Review for 10.1186/s12876-021-01609-8 (2021)

Reviewer’s report
Title: 
Incidence and risk factors of micronutrient deficiency in patients with IBD
and intestinal Behçet’s disease: Folate, Vitamin B12, 25-OH-vitamin D, and
Ferritin
Version: 
0 
Date: 
15 Nov 2020
Reviewer's report:
This paper describes a retrospective analysis of micronutrient deficiencies in
patients with IBD or Behcet's disease. This is an important subject, and the
inclusion of patients with Behcets is almost unique. It would be highly desirable
to see such work published, but in its current form the manuscript is
compromised by several deficiencies which could be addressed.
Major issues
1 The hypothesis is not clearly stated, which leads to some lack of clarity in the
statistics. It would be good to set it out as, for example, is micronutrient
deficiency more common in Behcet's than Crohn's. It is not helpful in this
context to lump together Crohn's and UC due to differences in small intestinal
involvement, and these diseases should be separated. The statistical hypothesis
testing should then be easy - a comparison of Crohn's and Behcets.
2 The authors have not taken into account that inflammation itself changes
measured circulating micronutrient concentrations. This could be done by using
an index against CRP, as several authors have done. If this is not possible,
though I would strongly encourage it, then this limitation should be included in
the Discussion. Inflammatory markers should be included in Table 1 to aid
interpretation.
3 The authors recognise that there is a potential bias in who gets tested in routine
practice. Presumably only those felt to be at risk of deficiency get tested. So how
representative are the tested patients against the whole group of their patients?
Minor issues
4 In the Background, IBD is referred to as a single disease. These diseases
should be disaggregated.
5 Water is not a nutrient.
6 The first paragraph of Results is confusing. What is higher? What is lower?
Again, the lack of hypothesis contributes to the confusion
7 Table 1 should be set out by disease group, and the Montreal classification
included
8 Somewhere, possibly in Figure 2, actual nutrient values should be given, not
just categorised as "deficient" or not.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
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No
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Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes