The metabolic syndrome is a collection of interrelated risk factors of metabolic origin, whose main clinical outcomes are diabetes and coronary heart disease. According to the 2007 Chinese guidelines for the prevention and treatment of adult dyslipidemia, metabolic syndrome is defined as having three or more of the following: (1) abdominal obesity: waist circumference >2250px in men and >2125px in women; (2) blood triglycerides (TG) ≥1.7mmol/l (150mg/dl). (3) Blood high-density lipoprotein (HDL-C) <1.04mmol/l (40mg/dl). (4) Blood pressure ≥ 130/85mmHg. (5) Fasting blood glucose ≥ 6.1mmol/l (110mg/dl) or 2h post glucose load blood glucose ≥ 7mmol/l (140mg/dl) or history of diabetes mellitus. In a survey of schizophrenia inpatients at the Shanghai Mental Health Center in 2000, it was found that 15.1% of patients had diabetes, 13.7% of whom were men and 18% of whom were women, which was much higher than the 2.1% incidence in the Chinese general population. The metabolic syndrome not only affects the recovery of cognitive function, but also the occurrence of cardiovascular and cerebrovascular events that affect patients' life treatment and even life expectancy. 1. Mechanisms of combined metabolic syndrome in schizophrenia There are two reasons for the increased risk of metabolic syndrome in schizophrenia patients: i. the patient's own genetic quality; ii. the effect of antipsychotic drugs. The mechanism behind the higher proportion of metabolic abnormalities in first unmedicated schizophrenia patients alone than in the general population is also a hot topic of current research. In the study of genetic loci and signaling pathways common to schizophrenia and metabolic syndrome, more than 28 signaling pathways related to the development of schizophrenia and diabetes and the relationship network between the pathways have been identified; 364 proteins, which may be candidate risk factors common to both schizophrenia and diabetes, have been clarified; providing a new mechanism for the co-morbidity between schizophrenia and diabetes. A recent study from Schizophrenia A recent study from Schizophrenia Research further confirms the small number of previous studies: 102 patients with spermatozoa (both unmedicated and currently unmedicated) and 64 of their siblings and 70 age-matched healthy controls were included in the study. The metabolic syndrome was assessed by the Adult Treatment Panel (ATP) III, adapted from ATP III, and the International Diabetes Federation criteria. The results showed that: (1) The frequency of metabolic syndrome diagnoses and metabolic disorders was statistically higher in the seminomic patients and their siblings than in the healthy controls and their siblings. (2) The refined patient group had lower high-density lipoprotein (HDL) levels and higher blood pressure (both systolic and diastolic) levels than the control group, both of which already put patients at high risk for metabolic syndrome, even if they had not started antipsychotic medications. This study suggests that there are factors other than antipsychotic medications that contribute to the high prevalence of metabolic syndrome in patients with schizophrenia. Since schizophrenia itself is strongly associated with the development of metabolic syndrome, assessment and attention to metabolic risk in these patients should begin as early as possible, perhaps the moment the diagnosis becomes clear. There is more research evidence that antipsychotic drugs cause increased risk of metabolic abnormalities in patients with psychiatric disorders. It is thought that the main mechanisms may be as follows: stimulation of increased appetite, which is currently thought to be caused by the drug through agonism/antagonism of the corresponding receptors (H1 , a-1A , 5-HT2C , 5-HT6 receptors), and may also be related to the brain opioid system and certain peptides; decreased exercise, with a relative lack of initiative and relatively low activity in the seminomic patient; disruption of the neuroendocrine axis, including hypothalamic-pituitary -adrenal/hypothalamic-pituitary-gonadal axis; the development of insulin resistance; and affected cytokine levels, such as leptin and lipocalin. The effects of different types of antipsychotics on metabolism vary and are closely related to different receptor binding mechanisms. 2.How can schizophrenia patients prevent and treat metabolic syndrome? From the perspective of patients themselves, age, gender, disease duration, family history, ethnicity and psychogenic factors may all be susceptibility factors for metabolic syndrome. According to a Danish study tracking the risk of diabetes in more than 40,000 adolescent schizophrenics, being female and older at diagnosis were significantly associated with the risk of rapid onset of diabetes, and the use of antipsychotic medications tended to increase the risk of rapid onset of diabetes. In general, patients with clinical obesity, a first-degree family history of metabolic syndrome, and use of some antipsychotic medications (those with high metabolic impact, such as clozapine and olanzapine) need to be monitored regularly for metabolism-related indicators. in early 2014, NICE made updates and additions to the consultation and management of schizophrenia in adults, and when assessing adverse effects of medications, it requires metabolism as the most important factor to be considered, with greater emphasis on baseline metabolic and cardiovascular system recording and assessment during acute interventions, and on systematic and regular testing of indicators. BMI, waist circumference, lipids, and fasting glucose should be performed at the beginning of treatment and quarterly after treatment in patients receiving atypical antipsychotics. For those at high risk for diabetes with a positive family history of obesity or abnormal fasting glucose measurements, monthly monitoring should be performed during the first 3 months of treatment. For patients who are already overweight or have abnormal blood glucose and lipids, the following measures are recommended for comprehensive prevention and treatment: (1) Establish good lifestyle habits, avoid bad moods, and exercise to burn excess fat stored in the body, lower plasma cholesterol and triglyceride levels, and increase HDL concentrations. (2) Dietary modification: avoid high-fat and high-sugar diets, and consume more vegetables and high-fiber cereals. (3) For medications, the American Diabetes Association (ADA) and the American Psychiatric Association (APA) recommend that the metabolic risks of second-generation atypical antipsychotics should be carefully considered when starting treatment; if the patient has an initial weight gain of ≥10%, consider reducing the dose or changing to another antipsychotic if it is safe to do so; if the patient has an increase in blood glucose or dyslipidemia during treatment, consider Consider switching to a second-generation antipsychotic that is not associated with significant weight gain or diabetes; in addition, studies have demonstrated that intervention with metformin is effective in preventing some antipsychotic-induced glucose and lipid abnormalities.