Correlation between serum total bilirubin,albumin levels and cognitive function in first-episode drug-naïve patients with schizophrenia

DU Weinan; LANG Xiao'e

doi:10.12102/j.issn.1009-6493.2026.05.006

Abstract：Objective:To investigate the correlation between peripheral non-enzymatic antioxidant levels,such as serum uric acid(UA),total bilirubin(TBIL),and albumin(ALB),and cognitive impairment in first-episode drug-naïve(FEDN)patients with schizophrenia(SZ).Methods:A total of 167 FEDN schizophrenia patients from the department of psychiatry,First Hospital of Shanxi Medical University,were enrolled as the case group from October 2022 to October 2024,along with 103 matched healthy volunteers as the control group.Fasting venous blood was collected to measure serum UA,TBIL,and ALB levels.Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).Results:The case group showed significantly lower serum ALB and TBIL levels compared to the healthy control group(P<0.001).Total scores of RBANS as well as scores across all domains were also lower in the case group(P<0.001).After adjusting for confounding factors,serum TBIL levels were positively correlated with immediate memory(β=0.67,P<0.001),delayed memory(β=1.06,P<0.001),and the RBANS total scores(β=0.47,P<0.001).Serum ALB levels were positively correlated with immediate memory(β=0.60,P<0.001)and delayed memory scores(β=1.39,P<0.001).However,no significant correlations were observed between serum TBIL or ALB levels and the RBANS scores in the healthy control group.Conclusions:In clinical practice,early correction of peripheral non-enzymatic antioxidant levels,such as specifically serum total bilirubin and albumin,in FEDN schizophrenia patients may enhance antioxidant capacity and improve cognitive function,particularly memory,highlighting its clinical importance.