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Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
摘要：
■代谢综合征（MetS）在首发精神病（FEP）后很常见，导致大量的发病率和死亡率。精神病代谢风险计算器（PsyMetRiC），FEP诊断后的MetS风险预测算法，是在英国开发的，并在其他欧洲人群中得到了验证。然而,PsyMetRiC在中国人群中的预测准确性未知.
■15-35岁的FEP患者，包括于2012年至2021年期间首次提交给香港早期精神病青少年早期评估服务（EASY）计划。根据基线评估后1至12年的最新可用随访临床信息确定二元MetS结果。对PsyMetRiC完整和部分算法进行了歧视评估，香港样本的校准和临床应用，并进行了逻辑校准以考虑人群差异。对年龄>35岁的患者采用中国MetS标准进行敏感性分析。
■主要分析包括416名FEP患者（平均年龄=23.8岁，男性=40.4%，随访时MetS患病率为22.4%)。PsyMetRiC显示出足够的判别性能（全模型C=0.76，95％C.I.=0.69-0.81；部分模型：C=0.73，95％C.I.=0.65-0.8）。使用逻辑校准对两个模型中的系统风险低估进行校正，以完善香港中国FEP人群的PsyMetRiC（PsyMetRiC-HK）。PsyMetRiC-HK提供了比竞争策略更大的净收益。在中国的MetS定义下，结果仍然稳健，但对老年群体来说更糟。
■具有良好的事件MetS预测性能，PsyMetRiC-HK为香港年轻中国FEP患者的心脏代谢发病率和死亡率的个性化预防策略迈出了一步。
■这项研究没有获得公众资助机构的任何具体资助，商业,或非营利部门。
■15-35岁的FEP患者，包括于2012年至2021年期间首次提交给香港早期精神病青少年早期评估服务（EASY）计划。根据基线评估后1至12年的最新可用随访临床信息确定二元MetS结果。对PsyMetRiC完整和部分算法进行了歧视评估，香港样本的校准和临床应用，并进行了逻辑校准以考虑人群差异。对年龄>35岁的患者采用中国MetS标准进行敏感性分析。
■主要分析包括416名FEP患者（平均年龄=23.8岁，男性=40.4%，随访时MetS患病率为22.4%)。PsyMetRiC显示出足够的判别性能（全模型C=0.76，95％C.I.=0.69-0.81；部分模型：C=0.73，95％C.I.=0.65-0.8）。使用逻辑校准对两个模型中的系统风险低估进行校正，以完善香港中国FEP人群的PsyMetRiC（PsyMetRiC-HK）。PsyMetRiC-HK提供了比竞争策略更大的净收益。在中国的MetS定义下，结果仍然稳健，但对老年群体来说更糟。
■具有良好的事件MetS预测性能，PsyMetRiC-HK为香港年轻中国FEP患者的心脏代谢发病率和死亡率的个性化预防策略迈出了一步。
■这项研究没有获得公众资助机构的任何具体资助，商业,或非营利部门。
