Review for 10.1186/s12876-021-01601-2 (2021)

Reviewer’s report
Title: 
Factors associated with elevated alanine aminotransferase in employees of
a German chemical company: results of a large cross-sectional study
Version: 
0 
Date: 
19 Sep 2020
Reviewer's report:
The authors reported the association between sociodemographic, work- and
lifestyle-related characteristics and elevated alanine aminotransferase (eALT).
It is an important information clinically.
There are some minor concerns.
#1. The authors described odds of eALT were comparatively higher for manual
workers than managerial staff. Is there a difference in chemical exposure? Please
give us a supplement regarding the work environment.
#2. The authors describe the eALT is considered an indicator for NAFLD but
this study included drinkers.I understand that the details of alcohol consumption
are unknown as a limitation of research methods.
Please make a comment for this point or add the data for non-drinkers only.
3. It is interesting the seasonal variation in the prevalence of eALT.
In Discussion, the authors cited Miyake's report and describe the increased
physical activity and/or higher temperatures in the summer season leads to
reduced vascular tone which in turn causes haemodilution of intravascular
substances.
Do you have any blood data or physical activity data to support your hypothesis?
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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?
Yes
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from apparent manipulation?
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