The relationship between inflammation and cognitive function in drug-naïve schizophrenia with or without pre-metabolic syndrome

Qiao Su; Jiayue Wang; Hongmin Ge; Meijuan Li; Xiaoxiao Sun; Shuo Wang; Zaimina Xuekelaiti; Zhenning Feng; Ying Xu; Yuying Qiu; Jie Li

doi:10.1016/j.psychres.2025.116604

The relationship between inflammation and cognitive function in drug-naïve schizophrenia with or without pre-metabolic syndrome

Psychiatry Res. 2025 Jun 20:351:116604. doi: 10.1016/j.psychres.2025.116604. Online ahead of print.

Authors

Qiao Su¹, Jiayue Wang¹, Hongmin Ge¹, Meijuan Li¹, Xiaoxiao Sun¹, Shuo Wang¹, Zaimina Xuekelaiti¹, Zhenning Feng¹, Ying Xu¹, Yuying Qiu², Jie Li³

Affiliations

¹ Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China.
² Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China. Electronic address: qiuyuying1987@126.com.
³ Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China. Electronic address: jieli@tmu.edu.cn.

PMID: 40580796
DOI: 10.1016/j.psychres.2025.116604

Abstract

Background: Inflammation has been linked to cognitive function in schizophrenia (SCZ), but no studies have examined the impact of pre-metabolic syndrome (pre-MetS) on this relationship. Herein, we aimed to investigate their relationship in drug-naïve SCZ from a novel perspective.

Methods: We conducted a cross-sectional study of 228 drug-naïve SCZ, divided into pre-MetS and non-pre-MetS groups. Blood samples were collected to measure the markers, including fasting plasma glucose (FPG), cholesterol (CHO), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), CRP-albumin ratio (CAR), and neutrophils-lymphocytes ratio (NLR). MATRICS Consensus Cognitive Battery (MCCB) was used to assess cognitive function. Partial correlation analysis was used to explore the relationship between the markers and cognitive function.

Results: Patients with pre-MetS exhibited significant differences from those in the non- pre-MetS group on five dimensions of cognitive function (P < 0.05). In the pre-MetS group, FPG, TG, HDL and NLR were all significantly correlated with cognitive function (P < 0.05), and the combined HDL and NLR showed good performance in identifying cognitive impairment with an area under the curve (AUC) of 0.712. In the non-pre-MetS group, CRP and CAR were significantly correlated with cognitive function (P < 0.05), and the combination of CRP and CAR had a better ability to identify cognitive impairment (AUC = 0.744).

Conclusion: Patients with pre-MetS have more cognitive impairment. These findings provide insights into the different mechanisms by which inflammation is involved in the process of cognitive impairment in SCZ with and without pre-MetS.

Keywords: Cognition; Inflammation; Pre-metabolic syndrome; Schizophrenia.