The Association Between Cognitive Function,Psychotic Symptom And Glucolipid Metabolism In Patients With Schizophrenia

Background: Cognitive deficits are one of the core symptoms of schizophrenia,including the impairment of attention,working memory,speed of processing,verbal learning and other cognitive fields,which is closely related to the prognosis of patients.At present,the mechanism of cognitive deficits in patients with schizophrenia is unclear.Antipsychotic medications are the mainstay treatment for schizophrenia,which have little effect on cognitive deficits.There is no effective invention for cognitive deficits of patients with schizophrenia.Therefore,it is of great significance to find out the related factors affecting the cognitive deficits of schizophrenia patients for clarifying the mechanism of cognitive deficits and early intervention.The purpose of this study was to investigate the correlation between cognitive function and psychotic symptom as well as glucolipid metabolism in first episode patients with schizophrenia.Methods: A total of 172 first episode patients with schizophrenia were enrolled in this study after screening,and 169 patients completed the study process.The MATRICS consensus cognitive battery(Measurement and Treatment Research to Improve Cognition in Schizophrenia consensus cognitive battery,MCCB)was used to assess the cognitive function of patients;The severity of psychotic symptoms was evaluated by Positive and Negative symptom scale(PANSS).Blood samples were collected from all patients after fasting overnight to detect glucolipid metabolism.Patients were divided into obvious cognitive deficit group,mild cognitive impairment group and normal group according the degree of cognitive impairment.Glucolipid metabolism indexes,PANSS and MCCB were compared among the groups.The correlation between psychotic symptom and glucolipid metabolism related to cognitive function was analyze using correlation analysis and further regression analysis.Results: 1.Compared patients with significant cognitive deficits,mild cognitive deficits and normal cognitive function(1)The average age of patients in the group with significant cognitive impairment was significantly lower than that in the group with normal cognitive function(P = 0.022),and the years of education was significantly lower than that in the group with mild cognitive impairment(P = 0.020).There was no statistical difference in other demographic data(P > 0.05).(2)The MCCB scores of 7 cognitive function domains were significantly impaired in the cognitive impairment group,especially in the areas of speed of processing,working memory and verbal learning.(3)The negative symptom subscale score of PANSS in the obvious cognitive impairment group was significantly higher than that in the normal group(P = 0.002)and mild cognitive impairment group(P =0.012).There were no significant differences in PANSS positive symptom score,PANSS general pathology score and PANSS total score among the three groups(P > 0.05).(4)There were no significant differences in BMI,fasting blood glucose,insulin resistance index,triglyceride,total cholesterol,high-density lipoprotein and low-density lipoprotein between the obvious cognitive deficit group,mild cognitive deficit group and the normal group(P > 0.05).2.Correlation analysis between PANSS scale and MCCB(1)PANSS negative symptom subscale score was significantly negatively correlated with speed of processing(r =-0.306,P = 0.004)and social cognition(r =-0.254,P = 0.028).PANSS positive symptom score and PANSS general pathology scale score were not correlated with cognitive function(P > 0.05)(2)Further regression analysis showed that the subscales of negative symptoms of PANSS were social cognition(β =-0.227,P = 0.006)and speed of processing(β =-0.306,P < 0.001).3.Correlation analysis of glucolipid metabolism index and MCCB(1)There was a positive correlation between the increase of BMI and verbal learning(r = 0.218,P = 0.078);Increased insulin resistance index was positively correlated with social cognition(r = 0.223,P =0.089).Increased triglyceride level was positively correlated with visual memory(r = 0.273,P = 0.018).(2)Regression analysis showed that there was no correlation between insulin resistance index and social cognition(β = 0.107,P =0.191).Elevated triglyceride levels were not associated with visual memory(β = 0.020,P = 0.804).BMI was not associated with verbal learning(β =-0.009,P = 0.912).Conclusions: 1.Most first-episode schizophrenics have shown significant cognitive impairment,involving multiple areas of cognitive function;2.Speed of processing and social cognition were negatively correlated with negative symptoms,while cognitive function was not correlated with positive symptoms and general pathological symptoms.3.No significant impairment of glucose and lipid metabolism was found in the enrolled patients in this study,and the cognitive function was not related to the changes of glucose and lipid metabolism indexes within the normal range.