Pretreatment cardiometabolic status in youth with early-onset psychosis: Baseline results from the TEA trial

Karsten G. Jensen; Christoph U. Correll; Ditte Rudå; Dea G. Klauber; Marie Stentebjerg-Olesen; Birgitte Fagerlund; Jens Richardt Møllegaard Jepsen; Anders Fink-Jensen; Anne Katrine Pagsberg

doi:10.4088/JCP.15m10479

Pretreatment cardiometabolic status in youth with early-onset psychosis: Baseline results from the TEA trial

Karsten G. Jensen, Christoph U. Correll, Ditte Rudå, Dea G. Klauber, Marie Stentebjerg-Olesen, Birgitte Fagerlund, Jens Richardt Møllegaard Jepsen, Anders Fink-Jensen, Anne Katrine Pagsberg^*

^*Corresponding author for this work

Department of Clinical Medicine

18 Citations (Scopus)

Abstract

Objective: To describe pretreatment cardiometabolic constitution in children and adolescents with first-episode psychosis (FEP). Methods: Baseline cardiometabolic assessment was performed in youths aged 12-17 years with FEP entering the Tolerability and Efficacy of Antipsychotics (TEA) trial and matched healthy controls. Patients were included between June 10, 2010, and January 29, 2014. ICD-10 was used as the diagnostic classification system. Cardiometabolic risk markers were compared between patients versus controls and antipsychotic-naive versus antipsychotic-exposed patients. Results: Comparing 113 youths with FEP (age ± SD = 15.74 ± 1.36 years, males = 30.1%, schizophrenia-spectrum disorders = 92.9%, antipsychoticnaive: n = 57) to 60 controls, patients had higher waist circumference (WC) zscores (1.13 ± 1.65 vs 0.42 ± 1.27, P =.018), cholesterol (4.10 ± 0.71 vs 3.79 ± 0.49 mmol/L, P =.014), low-density lipoproteins (2.37 ± 0.56 vs 2.13 ± 0.51, P =.012), and non-high-density lipoproteins (2.58 ± 1.60 vs 2.52 ± 0.52, P =.018). More patients than controls (42.9% vs 20.3%, P =.019) and antipsychotic-naive than antipsychotic-exposed (51.9% vs 34.0%, P =.023) had a WC > 90th percentile. Hypercholesterolemia (34.0% vs 12.5%, P =.015) was more frequent in patients, while decreased high-density lipoprotein cholesterol was more frequent in controls (32.5% vs 19.0%, P =.032). Family history of type 2 diabetes mellitus was associated with increased body mass index (BMI) zscore (P <.001), WC zscore (P =.001), insulin (P =.038), and homeostatic model assessment of insulin resistance (HOMA-IR; P =.025). Dyslipidemia was associated with significantly increased insulin (P =.041), HOMA-IR (P =.032), and low-density lipoprotein cholesterol (P =.041). Previous antipsychotic exposure was not associated with increased cardiometabolic risk. Early age at onset predicted increased BMI and WC z scores, while diagnosis of schizophrenia and higher Clinical Global Impression-Severity score were associated with increased blood lipids. Conclusions: Youths with FEP had significantly greater WC and lipid abnormalities than matched controls, regardless of antipsychotic exposure. In youths with FEP, elevated metabolic risk predates antipsychotic exposure.

Original language	English
Journal	Journal of Clinical Psychiatry
Volume	78
Issue number	8
Pages (from-to)	e1035-e1046
ISSN	0160-6689
DOIs	https://doi.org/10.4088/JCP.15m10479
Publication status	Published - 2017

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@article{eb89b141752448189a25b47bf37d6b3a,

title = "Pretreatment cardiometabolic status in youth with early-onset psychosis: Baseline results from the TEA trial",

abstract = "Objective: To describe pretreatment cardiometabolic constitution in children and adolescents with first-episode psychosis (FEP). Methods: Baseline cardiometabolic assessment was performed in youths aged 12-17 years with FEP entering the Tolerability and Efficacy of Antipsychotics (TEA) trial and matched healthy controls. Patients were included between June 10, 2010, and January 29, 2014. ICD-10 was used as the diagnostic classification system. Cardiometabolic risk markers were compared between patients versus controls and antipsychotic-naive versus antipsychotic-exposed patients. Results: Comparing 113 youths with FEP (age ± SD = 15.74 ± 1.36 years, males = 30.1%, schizophrenia-spectrum disorders = 92.9%, antipsychoticnaive: n = 57) to 60 controls, patients had higher waist circumference (WC) zscores (1.13 ± 1.65 vs 0.42 ± 1.27, P =.018), cholesterol (4.10 ± 0.71 vs 3.79 ± 0.49 mmol/L, P =.014), low-density lipoproteins (2.37 ± 0.56 vs 2.13 ± 0.51, P =.012), and non-high-density lipoproteins (2.58 ± 1.60 vs 2.52 ± 0.52, P =.018). More patients than controls (42.9% vs 20.3%, P =.019) and antipsychotic-naive than antipsychotic-exposed (51.9% vs 34.0%, P =.023) had a WC > 90th percentile. Hypercholesterolemia (34.0% vs 12.5%, P =.015) was more frequent in patients, while decreased high-density lipoprotein cholesterol was more frequent in controls (32.5% vs 19.0%, P =.032). Family history of type 2 diabetes mellitus was associated with increased body mass index (BMI) zscore (P <.001), WC zscore (P =.001), insulin (P =.038), and homeostatic model assessment of insulin resistance (HOMA-IR; P =.025). Dyslipidemia was associated with significantly increased insulin (P =.041), HOMA-IR (P =.032), and low-density lipoprotein cholesterol (P =.041). Previous antipsychotic exposure was not associated with increased cardiometabolic risk. Early age at onset predicted increased BMI and WC z scores, while diagnosis of schizophrenia and higher Clinical Global Impression-Severity score were associated with increased blood lipids. Conclusions: Youths with FEP had significantly greater WC and lipid abnormalities than matched controls, regardless of antipsychotic exposure. In youths with FEP, elevated metabolic risk predates antipsychotic exposure.",

author = "Jensen, {Karsten G.} and Correll, {Christoph U.} and Ditte Rud{\aa} and Klauber, {Dea G.} and Marie Stentebjerg-Olesen and Birgitte Fagerlund and Jepsen, {Jens Richardt M{\o}llegaard} and Anders Fink-Jensen and Pagsberg, {Anne Katrine}",

year = "2017",

doi = "10.4088/JCP.15m10479",

language = "English",

volume = "78",

pages = "e1035--e1046",

journal = "Journal of Clinical Psychiatry",

issn = "0160-6689",

publisher = "Physicians Postgraduate Press, Inc",

number = "8",

}

TY - JOUR

T1 - Pretreatment cardiometabolic status in youth with early-onset psychosis

T2 - Baseline results from the TEA trial

AU - Jensen, Karsten G.

AU - Correll, Christoph U.

AU - Rudå, Ditte

AU - Klauber, Dea G.

AU - Stentebjerg-Olesen, Marie

AU - Fagerlund, Birgitte

AU - Jepsen, Jens Richardt Møllegaard

AU - Fink-Jensen, Anders

AU - Pagsberg, Anne Katrine

PY - 2017

Y1 - 2017

N2 - Objective: To describe pretreatment cardiometabolic constitution in children and adolescents with first-episode psychosis (FEP). Methods: Baseline cardiometabolic assessment was performed in youths aged 12-17 years with FEP entering the Tolerability and Efficacy of Antipsychotics (TEA) trial and matched healthy controls. Patients were included between June 10, 2010, and January 29, 2014. ICD-10 was used as the diagnostic classification system. Cardiometabolic risk markers were compared between patients versus controls and antipsychotic-naive versus antipsychotic-exposed patients. Results: Comparing 113 youths with FEP (age ± SD = 15.74 ± 1.36 years, males = 30.1%, schizophrenia-spectrum disorders = 92.9%, antipsychoticnaive: n = 57) to 60 controls, patients had higher waist circumference (WC) zscores (1.13 ± 1.65 vs 0.42 ± 1.27, P =.018), cholesterol (4.10 ± 0.71 vs 3.79 ± 0.49 mmol/L, P =.014), low-density lipoproteins (2.37 ± 0.56 vs 2.13 ± 0.51, P =.012), and non-high-density lipoproteins (2.58 ± 1.60 vs 2.52 ± 0.52, P =.018). More patients than controls (42.9% vs 20.3%, P =.019) and antipsychotic-naive than antipsychotic-exposed (51.9% vs 34.0%, P =.023) had a WC > 90th percentile. Hypercholesterolemia (34.0% vs 12.5%, P =.015) was more frequent in patients, while decreased high-density lipoprotein cholesterol was more frequent in controls (32.5% vs 19.0%, P =.032). Family history of type 2 diabetes mellitus was associated with increased body mass index (BMI) zscore (P <.001), WC zscore (P =.001), insulin (P =.038), and homeostatic model assessment of insulin resistance (HOMA-IR; P =.025). Dyslipidemia was associated with significantly increased insulin (P =.041), HOMA-IR (P =.032), and low-density lipoprotein cholesterol (P =.041). Previous antipsychotic exposure was not associated with increased cardiometabolic risk. Early age at onset predicted increased BMI and WC z scores, while diagnosis of schizophrenia and higher Clinical Global Impression-Severity score were associated with increased blood lipids. Conclusions: Youths with FEP had significantly greater WC and lipid abnormalities than matched controls, regardless of antipsychotic exposure. In youths with FEP, elevated metabolic risk predates antipsychotic exposure.

AB - Objective: To describe pretreatment cardiometabolic constitution in children and adolescents with first-episode psychosis (FEP). Methods: Baseline cardiometabolic assessment was performed in youths aged 12-17 years with FEP entering the Tolerability and Efficacy of Antipsychotics (TEA) trial and matched healthy controls. Patients were included between June 10, 2010, and January 29, 2014. ICD-10 was used as the diagnostic classification system. Cardiometabolic risk markers were compared between patients versus controls and antipsychotic-naive versus antipsychotic-exposed patients. Results: Comparing 113 youths with FEP (age ± SD = 15.74 ± 1.36 years, males = 30.1%, schizophrenia-spectrum disorders = 92.9%, antipsychoticnaive: n = 57) to 60 controls, patients had higher waist circumference (WC) zscores (1.13 ± 1.65 vs 0.42 ± 1.27, P =.018), cholesterol (4.10 ± 0.71 vs 3.79 ± 0.49 mmol/L, P =.014), low-density lipoproteins (2.37 ± 0.56 vs 2.13 ± 0.51, P =.012), and non-high-density lipoproteins (2.58 ± 1.60 vs 2.52 ± 0.52, P =.018). More patients than controls (42.9% vs 20.3%, P =.019) and antipsychotic-naive than antipsychotic-exposed (51.9% vs 34.0%, P =.023) had a WC > 90th percentile. Hypercholesterolemia (34.0% vs 12.5%, P =.015) was more frequent in patients, while decreased high-density lipoprotein cholesterol was more frequent in controls (32.5% vs 19.0%, P =.032). Family history of type 2 diabetes mellitus was associated with increased body mass index (BMI) zscore (P <.001), WC zscore (P =.001), insulin (P =.038), and homeostatic model assessment of insulin resistance (HOMA-IR; P =.025). Dyslipidemia was associated with significantly increased insulin (P =.041), HOMA-IR (P =.032), and low-density lipoprotein cholesterol (P =.041). Previous antipsychotic exposure was not associated with increased cardiometabolic risk. Early age at onset predicted increased BMI and WC z scores, while diagnosis of schizophrenia and higher Clinical Global Impression-Severity score were associated with increased blood lipids. Conclusions: Youths with FEP had significantly greater WC and lipid abnormalities than matched controls, regardless of antipsychotic exposure. In youths with FEP, elevated metabolic risk predates antipsychotic exposure.

U2 - 10.4088/JCP.15m10479

DO - 10.4088/JCP.15m10479

M3 - Journal article

C2 - 28102978

AN - SCOPUS:85026676723

SN - 0160-6689

VL - 78

SP - e1035-e1046

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

IS - 8

ER -

Pretreatment cardiometabolic status in youth with early-onset psychosis: Baseline results from the TEA trial

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