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%, antipsychotic-naive: n = 57) to 60 controls, patients had higher waist circumference (WC) z scores (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) z score (P < .001), WC z score (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.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01119014; European Clinical Trials Database (EudraCT): 2009-016715-38​​​.
authors.affiliation: Centre for Child and Adolescent Mental Health, Mental Health Services, Capital Region of Denmark and Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark.
authors.forename: Karsten G
authors.initials: KG
authors.lastname: Jensen
authors.affiliation: Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York; Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, New York; and The Feinstein Institute for Medical Research, Manhasset, New York, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Centre for Child and Adolescent Mental Health, Mental Health Services, Capital Region of Denmark and Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark.
authors.forename: Ditte
authors.initials: D
authors.lastname: Rudå
authors.affiliation: Centre for Child and Adolescent Mental Health, Mental Health Services, Capital Region of Denmark and Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark.
authors.forename: Dea G
authors.initials: DG
authors.lastname: Klauber
authors.affiliation: Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark and Laboratory of Neuropsychiatry, University of Copenhagen, Denmark.
authors.forename: Marie
authors.initials: M
authors.lastname: Stentebjerg-Olesen
authors.affiliation: Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Copenhagen University Hospital, Psychiatric Center Glostrup, Capital Region of Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Fagerlund
authors.affiliation: Centre for Child and Adolescent Mental Health, Mental Health Services, Capital Region of Denmark and Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark.|Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Copenhagen University Hospital, Psychiatric Center Glostrup, Capital Region of Denmark.
authors.forename: Jens Richardt Møllegaard
authors.initials: JRM
authors.lastname: Jepsen
authors.affiliation: Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark and Laboratory of Neuropsychiatry, University of Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Fink-Jensen
authors.affiliation: Centre for Child and Adolescent Mental Health, Mental Health Services, Capital Region of Denmark and Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Nordre Ringvej 69, DK- 2600 Glostrup, Denmark. anne.katrine.pagsberg@regionh.dk.|Centre for Child and Adolescent Mental Health, Mental Health Services, Capital Region of Denmark and Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark.
authors.forename: Anne Katrine
authors.initials: AK
authors.lastname: Pagsberg
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood*; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology; D017050:Episode of Care; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D038801:International Classification of Diseases; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D065129:Pre-Exposure Prophylaxis / Q000379:methods / Q000706:statistics & numerical data; D011379:Prognosis; D011618:Psychotic Disorders / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012559:Schizophrenia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D055105:Waist Circumference
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D008078:Cholesterol, LDL