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Wenying Yi,1,2 Haibo Wu,1,2 Weibin Fu,1,2 Huimei Feng,1,2 Jie Huang,1,2 Haijing Li,1,2 Zhen Song,1,2 Yuwei Chen,1,2 Yingjun Zheng,1,2 Shenglin She1,2 1Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of ChinaCorrespondence: Shenglin She, Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou MedicalUniversity, No. 36 Mingxin Road, Liwan District, Guangzhou, People’s Republic of China, Tel +86-13825154669, Fax +86-20-82068107, Email shenglinshe@gzhmu.edu.cnBackground: To assess the prevalence and risk factors of NAFLD in non-obese patients with schizophrenia in a public psychiatric hospital in China.Methods: A total of 1,305 adult inpatients with schizophrenia in 2019 were included in this retrospective study. Body mass index (BMI) ≥ 25 kg/m2 was considered obese, and BMI < 25 kg/m2 was considered non-obese. We obtained the data from electronic records of the Affiliated Brain Hospital of Guangzhou Medical University.Results: A total of 1,045 non-obese patients and 260 obese patients were included in this study. The prevalence of NAFLD in non-obese patients was 25.0%, and it was much lower that in the obese patients (25.0% vs 64.6%, p < 0.001). Among the non-obese patients, there were significant differences in age, BMI, alanine aminotransferase (ALT), metabolic indices, and the prevalence of diabetes and hypertension between patients with NAFLD and patients without NAFLD. According to the results of binary logistic regression analysis, age, BMI, ALT, triglyceride (TG) and diabetes were significantly related to NAFLD among non-obese patients with schizophrenia. In contrast, HDL-C was was negatively associated with NAFLD among non-obese patients.Conclusion: This study suggested that NAFLD was c