Review for 10.1186/s12876-017-0609-6 (2017)

Reviewer ’s report  
 
Title: The inverse effect of meal intake on contr olled attenuation parameter and liver stiffness as 
assessed by transient elastography  
 
Version: 0 Date: 14 Jan 2017  
 
Reviewer: Naoki Tanaka  
 
Reviewer's report:  
 
The authors examined the effect of meal on CAP and LS in biopsy -proven NAFLD patients. This 
study is interesting and well written, but there are some points to be revised.   
1. The last sentence of Abstract: To avoid misreading, you can correct to "A fasting period or 
more than 150 minutes after a meal is recommended for patients undergoing TE.  
 
2. The accuracy of CAP for steatosis determination is low in the patients with obesity and 
advanced fibrosis (Fujimori et al., Hepatology Research 2016). The authors should cite this 
manuscript.  
 
3. The authors should show the effect of meal on LS values a ccording to fibrosis and steatosis 
stages, like Figures 3 and 4.  
 
4. The authors should discuss the possible mechanism on how meal influences CAP and LS 
values.  
 
5. Limitation: The authors should mention small number of the cohort and the reasons as a 
majo r limitation and describe the reasons.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the wo rk include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
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 statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editor s. 
 
Not relevant to this manuscript  
 
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 publi cation 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 or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you curr ently 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.  
 
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