Review for 10.1186/s12876-022-02604-3 (2022)

Title: Effect of Helicobacter pylori Eradication on Metabolic Profile: An International,
Multicenter, Case-Control Study
Version: 3 Date: 02 Sep 2022
Reviewer's report:
This is a Case-Control Study to evaluate that the effect of Helicobacter pylori Eradication on
Metabolic Profile. This is a very interesting manuscript, however, some problems are listed
below.
I think 3 months of observation is too short a period. It will take more time for the effects of
gastritis improved by eradication on lipid profile to settle down. I think the results of this study
are an observation of that process.
The third month after successful eradication is also a time when duodenitis and/or transient
reflux esophagitis may occur, therefore, patients may temporarily decrease their appetite and
their blood tests may be affected.
The eradication rate is low in patients with comorbidities, but is it possible that patients with
comorbidities have a history of bacterial infection and have taken antibiotics, which may induce
resistance to drugs (clarithromycin, e.t.c.)?
It is strange that after successful edradication, body weight was decreased but BMI had hardly
changed. Had patients shrunk in height?
It is strange and inappropriate that alcohol consumption and dietary intake were not included
in the considerations., even though the study aimed to investigate the relationship between HP
infection eradication and metabolic profile.
In result section, authors mentioned “The results of logistic regression showed that the
eradication of infection has no significant affect any of the metabolic profile parameters.
The adjusted logistic regression model based on various variables (including age, sex, race,
nationality, underlying disease, type of HP induced GI disease, therapeutic regimen, and
smoking), showed that eradication of HP infection had no significant effect on the any of the
patients' metabolic profile parameters (Table 5).”, but in discussion section, “According to
findings of the current study, successful HP eradication could be accompany by a significant
decrease in serum TG levels, 3 months after the treatment compared to baseline values. However,
there was no difference between the responders and refractory cases in other metabolic profile
parameters. Moreover, the levels of other metabolic profile parameters would not significantly
change up to 3 months after the treatment.” and in conclusion section, “HP infection eradication
significantly reduced the serum TG levels in the patients with successful eradication. However, it
had no significant effect on other metabolic profile parameters up to 3 months after eradication.”.
The authors should explain how they interpret the results of logistic regression (TG: Non-
Adjusted analysis, p=0.783, Adjusted analysis, p=0.829).
Is the number of people in Race on Table.1 and Group A on Table.3 accurate? The total may
not match the number of participants (N=164, 35).
Calcium levels differ between the two groups after treatment.
PLT and ALP are significantly different before and after eradication in Group B (resistant to
treatment).
The explanations of the abbreviations listed in Table 5 should be mentioned in Table 4.
Is it possible to analyze only patients without comorbidities?