Association of pesticide exposure with overweight and obesity among school-aged children in Guangzhou, China

Objective To investigate the levels of urinary pesticide metabolites and their association with overweight and obesity in children.

Methods A cross-sectional study was conducted on 1969 school-aged children in Guangzhou, China, in 2022. Ultra-high-performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC-MS/MS) was used to measure the concentrations of pesticide metabolites in urine. According to the Screening for Overweight and Obesity among School-age Children and Adolescents (WS/T 586-2018), the children were divided into two groups, namely normal and overweight/obesity. The relationship between the concentrations of urinary pesticide metabolites and overweight/obesity in children was evaluated using binary logistic regression and restricted cubic spline (RCS) models. Weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) regression models were used to assess the overall effects of pesticide mixture exposure on overweight/obesity. Stratified and interaction analyses were conducted by sex.

Results The proportions of overweight and obesity were 17.78% and 10.77%, respectively, among 1 969 children. After adjusting for confounding factors, binary logistic regression models showed that urinary levels of 3-phenoxybenzoic acid (3-PBA), cis-3-(2, 2-dichlorovinyl)-2, 2-dimethylcyclopropane-1-carboxylic acid (cis-DCCA), and trans-3-(2, 2-dichlorovinyl)-2, 2-dimethylcyclopropane-1-carboxylic acid (trans-DCCA) were positively correlated with overweight/obesity in children, with corresponding odds ratios (OR) and 95% confidence intervals (CI) being 1.13 (1.03, 1.23), 1.09 (1.01, 1.17), and 1.10 (1.02, 1.19), respectively. The results of RCS analyses revealed a non-linear dose-response relationship between urinary trans-DCCA level and overweight/obesity (P_overall=0.003, P_nonlinear=0.028). The WQS and qgcomp models revealed that there were no significant effects of six-pesticide mixture exposure on the risk of overweight/obesity in children (P>0.05). Stratified analysis showed that there was a significantly positive correlation of the concentrations of 3-PBA, cis-DCCA, and trans-DCCA with the risk of overweight/obesity in girls (P < 0.05) but not in boys.

Conclusion The urinary levels of 3-PBA, cis-DCCA, and trans-DCCA are positively correlated with the risk of overweight/obesity in children, suggesting that exposure to pyrethroid pesticides may increase the risk of overweight/obesity in children.