Review for 10.1186/1471-230X-12-123 (2012)

Reviewer's report
Title:Prevalence and factors associated with nonalcoholic fatty liver disease in
shanghai work-units
Version: 1Date:26 June 2012
Reviewer: Aline de Piano
Reviewer's report:
Reviewer' comments:
The manuscript presented by Huang and colleagues examines: Prevalence and
factors associated with nonalcoholic fatty liver disease in shanghai work-units.
This manuscript investigates a relevant issue. However, this reviewer has some
concerns with the manuscript.
1) There are some improper sentence structures and the English should be
revised by a native.
2) Abstract
I suggested to change the sentence “to investigate the prevalence of NAFLD in
shanghai employees, and to assess the relationship between NAFLD and age,
gender, metabolic risk factors in shanghai people” to “to investigate the
prevalence of NAFLD in Shangai employees to assess the relationship between
NAFLD and age, gender, metabolic risk factor I this studied population”.
It is suggest avoiding abbreviations in abstract section, such as UA, BMI…
According to manuscript, specifically in table 4, the BMI was not the best index to
NAFLD diagnosis, The BMI was better than WC parameter. This way, I suggest
changing this sentence. Conclusion: beginning the conclusion reinforcing the risk
factors for NAFLD development and after to cite the high prevalence of this
disease.
3) Backgrounds:
a) I suggested explore more about etiology, physiopathology, age and ethnic
factors of NAFLD previous described in the literature.
4) Methods:
a) It is necessary to include the inclusion criteria.
b) In the subject recruitment it was cited that the US was carried out by
hepatologist trained and in the Ultrasonographic examination it was cited that the
US was performed by the same operator. It is important to clarify this point, once
this can be a limitation of the study. When the US was made by the same
radiologist, it is important to examine the intra-examination coefficient of variation
for ultrasound.
5) Results:
a) Line 7: in the sentence “subjects with NAFLD was 46.82±13.50, and it was
40.29±14.76 in …” rewrite the sentence by: subjects with NAFLD was
46.82±13.50, and 40.29±14.76 in …”.
b) Line 11: Change the sentence: “non NAFLD group both in males and females”
to “non NAFLD group in both genders”.
c) Item 2. Age-specific prevalence of NAFLD
Substitute the sentence: “As show in figure 1, the prevalence of NAFLD
increased with the increasing age” to “ As showed in figure 1, the prevalence of
NAFLD increased according to age”.
d) Table 1: Cite the signification of TH/HDL and include the units for all variables
analyzed. Was there difference between genders? It is necessary to include a
symbol representing this statistical difference, as well include this symbol in the
legend of table.
e) Figure 1. Include in the symbol of statistical difference in the NAFLD
prevalence, as well as in the legend of figure, citing the statistical test performed.
f) Table 2 and 4: obesity is written wrong: obesty, correct it. In table 2 and 4 the
Blood pressure criteria used was #130 and in the methods section it was cited #
140. How criteria were adopted? Standard this criteria in both tables.
g) Item 4:
First paragraph: I suggest excluding it, once this paragraph repeat the data
presented in table 3.
Second paragraph: change sex to gender.
h) Item 5:
Central obesity is not defined by BMI # 25. It is necessary to perfume a body
composition analysis. The BMI# 25 is defined as overweight status.
Why did you not performed the OR according to gender?
6) Discussion:
a) Include the reference in the first paragraph.
b) Third paragraph: in the second line: I suggest including the word: important.
…was another important finding.
c) After third paragraph, I suggest to include a discussion about genesis,
physiopathology of NAFLD linking it with metabolic syndrome components to
explain better the increase of NAFLD prevalence and MS (%), as well as linking
with the next paragraph too.
d) According to table 4, the BMI was not the best index to diagnosis of NAFLD in
Shangai population; in this studied model, the best parameter was the TG. The
BMI was better than WC and it was not the best. This way, I suggest correcting
this sentence. Indeed, it is relevant to compare some predictors to other
population.
7) Conclusion:
I suggest adjusting the conclusion with the proposed aim in this study, reinforcing
the important findings and suggesting some next steps I future studies.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.