and
adds knowledge to the field.
Minor Essential Revisions. The one concern that I think the authors really need to
address to make this a higher impact paper is the issue of age. Clearly, the no
adenoma group is considerably younger. Age is both a major risk factor for
adenoma and elevated serum lipids. The authors have adjusted for age as a
confounder, which is appropriate. However it would be informative to evaluate
the relationship between TG and adenoma by age strata and also by gender.
While the study may be underpowered for the more advanced histology, results
of stratified analyses, even if exploratory in nature, would be informative as it is
unclear if these relationships are present in younger individuals or restricted to
older populations. This would help to inform on when interventions targeting TGs
or other serum lipids would make sense.
Discretionary Revisions
The data suggest the primary factor of interest is TG and not 'insulin' related
features. The discussion might benefit from focus around those factors that are
mechanistically related to TGs such as increased fecal bile acid content and
effects on the colonic environment including effects on gut flora. This would also
slightly shorten a fairly long discussion text.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Please review this paper.
user
Reviewer's report
Title:The Association of Serum Lipids with the Histological Pattern of
Rectosigmoid Adenoma in Taiwanese Adults
Version: 3Date:13 December 2010
Reviewer: Patricia Thompson
Reviewer's report:
Review manuscript titled "The Association of Serum Lipids with the histological
patterns of rectosigmoid adenoma in Taiwanese Adults" Sun et al.
The manuscript is very well written and focused on the relationship between
serum lipid levels and histologic features of rectosigmoid adenomas at detection
using data from 2506 otherwise healthy screened individuals. The investigators
show a strong independent association between serum triglyceride levels and
adenoma with villous histology even after accounting for obesity and diabetes
determined by fasting glucose tolerance testing. The study is well conducted and
adds knowledge to the field.
Minor Essential Revisions. The one concern that I think the authors really need to
address to make this a higher impact paper is the issue of age. Clearly, the no
adenoma group is considerably younger. Age is both a major risk factor for
adenoma and elevated serum lipids. The authors have adjusted for age as a
confounder, which is appropriate. However it would be informative to evaluate
the relationship between TG and adenoma by age strata and also by gender.
While the study may be underpowered for the more advanced histology, results
of stratified analyses, even if exploratory in nature, would be informative as it is
unclear if these relationships are present in younger individuals or restricted to
older populations. This would help to inform on when interventions targeting TGs
or other serum lipids would make sense.
Discretionary Revisions
The data suggest the primary factor of interest is TG and not 'insulin' related
features. The discussion might benefit from focus around those factors that are
mechanistically related to TGs such as increased fecal bile acid content and
effects on the colonic environment including effects on gut flora. This would also
slightly shorten a fairly long discussion text.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
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