Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study.

Autor:	Tse W; Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China., Khandaker GM; Bristol Medical School, University of Bristol, Bristol, England., Zhou H; Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.; Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China., Luo H; Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China., Yan WC; Department of Psychiatry, Kowloon Hospital, Hong Kong Special Administrative Region, China., Siu MW; Department of Psychiatry, Kowloon Hospital, Hong Kong Special Administrative Region, China., Poon LT; Department of Psychiatry, United Christian Hospital, Hong Kong Special Administrative Region, China., Lee EHM; Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China., Zhang Q; Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong Special Administrative Region, China.; Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China., Upthegrove R; Institute for Mental Health, University of Birmingham, England., Osimo EF; Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, England.; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England., Perry BI; Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, England.; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England., Chan SKW; Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Western Pacific [Lancet Reg Health West Pac] 2024 May 14; Vol. 47, pp. 101089. Date of Electronic Publication: 2024 May 14 (Print Publication: 2024).
DOI:	10.1016/j.lanwpc.2024.101089
Abstrakt:	Background: Metabolic syndrome (MetS) is common following first-episode psychosis (FEP), contributing to substantial morbidity and mortality. The Psychosis Metabolic Risk Calculator (PsyMetRiC), a risk prediction algorithm for MetS following a FEP diagnosis, was developed in the United Kingdom and has been validated in other European populations. However, the predictive accuracy of PsyMetRiC in Chinese populations is unknown. Methods: FEP patients aged 15-35 y, first presented to the Early Assessment Service for Young People with Early Psychosis (EASY) Programme in Hong Kong (HK) between 2012 and 2021 were included. A binary MetS outcome was determined based on the latest available follow-up clinical information between 1 and 12 years after baseline assessment. The PsyMetRiC Full and Partial algorithms were assessed for discrimination, calibration and clinical utility in the HK sample, and logistic calibration was conducted to account for population differences. Sensitivity analysis was performed in patients aged >35 years and using Chinese MetS criteria. Findings: The main analysis included 416 FEP patients (mean age = 23.8 y, male sex = 40.4%, 22.4% MetS prevalence at follow-up). PsyMetRiC showed adequate discriminative performance (full-model C = 0.76, 95% C.I. = 0.69-0.81; partial-model: C = 0.73, 95% C.I. = 0.65-0.8). Systematic risk underestimation in both models was corrected using logistic calibration to refine PsyMetRiC for HK Chinese FEP population (PsyMetRiC-HK). PsyMetRiC-HK provided a greater net benefit than competing strategies. Results remained robust with a Chinese MetS definition, but worse for the older age group. Interpretation: With good predictive performance for incident MetS, PsyMetRiC-HK presents a step forward for personalized preventative strategies of cardiometabolic morbidity and mortality in young Hong Kong Chinese FEP patients. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Competing Interests: RU is supported by the NIHR Oxford Health Biomedical Research Centre. The views expressed are those of the author and not necessarily those of the NIHR or the Department of Health and Social Care. RU has received speaker fee at non promotional educational event for Otsuka June 2022, paid consultancy for Vitaris July 2022 and for Springer Healthcare December 2021. SKWC received research funding from the Health and Medical Research Fund and General Research Fund of Hong Kong. HL received research funding from the General Research Fund of Hong Kong. (© 2024 The Author(s).)
Databáze:	MEDLINE
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