Review for 10.1186/1471-230X-11-54 (2011)

Reviewer's report
Title:The Association of Serum Lipids with the Histological Pattern of
Rectosigmoid Adenoma in Taiwanese Adults
Version: 3Date:28 December 2010
Reviewer: Georgia Lazaraki
Reviewer's report:
To the authors:
In this study the authors try to elucidate the relationship between dyslipidemia
and adenoma formation of the left colon. It is a well written manuscript with a
meticulous statistical analysis. A few points remain to be clarified:
Major compulsory revisions:
• The authors should clearly state in the first paragraph of the methods part
whether this is a retrospective study or the examinees were prospectively
included. When reading the subjects part one comes to the conclusion that this is
a retrospective study since finally from ~5000 examinees only one half were
finally included. If this was a prospective study the authors should comment on
this poor inclusion percentage. After that, in the study design part, it is stated that
all participants filled a questionnaire regarding medical history, lifestyle and
demographic data: was this prospective or this is part of a standard visit?
• Same comment as above regarding the blood sample: the authors describe the
conditions the blood sample was taken, but again this is only the proper way to
take blood sample for lipid levels. Were these instructions given in a prospective
way to include patients or these are the standard instructions given for a correct
blood sample and were estimated retrospectively by extracting data from
patients’ files?
• Discussion part: “…We found that subjects with adenoma were older, and had
higher fasting glucose and blood pressure than normal subjects. Male gender,
diabetes, hypertension, general obesity, abdominal obesity, smoking, and alcohol
consumption were also more common in those with adenoma (data not shown)”.
I find a little bit odd the fact that the authors, in the first paragraph of the
discussion part, comment on data that are not presented in the results part. I
think that these data, that were may be expected, should be presented in a table
in the results part.
• Discussion part: “…One possible explanation is that, different to the previous
studies, we had fewer subjects with pure villous adenoma and we utilized a
different statistical methodology”. Since the authors think it is the different
statistical analysis used in the study that provides different results, they should
explain here why it is preferable compared to that used in previous studies.
Minor essential comments:
• Abstract, Results, the first sentence “…The eligible examinees were classified
into three groups: tubular adenoma (3333 subjects), villous-rich
(tubulovillous/villous) adenoma (53 subjects) and normal (2,120 subjects)”. I think
that population classification into groups should be included in the patients
methods part.
• Page 4, introduction, last paragraph: “…Previous studies on the relationship
between serum lipids and colorectal adenoma shows conflicting results…”. I think
that “shows” should be replaced by “show”.
• Page 5, Methods –Subjects part, GPT serum levels: I believe that the authors
should replace this term either by SGPT or ALT levels, terms that are
internationally more easily recognizable.
• Page 7, Methods-Study Design part, “automatic biochemical analyzer (Roche
Modular D&P)”, the authors should state the exact model, the manufacturer and
country where this was manufactured.
• Page 7: what is this electronic scale to count the height? If this is a device,
please provide the exact model, the manufacturer and country where this was
manufactured. If not, please provide a reference.
• Page 7, last line: I believe that “21” goes with the beginning of the next
paragraph and next sentence so it would be better if it was stated like this:
“Twenty-one experienced gastroenterologists…”
Discretionary Revisions:
• The authors could comment in the discussion on the data presented in a recent
similar Taiwanese study (Liu CS, BMC Gastroenterol. 2010 May 27;10:51)
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests