Title: Risk of cardiovascular disease in lean patients with nonalcoholic fatty liver disease
Version: 2 Date: 12 Apr 2023
Reviewer's report:
Apr 12, 2023                                                                                                                                      BMC
Gastroenterology
Submission ID: 3d4bbf80-1067-45e8-8d18-3dbf5f22a689
Risk of cardiovascular disease in lean patients with nonalcoholic fatty liver disease
In this manuscript, the authors compared the incidence of CVD in 219 lean Japanese NAFLD
patients with 362 non-lean Japanese NAFLD patients after 3 years follow-up period. They found
that CVD incidence was comparable between the two groups. This paper is well-described, but
some minor revisions seem to be needed before acceptance for publication as stated below.
Comments:
1. As the authors stated, it is well known that many patients with NAFLD are obese and the
proportion of lean NAFLD in this study was higher than in other studies. The authors should
describe more detailed data including conceivable reason.
2. Increased serum level of low-density lipoprotein was not included in the definition criteria of
dyslipidemia in this study. If this criterion is included, are the results amended? Please consider.
3. The prevalence of dyslipidemia, hypertension and diabetes, which are the risk factors of CVD,
were significantly higher in the non-lean NAFLD patients than in the lean NAFLD patients.
However, CVD incidence was comparable between the two groups. The authors should discuss
this discrepant observation.
4. In the future study, it would be interesting if the authors investigate the association between
metabolic dysfunction-associated fatty liver disease (MAFLD) and CVD incidence using the
same study population.
Title: Risk of cardiovascular disease in lean patients with nonalcoholic fatty liver disease
Version: 2 Date: 12 Apr 2023
Reviewer's report:
Apr 12, 2023                                                                                                                                      BMC
Gastroenterology
Submission ID: 3d4bbf80-1067-45e8-8d18-3dbf5f22a689
Risk of cardiovascular disease in lean patients with nonalcoholic fatty liver disease
In this manuscript, the authors compared the incidence of CVD in 219 lean Japanese NAFLD
patients with 362 non-lean Japanese NAFLD patients after 3 years follow-up period. They found
that CVD incidence was comparable between the two groups. This paper is well-described, but
some minor revisions seem to be needed before acceptance for publication as stated below.
Comments:
1. As the authors stated, it is well known that many patients with NAFLD are obese and the
proportion of lean NAFLD in this study was higher than in other studies. The authors should
describe more detailed data including conceivable reason.
2. Increased serum level of low-density lipoprotein was not included in the definition criteria of
dyslipidemia in this study. If this criterion is included, are the results amended? Please consider.
3. The prevalence of dyslipidemia, hypertension and diabetes, which are the risk factors of CVD,
were significantly higher in the non-lean NAFLD patients than in the lean NAFLD patients.
However, CVD incidence was comparable between the two groups. The authors should discuss
this discrepant observation.
4. In the future study, it would be interesting if the authors investigate the association between
metabolic dysfunction-associated fatty liver disease (MAFLD) and CVD incidence using the
same study population.
Please review this paper.
user
Title: Risk of cardiovascular disease in lean patients with nonalcoholic fatty liver disease
Version: 2 Date: 12 Apr 2023
Reviewer's report:
Apr 12, 2023                                                                                                                                      BMC
Gastroenterology
Submission ID: 3d4bbf80-1067-45e8-8d18-3dbf5f22a689
Risk of cardiovascular disease in lean patients with nonalcoholic fatty liver disease
In this manuscript, the authors compared the incidence of CVD in 219 lean Japanese NAFLD
patients with 362 non-lean Japanese NAFLD patients after 3 years follow-up period. They found
that CVD incidence was comparable between the two groups. This paper is well-described, but
some minor revisions seem to be needed before acceptance for publication as stated below.
Comments:
1. As the authors stated, it is well known that many patients with NAFLD are obese and the
proportion of lean NAFLD in this study was higher than in other studies. The authors should
describe more detailed data including conceivable reason.
2. Increased serum level of low-density lipoprotein was not included in the definition criteria of
dyslipidemia in this study. If this criterion is included, are the results amended? Please consider.
3. The prevalence of dyslipidemia, hypertension and diabetes, which are the risk factors of CVD,
were significantly higher in the non-lean NAFLD patients than in the lean NAFLD patients.
However, CVD incidence was comparable between the two groups. The authors should discuss
this discrepant observation.
4. In the future study, it would be interesting if the authors investigate the association between
metabolic dysfunction-associated fatty liver disease (MAFLD) and CVD incidence using the
same study population.
assistant