Objective To explore the metabolic markers of social anxiety disorder in schizophrenia patients with social anxiety disorder through metabolomic sequencing analysis.Methods From December 2022 to December 2023,a case-control study was carried out in the Neuropsychiatric Prevention and Control Hospital of Fuzhou Second General Hospital.One hundred sixty patients with schizophrenia were included in the study.The Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-Ⅳ)and Liebowitz social anxiety scale(LSAS)scores were used to classify subjects as patients with social anxiety disorder(n=64)and controls without social anxiety disorder(n=96).Peripheral blood samples were collected for non-targeted metabolomic sequencing,and the metabolites with statistical differences were analyzed by receiver operating characteristic(ROC)curve to find metabolic markers that may affect social anxiety disorder in schizophrenia patients.Results There were significant differences in 12 metabolites between the two groups(P<0.05).In ROC curve analysis,the top 3 metabolites with area under curve(AUC)values were 3-O-trans-coumaryl-alphetolic acid(AUC=0.637),3-mercaptopropionic acid(AUC=0.602)and nona-2-acylcarnitine(AUC=0.600).Conclusion In this study,the potential diagnostic metabolic markers of 3-O-trans-coumaryl-alphitoic acid,3-mercaptopropionic acid,nonyl-2-acylcarnitine as diagnostic metabolic markers can effectively distinguish patients with schizophrenia social anxiety disorder from patients with schizophrenia without social anxiety disorder.