Title: Celiac disease autoimmunity among Nigerian children and adolescents with type 1
diabetes mellitus
Version: 2 Date: 22 May 2024
Reviewer:  Glauce Hiromi Yonamine
Reviewer's report:
General comments:
The study is interesting because it is multicentric and aims to estimate the prevalence of celiac
disease in children and adolescents with type 1 diabetes. However, there are doubts regarding
the methods, that should be clarified.
Introduction:
Please review the English: Downs syndrome, Turner's syndrome, and Williams syndrome.
Some reference citations are incorrect, for example: [1].1
I this sentence: “In Nigeria, where bread, a gluten-rich diet...." Should you use, “a gluten-rich
food?”
Methods:
Is the term “proforma” correct?
The information: “Endoscopy and duodenal biopsy were performed on participants with celiac
antibodies.” Not all children had endoscopy. I suggest changing the text.
“Participants' nutritional status was determined using BMI-for-age and interpreted using WHO
Child Growth Standards [17].”
As there were children under 5 years old, it is necessary to include the reference for the
classification of these age group.
“Families were assigned a socio-economic class based on parents' occupations and education,
with mean scores falling within the 1-5 range. Those with 1 and 2 scores were upper class, while
those with 3, 4, and 5 scores were lower class [18].”
Does this instrument only classify into upper and lower class? Is there no middle class?
What about the diet of the participants? Were they consuming gluten regularly? This is an
important information for diagnosis.
Was it assessed whether the variables had parametric and non-parametric distribution?
If the variables were non-parametric, it should be described as median and interquartile range.
Results:
As stated in the methods section: “The study was carried out at seven tertiary hospitals in Nigeria
that have pediatric endocrinologists and access to children with type 1 diabetes mellitus.” In
the results section, I recommend excluding adults from the sample, focusing solely on children
and adolescents.
Table 2: Is the title correct? I think it is confusing. Were all the 10 participants considered with
low serum total IgA? They have serum IgA within laboratory reference values.
Conclusion:
I think the conclusion could address the importance of having surveillance for celiac disease
in children and adolescents with type 1 diabetes, especially in female and when there are
gastrointestinal symptoms.
Title: Celiac disease autoimmunity among Nigerian children and adolescents with type 1
diabetes mellitus
Version: 2 Date: 22 May 2024
Reviewer:  Glauce Hiromi Yonamine
Reviewer's report:
General comments:
The study is interesting because it is multicentric and aims to estimate the prevalence of celiac
disease in children and adolescents with type 1 diabetes. However, there are doubts regarding
the methods, that should be clarified.
Introduction:
Please review the English: Downs syndrome, Turner's syndrome, and Williams syndrome.
Some reference citations are incorrect, for example: [1].1
I this sentence: “In Nigeria, where bread, a gluten-rich diet...." Should you use, “a gluten-rich
food?”
Methods:
Is the term “proforma” correct?
The information: “Endoscopy and duodenal biopsy were performed on participants with celiac
antibodies.” Not all children had endoscopy. I suggest changing the text.
“Participants' nutritional status was determined using BMI-for-age and interpreted using WHO
Child Growth Standards [17].”
As there were children under 5 years old, it is necessary to include the reference for the
classification of these age group.
“Families were assigned a socio-economic class based on parents' occupations and education,
with mean scores falling within the 1-5 range. Those with 1 and 2 scores were upper class, while
those with 3, 4, and 5 scores were lower class [18].”
Does this instrument only classify into upper and lower class? Is there no middle class?
What about the diet of the participants? Were they consuming gluten regularly? This is an
important information for diagnosis.
Was it assessed whether the variables had parametric and non-parametric distribution?
If the variables were non-parametric, it should be described as median and interquartile range.
Results:
As stated in the methods section: “The study was carried out at seven tertiary hospitals in Nigeria
that have pediatric endocrinologists and access to children with type 1 diabetes mellitus.” In
the results section, I recommend excluding adults from the sample, focusing solely on children
and adolescents.
Table 2: Is the title correct? I think it is confusing. Were all the 10 participants considered with
low serum total IgA? They have serum IgA within laboratory reference values.
Conclusion:
I think the conclusion could address the importance of having surveillance for celiac disease
in children and adolescents with type 1 diabetes, especially in female and when there are
gastrointestinal symptoms.
Please review this paper.
user
Title: Celiac disease autoimmunity among Nigerian children and adolescents with type 1
diabetes mellitus
Version: 2 Date: 22 May 2024
Reviewer:  Glauce Hiromi Yonamine
Reviewer's report:
General comments:
The study is interesting because it is multicentric and aims to estimate the prevalence of celiac
disease in children and adolescents with type 1 diabetes. However, there are doubts regarding
the methods, that should be clarified.
Introduction:
Please review the English: Downs syndrome, Turner's syndrome, and Williams syndrome.
Some reference citations are incorrect, for example: [1].1
I this sentence: “In Nigeria, where bread, a gluten-rich diet...." Should you use, “a gluten-rich
food?”
Methods:
Is the term “proforma” correct?
The information: “Endoscopy and duodenal biopsy were performed on participants with celiac
antibodies.” Not all children had endoscopy. I suggest changing the text.
“Participants' nutritional status was determined using BMI-for-age and interpreted using WHO
Child Growth Standards [17].”
As there were children under 5 years old, it is necessary to include the reference for the
classification of these age group.
“Families were assigned a socio-economic class based on parents' occupations and education,
with mean scores falling within the 1-5 range. Those with 1 and 2 scores were upper class, while
those with 3, 4, and 5 scores were lower class [18].”
Does this instrument only classify into upper and lower class? Is there no middle class?
What about the diet of the participants? Were they consuming gluten regularly? This is an
important information for diagnosis.
Was it assessed whether the variables had parametric and non-parametric distribution?
If the variables were non-parametric, it should be described as median and interquartile range.
Results:
As stated in the methods section: “The study was carried out at seven tertiary hospitals in Nigeria
that have pediatric endocrinologists and access to children with type 1 diabetes mellitus.” In
the results section, I recommend excluding adults from the sample, focusing solely on children
and adolescents.
Table 2: Is the title correct? I think it is confusing. Were all the 10 participants considered with
low serum total IgA? They have serum IgA within laboratory reference values.
Conclusion:
I think the conclusion could address the importance of having surveillance for celiac disease
in children and adolescents with type 1 diabetes, especially in female and when there are
gastrointestinal symptoms.
assistant