| Cao Cong,Yin Hang,Xu Xuehao,Wang Fenglan,Lu Qiuyan,Sun Weishan,Wang Qin,Zhou Aihua,Correlation between serum total bile acid level and cognitive function in patients with stable schizophrenia and its predictive value for cognitive impairment[J].SICHUAN MENTAL HEALTH,2026,(2):133-139 |
| Correlation between serum total bile acid level and cognitive function in patients with stable schizophrenia and its predictive value for cognitive impairment |
DOI：10.11886/scjsws20250929001 |
| English keywords:Stable schizophrenia Cognitive Total bile acid Chinese Brief Cognitive Test |
| Fund projects:盐城市卫健委医学科研立项项目（项目名称：高频rTMS对缓解期精神分裂患者工作记忆的影响，项目编号：YK2024141） |
| Author Name | Affiliation | Postcode | | Cao Cong | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 | | Yin Hang | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 | | Xu Xuehao | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 | | Wang Fenglan | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 | | Lu Qiuyan | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 | | Sun Weishan | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 | | Wang Qin | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 | | Zhou Aihua* | The Fourth People's Hospital of Yancheng, Yancheng 224003, China | 224003 |
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| Background Persistent cognitive impairment is prevalent among patients with stable schizophrenia. While serum total bile acid （TBA） level in acute-phase patients are known to be associated with cognitive dysfunction， the relationship between serum TBA and multi-dimensional cognitive functions in stable phase patients remains unclear.Objective To investigate the correlation between serum TBA level and cognitive function in patients with stable schizophrenia， and to evaluate its predictive value for cognitive impairment， thereby providing a serological biomarker for the timely identification and objective assessment of cognitive dysfunction.Methods A cross-sectional study was conducted on 137 inpatients with stable schizophrenia at The Fourth People's Hospital of Yancheng from March to December 2024. All participants met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Cognitive function was evaluated using the Chinese Brief Cognitive Test （C-BCT）， patients were categorized into four groups： normal cognition （n=28）， mild impairment （n=28）， moderate impairment （n=47）， and severe impairment （n=34）. Fasting venous blood samples were collected， and serum TBA level was quantified using an enzymatic cycle assay. Spearman correlation analysis was ultilized to determine the relationship between serum TBA level， overall cognitive function， and specific cognitive domains. Binary Logistic regression model was used （adjusting for covariates such as age， gender， and disease duration） to analyze the impact of serum TBA level on overall and individual cognitive functions. The predictive value of serum TBA level for overall cognitive impairment was evaluated using receiver operating characteristic （ROC） curve.Results Serum TBA levels differed significantly among the four groups （H=18.677， P<0.01）. Specifically， serum TBA levels in both the moderate and severe cognitive impairment groups were significantly higher than those in the normal cognitive group （adjusted P<0.01）. Serum TBA level was positively correlated with the severity grading of overall cognitive impairment （rs=0.354， P<0.05）， and negatively correlated with T-scores on the trail making test （rs=-0.328， P<0.05）， continuous performance test （rs=-0.247， P<0.05）， digit span （rs=-0.265， P<0.05）， and symbol coding （rs=-0.221， P<0.05）. Binary Logistic regression analysis identified serum TBA level as an independent risk factor for overall cognitive impairment （OR=1.322， 95% CI： 1.021 - 1.713， P=0.034）， with a particularly robust predictive ability for impaired information processing speed （OR=1.325， 95% CI： 1.057 - 1.661， P=0.015）. The area under ROC curve （AUC） for serum TBA level in predicting overall cognitive impairment was 0.738， with a sensitivity of 60.61% and a specificity of 78.64%.Conclusion In patients with stable schizophrenia， elevated serum TBA levels are associated with worse overall cognitive function， as well as deficits in information processing speed， attention， working memory， and executive function. Serum TBA serves as an independent risk factor and exhibits moderate predictive value for overall cognitive impairmen，particularly in the domain of information processing speed. ［Funded by Yancheng Municipal Health Commission Medical Research Project （number， YK2024141）］ |
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