{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T21:25:46Z","timestamp":1785533146008,"version":"3.56.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T00:00:00Z","timestamp":1664755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Although growing evidence suggests that N,N-diethyl-<jats:italic>m-<\/jats:italic>toluamide (DEET) has adverse effects on public health, the relationship of DEET with cardiovascular disease (CVD) is still largely unknown. The purpose of this study was, therefore, to evaluate the association between DEET exposure and total and specific CVD among the US adults. In this cross-sectional study, a total of 5,972 participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2007\u20132014. CVD was defined as a combination of congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, or stroke. Logistic regression models were used to evaluate the association between DEET metabolites and the risks of total and specific CVD. Compared to the lowest quartile, 3-(diethylcarbamoyl) benzoic acid (DCBA) in the highest quartile was associated with the increased risks of CVD (odds ratio [OR]: 1.32, 95% CI: 1.03\u20131.68, <jats:italic>P<\/jats:italic> for trend = 0.025) and CHD (OR: 1.57, 95% CI: 1.10\u20132.25, <jats:italic>P<\/jats:italic> for trend = 0.017), after adjustment for potential covariates. Nevertheless, exposure to DCBA was not significantly associated with heart attack, CHF, angina, and stroke. Further studies are required to confirm these findings and identify the underlying mechanisms.<\/jats:p>","DOI":"10.3389\/fpubh.2022.922005","type":"journal-article","created":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T15:08:35Z","timestamp":1664809715000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Exposure to N,N-diethyl-m-toluamide and cardiovascular diseases in adults"],"prefix":"10.3389","volume":"10","author":[{"given":"Shiwei","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menglin","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziteng","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziqi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongfang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoying","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa011699","article-title":"Comparative efficacy of insect repellents against mosquito bites","volume":"347","author":"Fradin","year":"2002","journal-title":"N Engl J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1948-7134.2009.00007.x","article-title":"The role of the United States military in the development of vector control products, including insect repellents, insecticides, and bed nets","volume":"34","author":"Kitchen","year":"2009","journal-title":"J Vector Ecol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"103224","DOI":"10.1016\/j.ibmb.2019.103224","article-title":"DEET. and other repellents are inhibitors of mosquito odorant receptors for oviposition attractants","volume":"113","author":"Xu","year":"2019","journal-title":"Insect Biochem Mol Biol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"117","DOI":"10.32394\/pe.73.13","article-title":"Susceptibility of Dermacentor reticulatus tick to repellents containing different active ingrediens","volume":"73","author":"Gliniewicz","year":"2019","journal-title":"Przegl Epidemiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"120","DOI":"10.2987\/19-6905.1","article-title":"Field effectiveness of a metofluthrin fan-based emanator and deet as repellents against aedes vigilax in Southeast Queensland, Australia1","volume":"36","author":"Frances","year":"2020","journal-title":"J Am Mosq Control Assoc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"103550","DOI":"10.1016\/j.ibmb.2021.103550","article-title":"Mechanisms of DEET gustation in Drosophila","volume":"131","author":"Shrestha","year":"2021","journal-title":"Insect Biochem Mol Biol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3105","DOI":"10.1128\/AEM.02765-06","article-title":"Bacterial degradation of N,N-diethyl-m-toluamide (DEET): cloning and heterologous expression of DEET hydrolase","volume":"7","author":"Rivera-Cancel","year":"2007","journal-title":"Appl Environ Microbiol"},{"key":"B8","unstructured":"DEET2015"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3175","DOI":"10.1007\/s00216-012-6444-2","article-title":"Determination of biocides in different environmental matrices by use of ultrahigh-performance liquid chromatography\u2013tandem mass spectrometry","volume":"404","author":"Chen","year":"2012","journal-title":"Anal Bioanal Chem."},{"key":"B10","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ejphar.2018.02.033","article-title":"Unusual modes of action of the repellent DEET in insects highlight some human side effects","volume":"825","author":"Legeay","year":"2018","journal-title":"Eur J Pharmacol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1056\/NEJM198211183072113","article-title":"Anaphylaxis associated with insect repellent","volume":"307","author":"Miller","year":"1982","journal-title":"N Engl J Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1177\/106002809302700305","article-title":"Insect repellent (N,N-diethyl-m-toluamide) cardiovascular toxicity in an adult","volume":"27","author":"Clem","year":"1993","journal-title":"Ann Pharmacother."},{"key":"B13","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1191\/096032701676731093","article-title":"Toxic encephalopathy associated with use of DEET insect repellents: a case analysis of its toxicity in children","volume":"20","author":"Briassoulis","year":"2001","journal-title":"Hum Exp Toxicol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.yrtph.2009.09.004","article-title":"Adverse events associated with the use of insect repellents containing N,N-diethyl-m-toluamide (DEET)","volume":"56","author":"Osimitz","year":"2010","journal-title":"Regul Toxicol Pharmacol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1093\/jat\/bku082","article-title":"lethal case of DEET toxicity due to intentional ingestion","volume":"38","author":"Wiles","year":"2014","journal-title":"J Anal Toxicol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/j.ajem.2019.07.013","article-title":"Bug off! Severe toxicity following inhalational exposure to N, N-diethyl-meta-toluamide (DEET)","volume":"37","author":"Tavares","year":"2019","journal-title":"Am J Emerg Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"285","DOI":"10.4269\/ajtmh.2001.65.285","article-title":"Safety of the insect repellent N,N-diethyl-M-toluamide (DEET) in pregnancy","volume":"65","author":"McGready","year":"2001","journal-title":"Am J Trop Med Hyg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1001\/jama.2019.13771","article-title":"Trends in dietary carbohydrate, protein, and fat intake and diet quality among US adults, 1999-2016","volume":"322","author":"Shan","year":"2019","journal-title":"JAMA."},{"key":"B19","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1289\/ehp.7337","article-title":"Pirkle JL. Urinary creatinine concentrations in the US population: implications for urinary biologic monitoring measurements","volume":"113","author":"Barr","year":"2005","journal-title":"Environ Health Perspect."},{"key":"B20","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1093\/aje\/kwr154","article-title":"Longitudinal health study of US 1991 Gulf War veterans: changes in health status at 10-year follow-up","volume":"174","author":"Li","year":"2011","journal-title":"Am J Epidemiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1001\/jama.258.11.1509","article-title":"Severe toxic reactions and death following the ingestion of diethyltoluamide-containing insect repellents","volume":"258","author":"Tenenbein","year":"1987","journal-title":"JAMA."},{"key":"B22","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1080\/15287398809531203","article-title":"Some cardiovascular effects of the insect repellent N,N-diethyl-m-toluamide (DEET)","volume":"25","author":"Leach","year":"1988","journal-title":"J Toxicol Environ Health."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1002\/ps.5476","article-title":"Is DEET a dangerous neurotoxicant?","volume":"75","author":"Swale","year":"2019","journal-title":"Pest Manag Sci."},{"key":"B24","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1038\/nature04478","article-title":"Angiogenesis in life, disease and medicine","volume":"438","author":"Carmeliet","year":"2005","journal-title":"Nature."},{"key":"B25","doi-asserted-by":"publisher","first-page":"20770","DOI":"10.1074\/jbc.M002448200","article-title":"Vascular endothelial growth factor up-regulates ICAM-1 expression via the phosphatidylinositol 3 OH-kinase\/AKT\/Nitric oxide pathway and modulates migration of brain microvascular endothelial cells","volume":"275","author":"Radisavljevic","year":"2000","journal-title":"J Biol Chem."},{"key":"B26","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/j.yjmcc.2009.11.010","article-title":"Donepezil, an acetylcholinesterase inhibitor against Alzheimer's dementia, promotes angiogenesis in an ischemic hindlimb model","volume":"48","author":"Kakinuma","year":"2010","journal-title":"J Mol Cell Cardiol."},{"key":"B27","first-page":"279","article-title":"International Union of Pharmacology. XVII Classification of muscarinic acetylcholine receptors","volume":"50","author":"Caulfield","year":"1998","journal-title":"Pharmacol Rev."},{"key":"B28","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0163-7258(97)00085-5","article-title":"Non-neuronal acetylcholine, a locally acting molecule, widely distributed in biological systems: expression and function in humans","volume":"77","author":"Wessler","year":"1998","journal-title":"Pharmacol Ther."},{"key":"B29","doi-asserted-by":"publisher","first-page":"28546","DOI":"10.1038\/srep28546","article-title":"The insect repellent N,N-diethyl-m-toluamide (DEET) induces angiogenesis via allosteric modulation of the M3 muscarinic receptor in endothelial cells","volume":"6","author":"Legeay","year":"2016","journal-title":"Sci Rep."},{"key":"B30","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.reprotox.2012.08.010","article-title":"Pesticide and insect repellent mixture (Permethrin and DEET) induces epigenetic Transgenerational inheritance of disease and sperm Epimutations","volume":"34","author":"Manikkam","year":"2012","journal-title":"Reprod Toxicol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s12940-020-00666-y","article-title":"Epigenome-wide association study for pesticide (Permethrin and DEET) induced DNA methylation epimutation biomarkers for specific transgenerational disease","volume":"19","author":"Thorson","year":"2020","journal-title":"Environ Health"},{"key":"B32","first-page":"106","article-title":"Pharmacokinetic assessment of the dermal absorption of N,N-diethyl-m-toluamide (DEET) in cattle","volume":"22","author":"Taylor","year":"1994","journal-title":"Drug Metab Dispos."},{"key":"B33","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1021\/js960283m","article-title":"Pharmacokinetics of insect repellent N,N-Diethyl-m-toluamide in beagle dogs following intravenous and Topical routes of administration","volume":"86","author":"Qiu","year":"1997","journal-title":"J Pharm Sci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.taap.2007.05.016","article-title":"Percutaneous characterization of the insect repellent DEET and the sunscreen oxybenzone from topical skin application","volume":"223","author":"Kasichayanula","year":"2007","journal-title":"Toxicol Appl Pharmacol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1002\/bdd.765","article-title":"Tissue disposition of the insect repellent DEET and the sunscreen oxybenzone following intravenous and topical administration in rats","volume":"32","author":"Fediuk","year":"2011","journal-title":"Biopharm Drug Dispos."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3109\/15563659409000426","article-title":"Retrospective analysis of calls to poison control centers resulting from exposure to the insect repellent N,N-diethyl-m-toluamide (DEET) from 1985-1989","volume":"32","author":"Veltri","year":"1994","journal-title":"J Toxicol Clin Toxicol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1080\/10915810290096559","article-title":"Human Exposures to N,N-diethyl-m-toluamide insect repellents reported to the American Association of Poison Control Centers 1993-1997","volume":"21","author":"Bell","year":"2002","journal-title":"Int J Toxicol."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.922005\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T15:08:41Z","timestamp":1664809721000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.922005\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,3]]},"references-count":37,"alternative-id":["10.3389\/fpubh.2022.922005"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.922005","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,3]]},"article-number":"922005"}}