Review for 10.1186/s12876-020-01501-x (2020)

Reviewer’s report
Title: 
Loss of skeletal muscle mass affects the incidence of minimal hepatic
encephalopathy: A case control study
Version: 
1 
Date: 
02 Aug 2020
Reviewer's report:
I read the manuscript by Tateyama et al with great interest. Authors sought to
understand whether sarcopenia affects HE in patients with liver failure.
Although the study might be valid, the power of study is very limited.
Authors identified only 6 cases with sarcopenia. Moreover they did a
multivariate analysis without including many variables. 
It is clear rom the table that BMI in the MHE group is lower than MHE neg
group. So the correlation of BMI could give the same results as they did in
sarcopenia. (Fig 2). However low BMI doesn't not mean sarcopenia in fact we
dont know how many patients in low BMI group included also sarcopenia
patients.
Many studies in the literature include psoas muscle volume but authors did
skeletal muscle (could be also L3 level psoas but not clear in the manuscript).
Representative of CT scan how they measure the muscle volume should be
added. 
Another important factor in this cohort to identify if patients are on narcotics,
any psych meds, and any medications which could affect neurological function
and therefore HE.
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