REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1634292
This article is part of the Research TopicEndocrine Disruptors Affecting Human and Companion Animal Endocrine Function: Similarities and Indicators in the One Health Concept – Volume IIView all 3 articles
Association between DDT or its byproducts and T2DM: a systematic review and meta-analysis
Provisionally accepted
Weijian Tian1,2
Shaohui Bai2Ting Xie2Haolu Zha2Nan Wu3Shengze Zhang2Jianhui Yuan3Zhouning Yan3
Huanle Luo2*Ying Jiang3*
Qian Xie2*- 1Sun Yat-sen University, Shenzhen Campus, Shenzhen, China
- 2Sun Yat-Sen University School of Public Health Shenzhen, Shenzhen, China
- 3Shenzhen Nanshan Center for Disease Control and Prevention, Shenzhen, China
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Registration number: INPLASY202580049, DOI number: 10.37766/inplasy2025.8.0049. Background: Currently, Type 2 Diabetes Mellitus (T2DM) is among the fastest-growing global health emergencies of the century. Emerging evidence from epidemiological studies suggests a potential positive association between exposure to Dichlorodiphenyltrichloroethane (DDT) or its byproducts and an increasing risk of T2DM. Objective: We conducted a systematic review and meta-analysis to quantify the association between DDT or its byproducts and T2DM. Additionally, we aimed to identify the sources of heterogeneity contributing to the inconsistency of the results. Methods: Data analysis: assess the quality of the included studies using the Risk Of Bias In Non-randomised Studies-of Exposure tool, determine the source of heterogeneity using subgroup analysis, sensitivity analysis and meta regression model based on a fixed-effects model and analyse the publication bias using funnel plots, Egger's test and Begg's test. Results: DDT and its byproducts were associated with the risk of developing T2DM (total OR: 1.13, 95% CI: 1.08-1.15, I2=40%). Subgroup analysis stratified by biomarkers showed a stronger association between p,p′-DDE and T2DM (OR =1.13, 95% CI: 1.09-1.17, I²= 58.5%). The results of the funnel plot, Egger's test, and Begg's test showed publication bias and small study effect in studies included in the analysis (p<0.05), but the influence on the results was smaller. Conclusions: The systematic review and meta-analysis offer quantifiable proof of a positive correlation between exposure to DDT or its byproducts and a higher risk of developing T2DM.
Keywords: DDT, Byproducts, Meta-analysis, T2DM, quantitative evidence
Received: 24 May 2025; Accepted: 17 Sep 2025.
Copyright: © 2025 Tian, Bai, Xie, Zha, Wu, Zhang, Yuan, Yan, Luo, Jiang and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huanle Luo, luohle@mail.sysu.edu.cn
Ying Jiang, wangtiedan0111@126.com
Qian Xie, xieq59@mail.sysu.edu.cn
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