Assessing the risk of diabetes in participants with DDT DDE exposure- A systematic review and meta-analysis

We have performed a systematic review and meta-analysis of the association between DDT/DDE and diabetes, searching PubMed, Embase, and Cochrane for relevant articles published up to August 30, 2021, and eventually including 43 publications. Our researchers evaluate included studies’ quality and risk of bias via the recommended tool. This study uses meta-analyses of random effects of each exposure and outcome to estimate combined odds ratios (ORs) and 95% confidence intervals (CIs). Our research identified 43 cross-sectional, case-control, and cohort studies, including 40,141 individuals in America, Europe, Asia, and Africa. The summary ORs (95% CIs) of incident diabetes were 1.61 (1.10–2.39) for DDT, 1.67 (1.41–1.98) for DDE. The subgroup analysis indicated that the association is significantly higher in the region of Asia for both DDT (OR = 2.73) and DDE (OR = 2.62). Besides, we also tried various types of stratification to identify the more influential confounding factors, among which regional factors have a significant influence. Study evidence suggests that exposure to DDT and its breakdown product, DDE, might be associated with the risk of incident diabetes. Among Asian patients, DDT/DDE concentrations are more closely associated with diabetes. Further studies in specific regions will be considered in the future. •Exposure to DDT and its breakdown product, DDE, was associated with diabetes.•Regional factors have been demonstrated to have a significant influence.•Considering the heterogeneity of DDT/DDE studies, subgroup analyses are crucial.