Reviewer's report
Title:Relationships between vertebral fractures, sex hormones and vitamin D in
Moroccan postmenopausal women: a cross sectional study.
Version:2Date:4 March 2015
Reviewer: Sofija Zagarins
Reviewer's report:
Major Compulsory Revisions
1. The introduction describes some important information related to VFs and their
risk factors, but does not clarify the “research gap” being addressed in this
article. The second paragraph of the introduction states that there’s limited data
related to sex hormones and VFs, but the first paragraph described a number of
studies that have addressed this topic. Why aren’t these existing studies
sufficient? What does the current study add to this literature?
2. The rationale behind the comparisons presented in Table 2 is not clear. These
comparisons are also presented in Table 3, and Table 2 appears to be a more
detailed look at the data in Table 3. If Table 2 is intended to add detail to the
interesting correlations observed in Table 3, the order of the tables should be
reversed, and this rationale should be clarified in the methods.
3. Table 4 should include information about the variables included in the stepwise
models. Also, the headings should be translated into English.
4. The discussion section includes a long and detailed comparison of the results
of the current study with previous research, but it is not clear what the current
study adds to this research. This section should be shortened to focus on the
important findings of the current study, and should clarify what these findings add
to the literature. Given that many existing studies appear to be methodologically
superior, the authors should highlight why the results of this cross sectional study
of a younger, healthy population are important.
5. The main results highlighted in the conclusion (i.e., that VFs are best predicted
by years since menopause and low BMD) are very similar to findings of many
other studies. The conclusion should highlight why these results are important,
given that they aren’t novel. Similarly, the importance of the observed
associations between specific sex hormones and BMD should be clarified (again,
similar associations have been reported previously).
6. Overall, the authors should edit this manuscript to clarify what their research
adds to the literature, and should streamline the results and discussion sections
to focus on these contributions. Currently there are many results presented and
discussed, and it’s not clear what these results add to the existing research. A
more detailed description of this studies strengths and limitations, and of what
this paper adds to the literature, would strengthen the paper considerably.
Minor Essential Revisions
7. Line 84: there should be a comma between “and VFs” and “The objectives”
rather than a period
8. Line 86: should read “and prevalence of asymptomatic VFs” rather than “and
asymptomatic VFs prevalence”
9. Line 119: remove an extra period at the end of the sentence
10. Line 181: “Vfs” should be changed to “VFs”
11. Line 190: “patient” should be changed to “patients”
12. Line 192: should read “They also had a lower…)”
13. Lines 197-199: should read “…the following variables: age, parity, years
since menopause (YSM), OC, #-CTX, SHBG, FAI, age and BMI.”
14. Lines 200-202: should read “…with the following variables: age, parity, YSM,
OC, #-CTX, SHBG, FAI, S-DHEA and BMI.”
15. In general, the results section should not repeat information that is included in
the tables. Rather, this section should summarize the data presented and refer
the reader to the table to get the full details of these results.
16. Line 253: “In” should not be capitalized
17. Figure 1: A category should be added to clarify why data aren’t available for
all n=207 women at each site (e.g., why do only about 100 women have data for
T4? Were the T4 vertebra not visualized for the other 100 women?)
18. Figure 1: The key should link the colors used in the figure to the full
descriptions rather than use an intermediate set of abbreviations that are clarified
in a footnote.
Discretionary Revisions
19. Table 1 is difficult to read – could be improved by including “mean (SD)” in
the headings for the three group columns rather than in the variable descriptions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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.