Associations between neonicotinoids and inflammation in US adults using hematological indices: NHANES 2015-2016

Toxicological studies suggest neonicotinoids increase oxidative stress and inflammation, but few epidemiological studies have explored these effects.

National Health and Nutrition Examination Survey (NHANES) 2015-2016 data were used to estimate associations between neonicotinoid exposure and inflammatory markers, including the C-reactive protein-to-lymphocyte count ratio (CLR), monocyte-to-high-density lipoprotein ratio (MHR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) using linear and multinomial logistic regression models. Sex was evaluated as a potential modifier.

Detection of any parent neonicotinoid (β = -0.62, 95% confidence interval [CI] = -0.98, -0.26) and imidacloprid (β = -0.48, 95% CI = -0.87, -0.10) was associated with decreased CLR. Clothianidin was linked to reduced MLR (β = -0.04, 95% CI = -0.07, -0.02), but increased lymphocyte-to-monocyte ratio (β = 0.52, 95% CI = 0.27, 0.77). Higher dNLR (β = 0.85; 95% CI = 0.26, 1.43) was noted with detection of any neonicotinoid metabolite. Moderately high PLR was observed with detection of any neonicotinoid metabolite (relative risk ratio [RRR] = 1.63, 95% CI = 1.27, 2.09) or 5-hydroxy-imidacloprid (RRR = 2.19, 95% CI = 1.40, 3.41). Sex-modified analyses showed positive associations in males and inverse associations in females for MHR (P = 0.099, clothianidin), PLR (P = 0.026, clothianidin), and SII (P = 0.056, any parent neonicotinoid; P = 0.002, clothianidin), while the opposite pattern was noted with CLR (P = 0.073, any parent neonicotinoid) and NLR (P = 0.084, clothianidin).

Neonicotinoids may be associated with inflammatory changes, with potential sexual dimorphism. Further studies are required to explore these findings.