Review for 10.1186/s12876-020-01579-3 (2021)

Reviewer’s report
Title: 
Metabolic Syndrome Components and Acute Pancreatitis: A Case-Control
Study in China
Version: 
1 
Date: 
15 Nov 2020
Reviewer's report:
The manuscript has been revised and relevant 
changes have been incorporated.
However, i still have a few concerns.
The biggest limitation of the study is its retrospective design, and hence the
ability to only comment on association and not causation. Prospective cohort
studies are needed to comment on true incidence rates. This should be clearly
mentioned in the limitation section.
The novelty of the study is depiction of association of metabolic syndrome
components in AP patients amongst chinese population. However, there are
studies showing such association from other parts of the world. Authors should
mention clearly the lacunae in existing literature and a ground for their research
in introduction section.
The assumption by authors in discussion line 305/306, page 14 regarding
visceral obesity being difficult to distinguish from general obesity is not entirely
right. CT scans and 
DEXA scans are being used to evaluate visceral obesity, due
to it being the metabolically active fat. 
It is quite possible that visceral obesity
has an association with AP occurence whereas general AP does not. 
Visceral fat was not assessed and obesity was defined only on the basis of BMI
should be mentioned as a limitation.
The concept of "obesity paradox" can find mention in your discussion.
Line 263 and 264 page 12 is is not clear and needs rectification 
"TC and Apo A
values were correlated with TC and Apo A"
Line 319, "were" should be used instead of "was" since you are referring to a
plural that is patients.
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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?
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