BACKGROUND: Schizophrenia (SCZ) is a complex mental disorder that typically emerges in late adolescence or early adulthood. The underlying molecular mechanisms of SCZ remain unclear. There is growing evidence supporting the involvement of abnormalities in metabolic and endocrine systems in the pathophysiology of SCZ. Our study was designed to explore the interrelationship between gonadal hormones and glucose metabolism in patients with SCZ. METHODS: One hundred and twenty-four female first-episode patients diagnosed with SCZ according to DSM-IV were recruited. The glucose metabolism parameters, including fasting glucose, insulin, and insulin resistance index were measured. In addition, gonadal hormones, including follicle-stimulating hormone, testosterone, estradiol, progesterone, and luteinizing hormone were also determined in the same group of patients. RESULTS: Abnormal glucose metabolism and sex hormones were observed in female DNFES patients, with a particularly high rate of insulin resistance (49.6 %). Correlation analysis revealed significant associations between glucose metabolic disturbance and sex hormones (all p <
0.05). Moreover, regression analysis adjusted for age, waist circumference, and BMI revealed that estradiol was negatively correlated with fasting insulin in female patients (β = -0.37, t = -4.0, p <
0.001). CONCLUSION: These results provide evidence supporting the presence of disturbance in glucose metabolism and gonadal hormones at the onset of SCZ in female patients, suggesting that these dysregulations interact with each other to be involved in the disease's pathophysiological process.