Reviewer's report
Title:Relationship between spine osteoarthritis, bone mineral density and bone
turn over markers in post menopausal women.
Version: 1Date:26 April 2010
Reviewer: Daniel Salica
Reviewer's report:
In general, it is an interesting paper but, in my opinion, it needs correction of
certain aspects to which I will refer in the following required answers.
1.Is the question posed by the authors well defined?
It is well defined.
2.Are the methods appropriate and well described?
3. Are the data sound?
About questions 2 and 3, the answers are:
-To back up the criteria used to diagnose osteoporosis.
-The risk factors for osteoporosis of the patients have not been detailed.
-It is essential to specify how many bone fragility fractures the patients have.
-The prevalence of patients with low bone mass defined by the T score and
according to the analized region (spine, femoral neck, throcanther and total
femur) do not appear in the paper.
-The prevalence of patients with low body weight (BMI > 25) do not appear in the
paper.
-Several correlations are missing: BMI and: BMD, presence and s
everity of osteophytes and disc space narrowing (DSN), Maximum grade (MAX)
of individual radiographic features and bone turn-over markers.
-It has not been explained if the vertebras with clear arthrosic alterations, which
cause falsely increased levels of arthrosis, have been excluded from BMD test.
-Photographs are missing of at least one lumbar spine X-ray from the side of a
representative patient.
4. Does the manuscript adhere to the relevant standards for reporting and data
deposition?
I believe that, in general, it does.
5. Are the discussion and conclusions well balanced and adequately supported
by the data?
I believe that several relationships such as the relationship between BMI and
BMD, bone turnover markers, and other signs of spinal osteoarthritis have not
been taken into consideration in the results, discussion, and conclusions.
No comments have been made on the limits of the DXA to measure BMD in
patients with severe osteoarthrosis and high BMI (BMI (Kg/m2) Mean 29.08 ±
4.35)
6. Are limitations of the work clearly stated?
I believe that limitations of the work are not clearly stated, which I explained in
detail in the previous answers.
7. Do the authors clearly acknowledge any work upon which they are building,
both published and unpublished?
On the whole, they do but, in my opinion, the suggestions made above should be
included in the paper.
8. Do the title and abstract accurately convey what has been found?
In my opinion, the title is well expressed and the observations I made above
should be taken into account in the abstract.
9. Is the writing acceptable?
In my opinion, according to the observations I made above, the paper could be
reevaluated to consider its acceptance.
To conclude, in my opinion, it is a good paper and it contains important data.
Anything you need, please do not hesitate to let me know
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