Abstract： Objective The aim of this sdudy was to analyse the metabolic abnormalities in first epirode, drug-free schizophrenia, and discuss the pathophysiologic mechanisms. Methods 120 patients with the first-epizode and drug-free schizophrenics, who met CCMD-3 and excluded hypertension and diabetes, were measured the BMI, waistline, the fasting blood glucoses (FBG) and insulin concentration (FIC), the cholesterol and TG before treatment. Subjects were assessed for the presence of insulin resistance using homeostasis model assessment(HOMA) and metabolic syndrome according to the criteria by the International Diabetes Federation (IDF),and we rated the positive and negative symptoms scales (PANSS). Results Metabolic abnormalities were already present in first-epizode patients ,28. 3% with centricity fatness, 20% with the lower FIC, 35% with insulin resistance, and 10. 83% achieving the criteria of metabolic syndrome, and much higher rates of metabolic abnormalities were observed in the older and female subjects. In patients, there were significantly correlations between waistline and body mass index (BMI) (n=120, r=0.758,P＜0.01). They were also positively related to the age, weight, the FBG ,TG and cholesterol concentration, but had no relationship to the durations and FIC. The index of insulin resistance was positively related to waistline (r=0.207, P＜0.05) and the fasting insulin concentration. The metabolic indexes were negatively related to the P, N, G and the totoal scores of PANSS(P＞ 0.05). Conclusion The current data suggested that the high incidence of the insulin resistance and metabolic syndrome be a major problem for the first-epside schizophrenia patients. We should build the early interference models for metabolic abnormalities including the centricity fatness, the insulin resistance and lipid abnormalities in first-epside schizophrenia patients.