Abstract
INTRODUCTION AND METHODS: To discover biomarkers for schizophrenia (SCZ) at the metabolomics level, we registered this systematic review (CRD42024572133 (https://www.crd.york.ac.uk/PROSPERO/home)) including 56 qualified articles, and we identified the characteristics of metabolites, metabolite combinations, and metabolic pathways associated with SCZ. RESULTS: Our findings showed that decreased arachidonic acid, arginine, and aspartate levels, and the increased levels of glucose 6-phosphate and glycylglycine were associated with the onset of SCZ. Metabolites such as carnitine and methionine sulfoxide not only helped to identify SCZ in Miao patients, but also were different between Miao patients and Han patients. The decrease in benzoic acid and betaine and the increase in creatine were the notable metabolic characteristics of first-episode schizophrenia (FESCZ). The metabolite combination formed by metabolites such as methylamine, dimethylamine and other metabolites had the best diagnostic effect. Arginine and proline metabolism and arginine biosynthesis had a clear advantage in identifying SCZ and acute SCZ. Butanoate metabolism played an important role in identifying SCZ, toxoplasma infection and SCZ comorbidity. Biosynthesis of unsaturated fatty acids was also significantly enriched in the diagnosis and treatment of SCZ. DISCUSSION: This study summarizes the current progress in clinical metabolomic research related to SCZ, deepens understanding of the pathogenesis of SCZ, and lays a foundation for subsequent research on SCZ-related metabolites. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/home, identifier CRD42024572133.