Metabolic syndrome and pesticides: A systematic review and meta-analysis

Environ Pollut. 2022 Jul 15:305:119288. doi: 10.1016/j.envpol.2022.119288. Epub 2022 Apr 16.


The relation between pesticides exposure and metabolic syndrome (MetS) has not been clearly identified. Performing a systematic review and meta-analysis, PubMed, Cochrane Library, Embase, and ScienceDirect were searched for studies reporting the risk of MetS following pesticides exposure and their contaminants. We included 12 studies for a total of 6789 participants, in which 1981 (29.1%) had a MetS. Overall exposure to pesticides and their contaminants increased the risk of MetS by 30% (95CI 22%-37%). Overall organochlorine increased the risk of MetS by 23% (14-32%), as well as for most types of organochlorines: hexachlorocyclohexane increased the risk by 53% (28-78%), hexachlorobenzene by 40% (0.01-80%), dichlorodiphenyldichloroethylene by 22% (9-34%), dichlorodiphenyltrichloroethane by 28% (5-50%), oxychlordane by 24% (1-47%), and transnonchlor by 35% (19-52%). Sensitivity analyses confirmed that overall exposure to pesticides and their contaminants increased the risk by 46% (35-56%) using crude data or by 19% (10-29%) using fully-adjusted model. The risk for overall pesticides and types of pesticides was also significant with crude data but only for hexachlorocyclohexane (36% risk increase, 17-55%) and transnonchlor (25% risk increase, 3-48%) with fully-adjusted models. Metaregressions demonstrated that hexachlorocyclohexane increased the risk of MetS in comparison to most other pesticides. The risk increased for more recent periods (Coefficient = 0.28, 95CI 0.20 to 0.37, by year). We demonstrated an inverse relationship with body mass index and male gender. In conclusion, pesticides exposure is a major risk factor for MetS. Besides organochlorine exposure, data are lacking for other types of pesticides. The risk increased with time, reflecting a probable increase of the use of pesticides worldwide. The inverse relationship with body mass index may signify a stockage of pesticides and contaminants in fat tissue.

Keywords: Exposure; Meta-analysis; Meta-regression; Metabolic syndrome; Pesticide; Public health; Systemic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • DDT
  • Hexachlorocyclohexane
  • Humans
  • Hydrocarbons, Chlorinated*
  • Male
  • Metabolic Syndrome* / chemically induced
  • Metabolic Syndrome* / epidemiology
  • Pesticides*


  • Hydrocarbons, Chlorinated
  • Pesticides
  • Hexachlorocyclohexane
  • DDT