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The association between triglyceride-glucose index and cognitive impairment in patients with first-episode drug-naïve schizophrenia: a large-scale cross-sectional study

Year: 2026

Type: article

Abstract: The triglyceride-glucose (TyG) index serves as an innovative proxy for insulin resistance (IR) and has been correlated with cognitive performance. IR is prevalent in schizophrenia (SZ) patients and could potentially influence cognitive function. Nevertheless, the association between the TyG index and cognitive impairment in first-episode drug-naive (FEDN) SZ patients remains unexplored. The cross-sectional study recruited a large sample of 498 FEDN SZ patients, as well as 201 healthy controls matched for sex and age, whose age range is 16–48 years.Sociodemographic characteristics and clinical data were collected. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), while cognitive function was assessed with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The TyG index was calculated based on fasting triglyceride and glucose levels. The relationship between the TyG index and cognitive function was assessed using methods such as generalized linear models (GLM) and smooth fit curves. After controlling for potential confounders, the TyG index exhibited significant negative associations with immediate memory (β = -7.77), attention (β = -9.09), delayed memory (β = -11.39), and RBANS total score (β = -7.20) (all p < 0.001). Quartile analysis revealed that elevated TyG index values corresponded to decreased cognitive function scores (all p < 0.001). Stratified analyses indicated that these associations were consistent across sex, age, education, smoking, drinking status, and BMI (all p > 0.05). In FEDN SZ patients, the TyG index negatively correlates with cognitive impairment, specifically affecting immediate memory, attention, delayed memory, and overall cognitive function as measured by the RBANS. This suggests that the TyG index may serve as a potential indicator associated with cognitive impairment in this population. Routine assessment of the TyG index may help identify cognitive impairment in FEDN SZ patients, though longitudinal studies are needed to establish its clinical utility. These findings warrant further investigation to determine whether the TyG index could inform early identification strategies for cognitive decline in this population. retrospectively registered. not applicable.

Source: BMC Psychiatry

DOI: 10.1186/s12888-026-08596-8