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The Interaction of Inflammation and Exposure to Pyrethroids is Associated with Impaired Fasting Glucose and Type 2 Diabetes

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Pyrethroids (PYRs), a widely used class of insecticides, may pose a serious risk to human health. Our study aims to investigate the relationship between six PYRs and impaired fasting glucose (IFG) as well as type 2 diabetes (T2DM), and further explore the role of inflammatory indicators in their relationship. This study was conducted using a case–control design on 2701 individuals from the Henan Rural Cohort Study and measured six PYRs in plasma using gas chromatography–triple quadrupole mass spectrometry. By using generalized linear models, we investigated the potential relationships between six PYR exposures and the risk of IFG and T2DM. Inflammatory indicators were evaluated as mediators of the association between PYRs and T2DM using mediation analyses. After multiple variables were adjusted, per 1 unit increase in ln-cypermethrin and ln-deltamethrin was related to a 12.1% (odd ratio (OR 1.121, 95% confidence interval CI 1.059, 1.187) and an 8.1% (OR 1.081, 95% CI 1.033, 1.132) increased IFG risk, respectively. And there were statistically significant relationships between six PYRs and an increased risk of T2DM. Additionally, PYRs exposure significantly increased fasting plasma glucose, glycated hemoglobin, and HOMA2-IR levels, while they had inconsistent effects on fasting insulin and HOMA2-β levels. Furthermore, the relationship between cyfluthrin and T2DM is partly mediated by neutrophils (NE) and basophils (BASO), and the explainable percentages were 12.09% and 6.21%, respectively. The study showed that PYRs exposure is statistically significantly associated with the risk of developing IFG and T2DM in rural Chinese populations. In addition, NE and BASO partly mediated the association of cyfluthrin with T2DM.

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Data Availability

The datasets generated during and/or analyzed during the current study are not publicly available due to the protection of participant information but are available from the corresponding author on reasonable request.


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We are grateful to the research participants for their participation in this study. We are also grateful for the research team who contributed to the data collection and laboratory measurement.


This research was supported by the National Natural Science Foundation of China (Grant Nos. 42177415, 21806146), the Postdoctoral Science Foundation of China (Grant Nos. 2020T130604, 2021M702934), the Scientific and Technological Innovation of Colleges and Universities in Henan Province Talent Support Program (Grant No. 22HASTIT044), the Young Backbone Teachers Program of Colleges and Universities in Henan Province (Grant No. 2021GGJS015), the Science and Technique Foundation of Henan Province (Grant No. 212102310074), and the Excellent Youth Development Foundation of Zhengzhou University (Grant No. 2021ZDGGJS057).

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All authors contributed to the study’s design and data collection. Material preparation and data analysis were performed by MZ and DW. MZ: wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript and approved the submitted version.

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Correspondence to Zhenxing Mao.

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Zhao, M., Wei, D., Wang, L. et al. The Interaction of Inflammation and Exposure to Pyrethroids is Associated with Impaired Fasting Glucose and Type 2 Diabetes. Expo Health (2023).

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