Reviewer ’s report  
 
Title:  Breath test using 13C methacetin does not seem to be useful in the assessment of liver 
function in girls with anorexia nervosa: a case control study  
 
Version: 1 Date: 27 May 2018 
 
Reviewer:  Grzegorz  Oracz  
 
Reviewer’s report:  
 
Overview: The authors evaluate the usefulness of the 13C labeled Methacetin Breath Test 
(MBT) in the diagnostics of the liver function in girls with eating disorders. The study is original, 
prospective, performed in large group of girls with AN. Results of the study show that 13C 
methacetin metabolism in female patients with AN is significantly increased in comparison to 
healthy controls. Authors concluded that this test is not useful in in the assessment of liver 
function in girls with AN. In my opinion despite of negative results it is interesting study.  
 
 
Minor criticisms:  
 
1. page 2 line 15 and page 4 line 13 - DSM -5 - lack of explanation of the abbreviation  
 
2. Authors affiliations No 1 and No 2 - it seems that it is the same affiliation  
 
3. page 2 line 1 in abstract - lack of mean age of the patients  
 
4. In my opinion it is worth to underline that BMI percentile is more useful in children than BMI  
 
5. page 5 - after the Wagner company name should be country - Germany  
 
6. Table 3 - page 10  
 
BILIRUBIN - I'm sure authors by mistake putted mg/dl!!!  It should be umol/l?  
 
in table is lack of reference values of the studied parameters  
 
mean AST and ALT values are within no rmal values. In my opinion authors should give results 
of AST and ALT in these 5 girls with elevated results.  
 
7. The time of the study (years) is not given  
 
Are t he methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional stat istical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language  in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain o r lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be include d as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title:  Breath test using 13C methacetin does not seem to be useful in the assessment of liver 
function in girls with anorexia nervosa: a case control study  
 
Version: 1 Date: 27 May 2018 
 
Reviewer:  Grzegorz  Oracz  
 
Reviewer’s report:  
 
Overview: The authors evaluate the usefulness of the 13C labeled Methacetin Breath Test 
(MBT) in the diagnostics of the liver function in girls with eating disorders. The study is original, 
prospective, performed in large group of girls with AN. Results of the study show that 13C 
methacetin metabolism in female patients with AN is significantly increased in comparison to 
healthy controls. Authors concluded that this test is not useful in in the assessment of liver 
function in girls with AN. In my opinion despite of negative results it is interesting study.  
 
 
Minor criticisms:  
 
1. page 2 line 15 and page 4 line 13 - DSM -5 - lack of explanation of the abbreviation  
 
2. Authors affiliations No 1 and No 2 - it seems that it is the same affiliation  
 
3. page 2 line 1 in abstract - lack of mean age of the patients  
 
4. In my opinion it is worth to underline that BMI percentile is more useful in children than BMI  
 
5. page 5 - after the Wagner company name should be country - Germany  
 
6. Table 3 - page 10  
 
BILIRUBIN - I'm sure authors by mistake putted mg/dl!!!  It should be umol/l?  
 
in table is lack of reference values of the studied parameters  
 
mean AST and ALT values are within no rmal values. In my opinion authors should give results 
of AST and ALT in these 5 girls with elevated results.  
 
7. The time of the study (years) is not given  
 
Are t he methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional stat istical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language  in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain o r lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be include d as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title:  Breath test using 13C methacetin does not seem to be useful in the assessment of liver 
function in girls with anorexia nervosa: a case control study  
 
Version: 1 Date: 27 May 2018 
 
Reviewer:  Grzegorz  Oracz  
 
Reviewer’s report:  
 
Overview: The authors evaluate the usefulness of the 13C labeled Methacetin Breath Test 
(MBT) in the diagnostics of the liver function in girls with eating disorders. The study is original, 
prospective, performed in large group of girls with AN. Results of the study show that 13C 
methacetin metabolism in female patients with AN is significantly increased in comparison to 
healthy controls. Authors concluded that this test is not useful in in the assessment of liver 
function in girls with AN. In my opinion despite of negative results it is interesting study.  
 
 
Minor criticisms:  
 
1. page 2 line 15 and page 4 line 13 - DSM -5 - lack of explanation of the abbreviation  
 
2. Authors affiliations No 1 and No 2 - it seems that it is the same affiliation  
 
3. page 2 line 1 in abstract - lack of mean age of the patients  
 
4. In my opinion it is worth to underline that BMI percentile is more useful in children than BMI  
 
5. page 5 - after the Wagner company name should be country - Germany  
 
6. Table 3 - page 10  
 
BILIRUBIN - I'm sure authors by mistake putted mg/dl!!!  It should be umol/l?  
 
in table is lack of reference values of the studied parameters  
 
mean AST and ALT values are within no rmal values. In my opinion authors should give results 
of AST and ALT in these 5 girls with elevated results.  
 
7. The time of the study (years) is not given  
 
Are t he methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional stat istical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language  in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain o r lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be include d as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant